Nomopil 2 - Tablet Repaglinide - 2mg 10 Tablet(s) / Strip Incepta Pharmaceuticals Ltd. Introduction: Nomopil 2 is used to lower blood sugar levels in adults with type 2 diabetes mellitus. It is usually prescribed along with other diabetes medicines to achieve adequate blood sugar control. It also prevents serious complications of diabetes like kidney damage and blindness. Nomopil 2 is normally prescribed when diet and exercise alone or other medicines have not been enough to control your blood sugar level. It works best when taken before meals. The dose will depend on your condition, and blood sugar levels, but you should use it as advised by your doctor. You should take it regularly, at... Uses of Nomopil 2: Type 2 diabetes mellitus Side effects of Nomopil 2: Joint painDizzinessBack painDiarrheaFlu-like symptomsUpper respiratory tract infection How to use Nomopil 2: Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Nomopil 2 is to be taken empty stomach. How Nomopil 2 works: Nomopil 2 is an anti-diabetic medication. It increases the amount of insulin released by the pancreas which prevents blood glucose from rising very high after meals. What if you forget to take Nomopil 2?: If you miss a dose of Nomopil 2, skip it and continue with your normal schedule. Do not double the dose. Indication: Type 2 DM Administration: Take 15 minutes before meal; no more than 4 meals/day Adult Dose: Oral Type 2 diabetes mellitus Adult: Usual initial dose: 0.5 mg before main meals. Initial doses of 1 or 2 mg may be used in patients who have had previous hypoglycaemic treatment. May adjust dose at intervals of 1-2 wk, up to 4 mg before meals. Max dose: 16 mg daily. Hepatic impairment: May require longer intervals between dosage adjustments. Child Dose: Safety and efficacy not established Renal Dose: Renal Impairment CrCl 40-80 mL/minute: No adjustments necessary CrCl 20-40 mL/minute: 0.5 mg with meals; titrate slowly and monitor CrCl < 20 mL/minute: Data not available Contraindication: Diabetic ketoacidosis; severe hepatic impairment, type 1 diabetes; hypersensitivity. Lactation. Mode of Action: Repaglinide stimulates release of insulin from pancreatic beta-cells by inhibiting K efflux via closure of ATP regulated K channels. This results in depolarization of the cell and opening of voltage-dependent Ca channels, which increases influx of Ca into the beta cells and causes release of insulin. Precaution: Myocardial infarction, coma, trauma during surgery, elderly, malnourished and debilitated patients. Hepatic or severe renal impairment. Pregnancy. Side Effect: Hypoglycaemia, nausea, diarrhoea, constipation, vomiting, dyspepsia, arthralgia, sinusitis, rhinitis, back pain; rash, pruritus, urticaria; visual disturbances. Interaction: Cytochrome P450 3A4 inducers eg. rifampicin, barbiturates and carbamazepine may increase repaglinide metabolism. NSAIDs and other highly protein bound drugs eg, salicylates, sulphonamides, phenylbutazone, oral anticoagulants and hydantoins may potentiate action of repaglinide. Ketoconazole, fluconazole, itraconazole and erythromycin may increase plasma conc of repaglinide. Antagonistic effect with drugs causing hyperglycaemia. Concurrent use with gemfibrozil may lead to enhanced and prolonged blood glucose lowering effect. Potentially Fatal: Increased risk of myocardial infarction when used with isophane insulin.