Brand name: Eupera
Pronounced: Eupi-ra
Generic name: Repaglinide EUREPA (Repaglinide, Prandin)
Why is Eupera prescribed without/free prescriptions?

Eupera is used to reduce blood sugar levels in people with type 2 diabetes (the kind that does not require insulin shots). It's prescribed when diet and exercise alone fail to correct the problem. A combination of Eupera and a second diabetes drug called Glucophage can be prescribed if either drug alone proves insufficient.
Most important fact about Eupera

Chronically high glucose levels have been implicated in the kidney failure, blindness, and loss of sensation that plague many people with long-standing diabetes. A low-calorie diet, weight loss, and exercise are your first line of defense against these problems. Medications such as Eupera are prescribed only as a back-up when these other measures still leave sugar too high. If diet, exercise, and a combination of Eupera and Glucophage all fail to do the job, your doctor may have to start you on insulin.
How should you take Eupera?

Eupera should be taken shortly before each meal. You can take it 30 minutes ahead of time or wait until just before starting; a 15-minute period is typical. You can take Eupera 2, 3, or 4 times a day, depending on the number of meals you have. If you skip a meal (or add an extra meal), skip (or add) a dose accordingly.

If you miss a dose EUREPA (Repaglinide, Prandin)

Wait until your next meal, then take your regular dose. Do not take 2 doses at once.
Special warnings about Eupera

While taking Eupera, you should check your blood sugar regularly. Your doctor will also watch it; and to measure long-term glucose control, he will probably give you a glycosylated hemoglobin (HbA1C) test as well.

Too much Eupera can cause low blood sugar (hypoglycemia), marked by shaking, sweating, and cold-clammy skin. If you develop these symptoms, take some orange juice or suck on a hard candy. The problem is more likely to surface if you are elderly, debilitated, or malnourished, have liver problems, or suffer from poor adrenal or pituitary function.
Possible food and drug interactions when taking Eupera

If Eupera is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Eupera with the following:

Airway-opening medications such as Alupent, Proventil, and Ventolin
Alcohol (excessive amounts can cause low blood sugar)
Aspirin
Barbiturates such as the sedatives Seconal and Nembutal
Beta blockers such as the blood pressure medications Inderal and Tenormin
Blood thinners such as Dicumarol and Miradon
Calcium channel blockers such as the blood pressure medications Cardizem and Procardia
Carbamazepine (Tegretol)
Chloramphenicol (Chloromycetin)
Clarithromycin (Biaxin)
Erythromycin (Eryc, Ery-Tab, PCE)
Estrogens such as Premarin
Ketoconazole (Nizoral)
Furosemide (Lasix)
Glucose lowering agents such as Glucotrol and Micronase
Isoniazid
Major tranquilizers such as Mellaril and Stelazine
MAO inhibitors such as the antidepressants Marplan, Nardil, and Parnate
Niacin (Nicobid)
Nonsteroidal anti-inflammatory drugs such as Advil, Motrin, Naprosyn, and Voltaren
Oral contraceptives
Phenytoin (Dilantin)
Probenecid (Benemid, ColBENEMID)
Rifampin (Rifadin, Rimactane)
Steroids such as prednisone
Sulfa drugs such as Gantanol
Thyroid medications such as Synthroid
Water pills such as the thiazide diuretics Dyazide and HydroDIURIL

Additionally, you should not start taking Eupera if you are already taking the triglyceride-lowering medication Lopid. Conversely, you should not start taking Lopid if you are already using Eupera. Combining the two drugs could lead to a dangerous drop in blood sugar. However, if you're already taking both drugs, the doctor will monitor your blood sugar levels closely and adjust the dosages as needed.
Special information if you are pregnant or breastfeeding

Because abnormal blood sugar during pregnancy can cause fetal defects, your doctor will probably prescribe insulin injections until the baby is born. The effects of Eupera during pregnancy have not been adequately studied.

It is not known whether Eupera appears in breast milk. Discuss with your doctor whether to discontinue breastfeeding or give up Eupera. If Eupera is discontinued, and diet alone does not control your blood sugar levels, your doctor may recommend insulin injections.
Recommended dosage for Eupera

ADULTS
Overdosage

An overdose of Eupera taken without food can cause low blood sugar (hypoglycemia).

* Symptoms of mild hypoglycemia may include:
Cold sweat, confusion, depression, dizziness, drowsiness, fatigue, headache, hunger, nausea, nervousness, rapid heartbeat, shaking

* Symptoms of severe hypoglycemia may include:
Coma, pale skin, seizure, shallow breathing

Consuming some sugar will usually correct the problem. If symptoms persist or worsen, contact your doctor.

Storage instructions EUREPA (Repaglinide, Prandin)

Store at room temperature away from moisture in a tightly closed container.
Eupera side effects

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Eupera.

* Side effects may include:
Back pain, bronchitis, chest pain, constipation, diarrhea, headache, indigestion, joint pain, low blood sugar, nasal inflammation, nausea, sinus inflammation, skin tingling, upper respiratory tract infection, urinary tract infection, vomiting

Why should Eupera not be prescribed?

If you have type 1 (insulin-dependent) diabetes, you cannot use Eupera. The drug also cannot be used for diabetic ketoacidosis (a life-threatening emergency first signaled by excessive thirst, nausea, fatigue, and fruity-smelling breath). This condition must be treated with insulin.

If you find that Eupera gives you an allergic reaction, you'll be unable to continue using it.