What should I avoid while taking repaglinide Prandin? To make sure you can safely take repaglinide, tell your doctor if you have liver disease. Protein binding and binding to human serum was greater than 98%. money order indomethacin store usa
Why do I need Sulfonylurea agents? Food and Drug Administration. WebMD does not endorse any specific product, service, or treatment. PRANDIN is indicated as an adjunct to diet and exercise to improve glycemic control in adults with mellitus. Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. Use repaglinide regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.
Initial dose adjustment is not required in patients with mild to moderate renal dysfunction. Medscape - Depression, OCD, panic disorder, PTSD, PMDD-specific dosing for Zoloft sertraline frequency-based adverse effects, comprehensive interactions. Despite controversy regarding interpretation of these results, clinicians and patients should be aware of the potential risk when making treatment decisions for diabetes, particularly in the presence of underlying cardiovascular disease. Data are not available for other sulfonylureas or biguanides, nor for hypoglycemic agents belonging to other classes.
There was no average gain in body weight when patients previously treated with oral hypoglycemic agents were switched to PRANDIN. PRANDIN monotherapy, and 2% for monotherapy. Your doctor may need to adjust your diabetes medication, exercise program, or diet. Although it is not known whether repaglinide is excreted in human milk some oral agents are known to be excreted by this route. Because the potential for hypoglycemia in nursing infants may exist, and because of the effects on nursing animals, a decision should be made as to whether PRANDIN should be discontinued in nursing mothers, or if mothers should discontinue nursing. If PRANDIN is discontinued and if diet alone is inadequate for controlling blood glucose, insulin therapy should be considered. In rat reproduction studies, measurable levels of repaglinide were detected in the breast milk of the dams and lowered blood glucose levels were observed in the pups.
Ask your doctor how to adjust your repaglinide dose if needed. Do not change your medication dose or schedule without your doctor's advice. Repaglinide is used together with diet and exercise to treat type 2 diabetes. Other diabetes medicines are sometimes used in combination with repaglinide if needed. Know the signs of low blood sugar hypoglycemia and how to recognize them: headache, hunger, weakness, sweating, tremor, irritability, or trouble concentrating. At least one week should elapse to assess response after each dose adjustment. PRANDIN dose reductions and increased frequency of glucose monitoring may be required when coadministered.
Side Effects - Drugs. The opinions expressed in WebMD User-generated content areas like communities, reviews, ratings, or blogs are solely those of the User, who may or may not have medical or scientific training. These opinions do not represent the opinions of WebMD. User-generated content areas are not reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other reason except for compliance with our Terms and Conditions. The dose that achieved the targeted control or the maximum dose was continued to end of study. FPG and 2-hour post- glucose PPG increased in patients receiving placebo and decreased in patients treated with repaglinide. In clinical trials with PRANDIN, hypoglycemia is the most commonly observed adverse reaction. Patients and caregivers must be educated to recognize and manage hypoglycemia. Self-monitoring of plays an role in the prevention and management of hypoglycemia. In patients at higher risk for hypoglycemia and patients who have reduced symptomatic awareness of hypoglycemia, increased frequency of blood glucose monitoring is recommended. Prandin is used together with diet and exercise to treat type 2 non-insulin dependent diabetes. Learn about side effects, interactions and indications. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345. Love the ease of taking before meals but sugars tend to fluctuate greatly from low 60's to over 200 depending time of day and amount of activity. I have noticed onset of neuropathy type symptoms and recently strong pains in my arms since restarted Prandin use. Went to cardiologist regarding arm pain though heart is still pretty healthy found it interesting that someone else noted the leg and arm pains. Because clinical trials are conducted under widely varying designs, the adverse reaction rates reported in one clinical trial may not be easily compared to those rates reported in another clinical trial, and may not reflect the rates actually observed in clinical practice. avana
Take care not to let your blood sugar get too low. Low blood sugar hypoglycemia can occur if you skip a meal, exercise too long, drink alcohol, or are under stress. Symptoms include headache, hunger, weakness, sweating, tremor, irritability, or trouble concentrating. Carry hard candy or glucose tablets with you in case you have low blood sugar. Other sugar sources include orange juice and milk. Be sure your family and close friends know how to help you in an emergency. PRANDIN dose increases and increased frequency of glucose monitoring may be required when coadministered. These lists are not complete and there are many other medicines that can increase or decrease the effects of repaglinide on lowering your blood sugar. Using certain medicines can make it harder for you to tell when you have low blood sugar. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Check your blood sugar carefully during times of stress, travel, illness, surgery or medical emergency, vigorous exercise, or if you drink alcohol or skip meals. These things can affect your glucose levels and your dose needs may also change. Do not change your medication dose or schedule without your doctor's advice. Increased frequency of glucose monitoring may be required during concomitant use. The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables. If you miss a dose, skip that dose and resume your regular dosage schedule with your next meal. June 11, 2017. REPAGLINIDE - ORAL Prandin side effects, medical uses. target brand of pyrantel pyrantel
Prandin is only part of a treatment program that may also include diet, exercise, weight control, blood sugar testing, and special medical care. Follow your doctor's instructions very closely. Advair-Diskus-fluti casone-propionate-salmeterol-166 WebMD explains the causes, symptoms, and treatment of hypoglycemia, or low blood sugar, a common problem in people with diabetes. Limit alcohol while taking this medication because it can increase the risk of developing low blood sugar. Find a comprehensive guide to possible side effects including common and rare side effects when taking Prandin Repaglinide for healthcare professionals. PRANDIN therapy resulted in dose-proportional glucose lowering over the full dose range. Plasma insulin levels increased after meals and reverted toward baseline before the next meal. Most of the -lowering effect was demonstrated within 1-2 weeks. This difference was not reflected in the frequency of episodes male: 16%; female: 17% or other adverse events. The use of oral hypoglycemic agents may be associated with an increased risk of cardiovascular mortality compared to treatment with diet alone or diet with insulin. This warning is based on the University Group Diabetes Program UGDP study, a long-term prospective clinical trial designed to evaluate the effectiveness of glucose-lowering drugs in preventing or delaying vascular complications in patients with non-insulin-dependent diabetes. Every effort has been made to ensure that the information provided by Cerner Multum, Inc. 'Multum' is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. The intra-individual and inter-individual coefficients of variation were 36% and 69%, respectively. Repaglinide lowers levels by stimulating the release of from the pancreas. This action is dependent upon functioning beta ß cells in the pancreatic islets. Insulin release is glucose-dependent and diminishes at low glucose concentrations. It is not known whether repaglinide passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine. Other symptoms of low blood sugar such as dizziness, hunger, or sweating are unaffected by these drugs. Tablets - Summary of Product. PRANDIN was studied in combination with in 83 patients not satisfactorily controlled on exercise, diet, and metformin alone. PRANDIN dosage was titrated for 4 to 8 weeks, followed by a 3-month maintenance period. Combination therapy with PRANDIN and metformin resulted in statistically significant improvement in HbA 1c and fasting plasma glucose FPG compared to PRANDIN or metformin monotherapy Table 8. In this study where metformin dosage was kept constant, the combination therapy of PRANDIN and metformin showed dose-sparing effects with respect to PRANDIN. MANAGEMENT: Patients who regularly consume grapefruit or grapefruit juice should be monitored for adverse effects and altered plasma concentrations of drugs that undergo significant presystemic metabolism by CYP450 3A4. Grapefruit and grapefruit juice should be avoided if an interaction is suspected. Orange juice is not expected to interact with these drugs. order gefitinib online australia
Repaglinide is an oral diabetes medicine that helps control blood sugar levels. This medication lowers blood sugar by causing the pancreas to produce insulin. Sulfonylurea agents or oral hypoglycemic agents are one of six types of diabetes pills currently available to treat type 2 diabetes. MONITOR: Grapefruit juice may increase the plasma concentrations of orally administered drugs that are substrates of the CYP450 3A4 isoenzyme. Prandin is usually taken 2 to 4 times daily, within 30 minutes before eating a meal. Follow your doctor's instructions. If you skip a meal, do not take your dose of Prandin. Wait until your next meal. Combination therapy resulted in statistically significant improvement in HbA 1c and FPG compared to monotherapy Table 9 below. The glycemic effects of the combination therapy were dose-sparing with respect to both total daily PRANDIN dosage and total daily rosiglitazone dosage see Table 9 Legend. The improvement in HbA 1c and FPG of the combination therapy group was achieved with lower daily dose of PRANDIN and rosiglitazone, as compared to the respective monotherapy groups. Carbatrol, Equetro, Tegretol phenytoin Dilantin primidone Mysoline and others. Patients with severely reduced renal function had elevated mean AUC and C max values 98. Table 3 includes a list of drugs with clinically important drug interactions when administered concomitantly with PRANDIN and instructions for preventing or managing them. The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply. After having a stroke lost a great deal of weight and endocrinologist prescribed this and I got off insulin. Took Prandin for six months then lost more weight and stopped. How should I take Prandin? Repaglinide was non-genotoxic in a battery of in vivo and in vitro studies: Bacterial mutagenesis in vitro forward cell mutation assay in V79 cells HGPRT in vitro chromosomal aberration assay in human lymphocytes, unscheduled and replicating DNA synthesis in rat liver, and in vivo mouse and rat micronucleus tests. Drug interaction studies performed in healthy volunteers show that PRANDIN had no clinically relevant effect on the pharmacokinetic properties of digoxin, theophylline, or warfarin. Co-administration of cimetidine with PRANDIN did not significantly alter the absorption and disposition of repaglinide. Repaglinide is used alone or with other medications to control high blood sugar along with a proper diet and exercise program. It is used in people with type 2 diabetes. Controlling high blood sugar helps prevent kidney damage, blindness, nerve problems, loss of limbs, and sexual function problems. Proper control of diabetes may also lessen your risk of a heart attack or stroke. It works by stimulating the body to produce more insulin. Insulin is a natural substance that allows the body to properly use sugar from the diet. Severe hypoglycemia can cause seizures, may be life-threatening, or cause death. actonel zonder recept actonel
Symptoms of severe hypoglycemia include extreme weakness, blurred vision, sweating, trouble speaking, tremors, stomach pain, confusion, and seizure convulsions. What should I avoid while taking Prandin? The dosing of PRANDIN relative to meal-related insulin release was studied in three trials including 58 patients. Glycemic control was maintained during a period in which the meal and dosing pattern was varied 2, 3 or 4 meals per day; before meals x 2, 3, or 4 compared with a period of 3 regular meals and 3 doses per day before meals x 3. Blood glucose-lowering effect did not differ when PRANDIN was administered at the start of a meal, 15 minutes before, or 30 minutes before the meal. Chromium might help keep blood sugar levels normal by improving the way our bodies use insulin. Are there safety concerns? Repaglinide can cause low blood sugar hypoglycemia especially if you are taking other medicines for diabetes. Consuming large quantities of alcohol, not getting enough calories from food, or doing unusually heavy exercise may also lead to low blood sugar. Symptoms may include chills, cold sweat, dizziness, drowsiness, shaking, fast heartbeat, weakness, headache, fainting, tingling of the hands or feet, or hunger. It is a good habit to carry glucose tablets or gel to treat low blood sugar. If you don't have these reliable forms of glucose, raise your blood sugar quickly by eating a quick source of sugar such as table sugar, honey, candy, or drinking a glass of fruit juice or non-diet soda. Check with your doctor or pharmacist to find out what you should do if you miss a meal. After single and multiple oral doses in healthy subjects or in patients, peak plasma drug levels C max occur within 1 hour T max . Repaglinide is eliminated from the blood stream with a half-life of approximately 1 hour. The mean absolute bioavailability is 56%. Prandin is one of six types of diabetes pills currently available to treat type 2 diabetes. Remember, the cornerstone of diabetes control. Take Prandin exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended. FDA pregnancy category C. It is not known whether repaglinide will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. Many other medicines that can increase or decrease the effects of Prandin on lowering your blood sugar. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using. Check the labels on all your medicines such as cough-and-cold products carefully. Some products may contain sugar or alcohol and may affect your blood sugar levels. Ask your doctor or pharmacist about using these products safely. All doses should be taken within 15 minutes of the meal or as much as 30 minutes before the meal. If a meal is skipped, the Prandin dose should also be skipped. Likewise, if a meal is added during the day, so should a dose of Prandin. In children, chromium is LIKELY SAFE when taken by mouth in amounts that do not exceed the "adequate intake" AI levels. Taking chromium by mouth is POSSIBLY SAFE when used in amounts that exceed the AI levels. PRANDIN has been administered to 2931 individuals during clinical trials. Approximately 1500 of these individuals with have been treated for at least 3 months, 1000 for at least 6 months, and 800 for at least 1 year. The majority of these individuals 1228 received PRANDIN in one of five 1-year, active-controlled trials. Over one year, 13% of PRANDIN patients were discontinued due to adverse reactions.
What are the possible side effects of repaglinide Prandin? It is not known whether Prandin will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. Your doctor may recommend using insulin to be sure your blood sugar is well-controlled during pregnancy. You should not use Prandin together with gemfibrozil Lopid or NPH insulin such as isophane insulin. If you are changing from a different anti-diabetes drug such as chlorpropamide to repaglinide, follow your doctor's directions carefully for stopping the old drug and starting this medication. Avoid drinking alcohol on an empty stomach or following exercise, as it may increase the risk of hypoglycemia. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor. All informations on this page are taken from public sources such as search engines yahoo. Food and Drug Administration. WebMD does not endorse any specific product, service or treatment. Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. Use Prandin regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely. What happens if I overdose? Patients should administer PRANDIN before meals and be instructed to skip the dose of PRANDIN if a meal is skipped. You may experience blurred vision, dizziness, or drowsiness due to extremely low or high blood sugar levels. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely. Repaglinide may also be used for purposes not listed in this medication guide. Patients with moderate to severe impairment of liver function had higher and more prolonged serum concentrations. Therefore, PRANDIN should be used cautiously in patients with impaired liver function. Longer intervals between dose adjustments may be needed to allow full assessment of response. amev.info cetirizine
Do not stop taking any medications without consulting your healthcare provider. WebMD User Reviews should not be considered as medical advice and are not a substitute for professional medical advice, diagnosis, or treatment. Never delay or disregard seeking professional medical advice from your physician or other qualified healthcare provider because of something you have read on WebMD. You should always speak with your doctor before you start, stop, or change any prescribed part of your care plan or treatment. WebMD understands that reading individual, real-life experiences may be a helpful health information resource but they are never a substitute for professional medical advice from a qualified healthcare provider. Instruct patients to take PRANDIN within 30 minutes before meals. Consumer information for this interaction is not currently available. Your pharmacist can provide more information about repaglinide. In this study where pioglitazone dosage was kept constant, the combination therapy group showed dose-sparing effects with respect to PRANDIN see Figure 1 Legend. The improvement in HbA 1c and FPG of the combination group was achieved at a lower daily PRANDIN dosage than in the PRANDIN monotherapy group. Chromium is LIKELY SAFE for most adults when taken by mouth in doses up to 1000 mcg daily for up to 6 months. Chromium is POSSIBLY SAFE for most adults when used for longer periods of time. Some people experience side effects such as skin irritation, headaches, dizziness, nausea, mood changes and impaired thinking, judgment, and coordination. High doses have been linked to more serious side effects including blood disorders, liver or kidney damage, and other problems. It is not known for sure if chromium is the actual cause of these side effects. Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. 'Multum' is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Take this medication by mouth 15 minutes before each meal, usually 2-4 times daily depending on the number of meals or as directed by your doctor. Take this drug no earlier than 30 minutes before the meal. You may also take it just before the meal if necessary. Do not take a dose of medication if you are skipping that meal or if your blood sugar is low. Additionally, the following drugs were studied in healthy volunteers with co-administration of PRANDIN. The major metabolite M2 accounted for 60% of the administered dose. Less than 2% of parent drug was recovered in feces. Repaglinide appears to be a substrate for active hepatic uptake transporter organic anion transporting protein OATP1B1. buy epoetin-alfa tablets 100mg
If you have severe hypoglycemia and cannot eat or drink, use a glucagon injection. PRANDIN dosage was titrated during the first 12 weeks, followed by a 12-week maintenance period. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company. Protect from moisture. Keep bottles tightly closed. Daily maximum PRANDIN dose should be limited to 6 mg, and increased frequency of glucose monitoring may be required when PRANDIN is co-administered with cyclosporine. How does Chromium work? Check your blood sugar levels regularly as directed. Keep all medical appointments. Repaglinide is only part of a complete program of treatment that also includes diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely. Changing any of these factors can affect your blood sugar levels. In a 24-week placebo controlled trial, patients who were naïve to oral agent therapy and patients with a HbA 1c below 8% at baseline had a higher frequency of hypoglycemia. Weight gain, diarrhea, and joint pain may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly. June 16, 2017. Prandin Repaglinide: Side Effects, Interactions, Warning. PRANDIN is not indicated for use in combination with NPH-insulin. The dosage is based on your medical condition and response to treatment. Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, liver disease. Use this medication regularly as directed by your doctor in order to get the most benefit from it. Carefully follow the medication treatment plan, meal plan, and exercise program your doctor has recommended. It is not known whether repaglinide passes into breast milk or if it could be harmful to a nursing baby. You should not breast-feed while you are taking repaglinide. cozaar pills purchase online shopping
A1c should be performed periodically to check for side effects and monitor your response to treatment. Low blood sugar hypoglycemia can happen to everyone who has diabetes. Symptoms include headache, hunger, sweating, confusion, irritability, dizziness, or feeling shaky. Always keep a source of sugar with you in case you have low blood sugar. Sugar sources include fruit juice, hard candy, crackers, raisins, and non-diet soda. Be sure your family and close friends know how to help you in an emergency. It is not known whether this drug passes into breast milk and the effect on a nursing infant is unknown. Therefore, breast-feeding while using this drug is not recommended. Consult your doctor before breast-feeding. Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. Learn about Prandin Repaglinide may treat, uses, dosage, side effects, drug interactions, warnings, patient labeling, reviews, and related medications. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist. Store repaglinide at room temperature away from moisture and heat. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Prandin only for the indication prescribed. nimotop
Symptoms of high blood sugar hyperglycemia include thirst, increased urination, confusion, drowsiness, flushing, rapid breathing, and fruity breath odor. If these symptoms occur, tell your doctor right away. Your doctor may need to adjust your diabetes medications. Hypoglycemia can happen suddenly and symptoms may differ in each individual and change over time in the same individual. What is repaglinide Prandin? There have been no clinical studies establishing conclusive evidence of risk reduction with PRANDIN. Healthy volunteers were treated with a regimen of 2 mg PRANDIN taken before each of 3 meals. Prandin is only part of a complete program of treatment that also includes diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely. Changing any of these factors can affect your blood sugar levels. Do not start, stop, or change the dosage of any medicines without your doctor's approval. No evidence of carcinogenicity was found in female rats. What is the most important information I should know about repaglinide Prandin? Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Crestor but now am wondering if it could be the Prandin? Patients previously treated with an oral hypoglycemic or patients who have an HbA1c greater than or equal to 8%: 1 to 2 mg orally with meals. In clinical studies of 24 weeks or greater duration, 415 patients were over 65 years of age and no patients were greater than 75 years of age. In one-year, active-controlled trials, no differences were seen in effectiveness or adverse events between these subjects and those less than 65. There was no increase in frequency or severity of hypoglycemia in older subjects, but greater sensitivity of some older individuals to PRANDIN therapy cannot be ruled out. Store Prandin at room temperature away from moisture and heat.
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Check your blood sugar carefully during a time of stress or illness, if you travel, exercise more than usual, drink alcohol, or skip meals. These things can affect your glucose levels and your dose needs may also change. May 29, 2017. REPAGLINIDE - ORAL Prandin side effects, medical uses. Always keep a source of sugar available in case you have symptoms of low blood sugar. Sugar sources include orange juice, glucose gel, candy, or milk. If you have severe hypoglycemia and cannot eat or drink, use an injection of glucagon. Your doctor can give you a prescription for a glucagon emergency injection kit and tell you how to give the injection. albuterol
Avoid drinking alcohol. It lowers blood sugar and may interfere with your diabetes treatment. Do not share this medication with others. Safety and effectiveness have not been established in pediatric patients. Repaglinide is completely metabolized by oxidative biotransformation and direct conjugation with glucuronic acid after either an IV or oral dose. The major metabolites are an oxidized dicarboxylic acid M2 the aromatic M1 and the acyl glucuronide M7. The cytochrome P-450 enzyme system, specifically 2C8 and 3A4, have been shown to be involved in the N-dealkylation of repaglinide to M2 and the further oxidation to M1. Metabolites do not contribute to the glucose-lowering effect of repaglinide. Within 96 hours after dosing with 14C-repaglinide as a single, oral dose, approximately 90% of the radiolabel was recovered in the feces and approximately 8% in the urine. aripiprazole price per pill cvs
Read the Patient Information leaflet if one is available from your pharmacist before you start using repaglinide and each time you get a refill. If you have any questions, consult your doctor or pharmacist. RxList is part of the WebMD Health Network. The opinions expressed in the WebMD User Reviews are solely those of the User, who may or may not have medical or scientific training, and do not represent the opinions of WebMD. These member reviews have not been reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other purpose except for compliance with our Terms and Conditions.
What other drugs will affect repaglinide Prandin? CYP450 3A4. Because pharmacokinetic interactions involving grapefruit juice are often subject to a high degree of interpatient variability, the extent to which a given patient may be affected is difficult to predict. These data indicate that repaglinide did not accumulate in serum. Warnings: Pregnancy and breast-feeding: Chromium is LIKELY SAFE to use during pregnancy and breast-feeding when taken by mouth in amounts that are equal to or less than "adequate intake" AI levels. Chromium is POSSIBLY SAFE to use during pregnancy in amounts higher than the AI levels. However, pregnant women should not take chromium supplements during pregnancy or breast-feeding unless advised to do so by their healthcare provider. Kidney disease: There are at least three reports of kidney damage in patients who took chromium picolinate. Don't take chromium supplements, if you already have kidney disease. Liver disease: There are at least three reports of liver damage in patients who took chromium picolinate. Don't take chromium supplements, if you already have liver disease. Diabetes: Chromium might lower blood sugar levels too much if taken along with diabetes medications. If you have diabetes, use chromium products cautiously and monitor blood glucose levels closely. Dose adjustments to diabetes medications might be necessary.