ZREPAG RAPID 1 Tablet 10's

Introduction About ZREPAG RAPID 1 TABLET

ZREPAG RAPID 1 TABLET is a combination medication used in the management of type 2 diabetes mellitus. It helps control the high blood sugar levels in your body after each meal. It is used when other similar medicines along with a restricted diet, are unable to control abnormally high blood sugar levels.

ZREPAG RAPID 1 TABLET should be taken just after meals. The dose will be decided by your doctor. Do not stop taking it without asking your doctor. If you do, your blood sugar levels may increase and put you at risk of serious complications like kidney damage and blindness. If you miss a dose, do not take the missed dose between two meals. Wait until your next meal and take it just after meals as usual. Do not take a double dose to make up for the missed dose. Follow the prescribed diet and exercise plan along with taking this medication for best results.

The most common side effects of this medicine include hypoglycemia (low blood sugar level), bloating or diarrhea, headache, fatigue or dizziness, stomach pain, skin rash, fever, muscle pain, and/or tenderness. However, these are temporary and usually resolve on their own. Please consult your doctor if these do not resolve or persist for a longer duration. Monitor your blood sugar levels regularly while taking this medicine.

Before taking this medicine, inform your doctor if you have any kidney or liver problems or urinary tract infection or if you are on water pills (diuretics). Pregnant or breastfeeding women should also consult their doctor before taking it. Avoid excessive alcohol intake while taking it as this may increase the risk of developing some side effects.

Uses Of ZREPAG RAPID 1 TABLET

• Type 2 diabetes mellitus

KEY BENEFITS OF ZREPAG RAPID 1 TABLET for Diabetes:

1. Targets Post-Meal Blood Sugar Spikes: ZREPAG RAPID 1 TABLET effectively manages postprandial hyperglycemia by controlling blood sugar surges after meals. This helps improve overall glucose control in type 2 diabetes.
2. Dual Action Mechanism: Voglibose slows down carbohydrate absorption, while Repaglinide rapidly stimulates insulin release. Together, they provide quick and effective post-meal blood sugar control.
3. Flexible Dosage Timing: ZREPAG RAPID 1 TABLET is taken just before meals, ensuring convenience and immediate action to prevent blood sugar spikes after eating.
4. Reduced Risk of Long-Term Complications: By managing post-meal glucose levels effectively, it reduces the risk of diabetes-related complications like heart, nerve, and kidney issues.

How ZREPAG RAPID 1 TABLET Works

ZREPAG RAPID 1 TABLET is a combination of two active ingredients namely repaglinide and voglibose.

1. Voglibose (Alpha-Glucosidase Inhibitor):
   • Slows the digestion and absorption of carbohydrates in the small intestine.
   • This prevents sudden spikes in blood glucose after meals (postprandial hyperglycemia).
2. Repaglinide (Meglitinide Analog):
   • Stimulates the pancreas to release more insulin quickly after meals.
   • This rapid insulin release helps reduce high blood sugar levels caused by food intake.

Together, these two ingredients complement each other to provide fast and effective post-meal glucose control.

How to use ZREPAG RAPID 1 TABLET

• Follow your doctor's instructions regarding the exact dosage
• The usual dosage is typically one tablet taken before meals
• Take the tablet before meals (usually 15 to 30 minutes before mail meal)
• Swallow the tablet whole with a glass of water. Do not crush or chew it, as this may affect its effectiveness

Missed Dosage instructions for ZREPAG RAPID 1 TABLET:

If you miss a dose of ZREPAG RAPID 1 TABLET take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.

Overdosage of ZREPAG RAPID 1 TABLET:

If you or anyone else accidentally take too much of Repaglinide+Voglibose, consult and inform your doctor immediately or visit the nearby hospital. Symptoms of overdose are hypoglycaemia with associated signs such as dizziness, sweating, tremor, headache, loss of consciousness, seizure, and/or coma.

Side Effects Of ZREPAG RAPID 1 TABLET

Like all medicines, ZREPAG RAPID 1 TABLET may cause certain side effects in some individuals, although not everybody gets them.

The most common side effects of taking ZREPAG RAPID 1 TABLET are:

• hypoglycemia (low blood sugar level)
• bloating or diarrhea
• headache
• fatigue or dizziness
• stomach pain
• skin rash
• fever
• muscle pain, and/or tenderness

When to consult your doctor?

• allergic reactions such as swelling, difficulty in breathing, rapid heartbeat, feeling dizzy, and/or sweating, erythema, itching, rashes and/or itchy welts

How To Manage Side Effects

Diarrhea

Drink Fluids: Drink clear fluids such as water, broths, and oral rehydration solutions (ORS).

Electrolytes: If you're losing a lot of fluids (for example, from frequent diarrhea), consider drinking an electrolyte solution to help replenish lost minerals like potassium and sodium.

BRAT Diet: Try to take Bananas, Rice (white rice), Apple sauce and Toast (plain, without butter) to control diarrhoea management.

Avoid Certain Foods: While recovering avoid the following food items such as fatty, greasy, or fried foods, spicy foods, dairy products (especially if you have a temporary lactose intolerance), caffeinated drinks and alcohol and artificial sweeteners like sorbitol.

Over-the-Counter Medications: You can take over-the-counter anti-diarrheal medications such as loperamide, Bismuth subsalicylate if appropriate for you. Follow the recommended dosage.

Dizziness Or Drowsiness

• Sit or Lie Down: If you feel dizzy, sit down or lie down immediately to prevent falling. Keep your head still and close your eyes if needed.
• Hydrate: Dehydration can cause dizziness, so drink water or electrolyte-replenishing drinks like sports drinks.
• Avoid Sudden Movements: When standing or sitting, do so slowly to avoid triggering dizziness. Take your time when getting up.
• Eat Small, Regular Meals: Low blood sugar can cause dizziness, so eat small meals throughout the day and avoid skipping meals.
• Fresh Air: Sometimes dizziness can be alleviated by taking slow, deep breaths in a well-ventilated area.

Headache

• Rest in a Quiet, Dark Room: Find a calm, quiet space away from bright lights and loud noises. Lie down and close your eyes.
• Hydrate: Dehydration can contribute to headaches, so drink plenty of water.
• Apply a Cold or Warm Compress: A cold pack on your forehead may reduce pain, or a warm compress on your neck or shoulders can relieve tension.
• Over-the-Counter Pain Relief: You can take over-the-counter pain relievers like acetaminophen or ibuprofen if appropriate for you. Follow the recommended dosage.
• Practice Relaxation Techniques: Deep breathing exercises, meditation, or gentle stretching can help reduce stress and alleviate headache symptoms.

Warning & Precautions

Pregnancy

Monitoring required

ZREPAG RAPID 1 TABLET generally unsafe to use during pregnancy. Although there are limited studies in humans, animal studies have shown harmful effects on the developing baby. Your doctor will weigh the benefits and any potential risks before prescribing it to you. Please consult your doctor.

Breastfeeding

Contraindicated

ZREPAG RAPID 1 TABLET is probably unsafe to use during breastfeeding. Limited human data suggests that the drug may pass into the breastmilk and harm the baby. Please consult your doctor.

Driving and Using Machines

Use with Caution

Do not drive or operate machines if you experience signs of high/low blood sugar since it can endanger you/others.

Alcohol

Consult your doctor

Avoid consumption of alcohol while taking ZREPAG RAPID 1 TABLET since it may alter the effect of the medicine.

Kidney

Monitoring required

ZREPAG RAPID 1 TABLET should be used with caution in patients with kidney problems such as mild, moderate/severe renal impairment and in patients who are undergoing dialysis. Dosage adjustment and careful monitoring are required in such patients. Therefore, inform your doctor if you have any pre-existing kidney diseases as a precaution.

Liver

Contraindicated

ZREPAG RAPID 1 TABLET is probably unsafe in patients having severe liver disease. Regular medical check-ups and blood tests are required in such patients. Therefore, inform your doctor if you have any pre-existing liver diseases as a precaution.

Allergy

Contraindicated

Do not take ZREPAG RAPID 1 TABLET if you are allergic to Repaglinide, Voglibose, and/or any other ingredients of this medicine.

Use In Pediatrics

Contraindicated

ZREPAG RAPID 1 TABLET is unsafe for use in children and adolescents (aged below 18 years). Consult and inform your doctor before taking ZREPAG RAPID 1 TABLET.

Use In Geriatrics

Contraindicated

ZREPAG RAPID 1 TABLET is generally unsafe for use in elderly patients (aged above 75 years). Consult and inform your doctor before taking ZREPAG RAPID 1 TABLET.

Safety Advice

Expert Advice to follow while taking ZREPAG RAPID 1 TABLET:

• Follow the prescribed diet and exercise plan along with taking this medication for best results.
• Monitor your blood sugar levels regularly while taking this medicine.
• Avoid alcohol while taking this medication, as it can increase the risk of hypoglycemia.
• Always carry some sugary food to manage hypoglycemia symptoms (cold sweats, pale skin, tremors, and anxiety).
• This medicine must be taken 15 to 30 minutes before mail meal

Interactions

A. Drug-Drug Interactions:

Inform your physician if you are taking any of the following medicine before taking ZREPAG RAPID 1 TABLET:

1. Insulin or other oral hypoglycemics (e.g., sulfonylureas):

Interaction: Repaglinide and Voglibose can lower blood sugar, so when used together, the risk of excessive blood glucose lowering may increase.

Effect: The combination may increase the risk of hypoglycemia (low blood sugar).

2.CYP3A4 Inhibitors (e.g., Ketoconazole, Clarithromycin):

Interaction: Repaglinide is metabolized by CYP3A4 enzymes, and inhibitors of this enzyme can reduce its breakdown, leading to higher drug levels.

Effect: It can increase the concentration of repaglinide in the blood, leading to an increased risk of hypoglycemia.

3.CYP3A4 Inducers (e.g., Rifampicin, Phenytoin):

Interaction: It can increase the activity of CYP3A4 enzymes, which may cause repaglinide to be cleared from the body more quickly.

Effect: It can reduce the blood levels of repaglinide, making it less effective and potentially leading to poor blood sugar control.

4.Beta-blockers (e.g., Metoprolol):

Interaction: Repaglinide and Voglibose can lower blood sugar, so when used together, the risk of excessive blood glucose lowering may increase.

Effect: Beta-blockers may mask symptoms of hypoglycemia (such as tachycardia) and increase the risk of severe hypoglycemia.

5.Anticoagulants (e.g.,Warfarin):

Interaction: Warfarin may increase the effect of repaglinide, leading to a higher risk of hypoglycemia.

Effect: Repaglinide may increase the anticoagulant effect of warfarin, increasing the risk of bleeding.

Synopsis

More Information

How long will the effects of ZREPAG RAPID 1 TABLET last in the body?

Repaglinide and Voglibose generally provides a duration of action of about 4-8 hours, with Repaglinide acting more quickly to control blood sugar after meals and Voglibose helping to maintain steady blood sugar levels by slowing down carbohydrate absorption.

This combined effect helps in controlling postprandial (after-meal) blood sugar spikes. It is commonly taken before meals to optimize the control of blood sugar levels.

How fast ZREPAG RAPID 1 TABLET act?

When repaglinide and voglibose are combined into one tablet, the onset of action would generally be dictated by the faster-acting repaglinide, which starts working within 15-30 minutes. However, the overall effect may be a more gradual and sustained action, as voglibose will continue to work over a longer period by delaying the absorption of carbohydrates.

Differences from Other Anti-Diabetic Medications:

Advantages of ZREPAG RAPID 1 TABLET Over Glyciphage G, Trivolib and Others antidiabetic agents:

1. Focus on Post-Meal Control: Highly effective in patients with significant post-meal glucose spikes.
2. Minimal Risk of Hypoglycemia: Unlike insulin secretagogues (e.g., sulfonylureas), it does not directly lower blood sugar, reducing the risk of dangerously low blood sugar levels.
3. Weight Neutral: It does not cause weight gain, unlike other medications like sulfonylureas or thiazolidinediones.
4. Fast-Acting: Works quickly when taken just before meals, making it suitable for targeted post-meal glucose control.

Who Should Use ZREPAG RAPID 1 TABLET?

ZREPAG RAPID 1 TABLET is ideal for:

• Patients with type 2 diabetes who experience high postprandial (post-meal) blood sugar spikes.
• Those looking for a medication with minimal hypoglycemia risk.
• Patients for whom other medications like metformin are insufficient or intolerable.

FAQs About ZREPAG RAPID 1 TABLET

References

1. K.D. Tripathi. Insulin, Oral Hypoglycaemic Drugs and Glucagon. Essentials of medical pharmacology. Seventh edition. 2013. Page- 273, 277.

2. Repaglinide. NIH National Library of Medicine. National Center for Biotechnology Information. StatPearls [Internet]. [Revised in July 2022] [Accessed on 17th December 2024] click here

3. Ajay S. Dabhi,Nikita R. Bhatt, Mohit J. Shah. Voglibose: An Alpha Glucosidase Inhibitor. NIH National Library of Medicine. National Center for Biotechnology Information. PMC PubMed Central. [Revised in December 2013] [Accessed on 17th December 2024] click here

4. Torrent Pharmaceuticals Ltd. EUREPA-V.  [Revised in December 2019] [Accessed on 17th December 2024] click here

5. Medley Pharmaceuticals Ltd. Vogli-Rapid. [Accessed on 17th December 2024] click here

Useful Diagnostic Tests

• Post Prandial Blood Sugar (PPBS)
• Insulin - Post Prandial

Author Details

Written By Srilekha. R - B.Pharm

Reviewed For Accuracy By Dr. Jaya Prabakaran - MBBS, MD (Diabetology and Family Medicine)

Last updated on 18 Dec 2024 | 10:00 AM(IST)