Repaglinide

Class Oral hypoglycaemic
Chemistry

Meglitinide

Routes of administration

Oral only

Absorption

Completely absorbed, oral bioavailability 62%

Solubility

pKa=4.8; poorly water-soluble, but good lipid solubility

Distribution

VOD= 0.4L/kg; 97% protein bound

Metabolism

Extensive hepatic metabolism

Elimination

90% of the inactive metabolites are eliminated in the faeces

Time course of action

Half life 60 minutes

Target receptor

Sulfonylurea receptors (SUR1 and SUR2), which form a part of the ATP-sensitive potassium channel complex on pancreatic β-cells

Mechanism of action

By binding to the ATP-sensitive K channel, meglitinides act like ATP (i.e. same as a rise in blood glucose), closing the channel and stopping the efflux of potassium from the cell, which promotes depolarisation. The depolarisation then leads to insulin release

Clinical effects

Hypoglycaemia, but also:
- undesirable severe hypoglycaemia
(but less likely than with sulfonylureas)
- respiratory tract infections
- headache

Literature reference

Scott, 2012

CICM details of understanding Not specifically listed in the CICM syllabus
Mentioned around Deranged Physiology
Related SAQs