Prescription ·Strong evidence ·Reviewed May 2026
Repaglinide is a short-acting oral insulin secretagogue used before meals to improve postprandial glucose control in adults with type 2 diabetes. It can cause hypoglycemia, especially if meals are skipped or when combined with glucose-lowering supplements or interacting drugs. Concomitant gemfibrozil is contraindicated because it markedly increases repaglinide exposure.
The bottom line
Evidence rating strong. Most-documented uses: lowers postprandial glucose in type 2 diabetes, flexible pre-meal dosing, shorter action than many sulfonylureas. 3 sources indexed (2000–2026), with 3 interaction records on file.
Core mechanism
Repaglinide binds ATP-dependent potassium channels on pancreatic beta cells, causing membrane depolarization, calcium influx, and meal-timed insulin release. It is metabolized mainly by CYP2C8 and CYP3A4 and transported partly by hepatic uptake pathways, so inhibitors can increase hypoglycemia risk and inducers can reduce efficacy. Its short duration is why it is dosed before meals and skipped when a meal is skipped.1,2
Take before meals; skip the dose if a meal is skipped to reduce hypoglycemia risk.
Berberine may lower glucose and add to the glucose-lowering effects of Repaglinide, increasing hypoglycemia risk.
Recommendation: Increase glucose monitoring when starting, stopping, or changing the supplement; coordinate diabetes medication adjustments with the prescriber.
Alpha-Lipoic Acid may lower glucose and add to the glucose-lowering effects of Repaglinide, increasing hypoglycemia risk.
Recommendation: Increase glucose monitoring when starting, stopping, or changing the supplement; coordinate diabetes medication adjustments with the prescriber.
St. John's Wort can induce drug-metabolizing enzymes and transporters and may lower Repaglinide exposure or undermine therapy.
Recommendation: Avoid starting or stopping St. John's Wort without prescriber review while taking Repaglinide.
Numbered references. Citations throughout the page link here.
Review summarized meal-time insulin secretagogue efficacy and safety.
Label lists gemfibrozil contraindication and glucose monitoring needs.
Gemfibrozil increased repaglinide exposure and hypoglycemia risk.
This page is educational. Do not start, stop, or change a supplement or medication based on it without checking with a qualified healthcare professional.
Use this with your stack
Add it to your stack, see how it interacts with everything else you take, and get a Stack Score that updates the moment it does.
NutriStack is an informational and organizational tool, not a medical service, and not a substitute for professional advice. Always consult a qualified healthcare professional before starting, stopping, or changing any supplement or medication.
