When This Medicine Should Not Be Used:
Do not use this medicine if you have had an allergic reaction to repaglinide or metformin, or if you have kidney disease or metabolic acidosis (including diabetic ketoacidosis). Do not use this medicine if you are also using gemfibrozil (Lopid®).

How to Use This Medicine:
Tablet

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
• Take this medicine up to 30 minutes before a meal.
• Carefully follow your doctor's instructions about any special diet or exercise program. Test your blood sugar regularly.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not take gemfibrozil while you are taking this medicine.
• Make sure your doctor knows if you are using insulin (especially NPH insulin), amiloride (Midamor®), cyclosporine (Gengraf®, Neoral®, Sandimmune®), deferasirox (Exjade®), digoxin (Lanoxin®), itraconazole (Sporanox®), ketoconazole (Nizoral®), morphine (Duramorph®), procainamide (Procanbid®), quinidine (Quinora®), quinine, ranitidine (Zantac®), rifampin (Rifadin®, Rimactane®), triamterene (Dyrenium®), trimethoprim (Trimpex®), or vancomycin (Vancocin®). Tell your doctor if you are using certain blood pressure medicines such as atenolol, metoprolol, propranolol, or Toprol®.
• Do not drink too much alcohol while you are taking this medicine.

Warnings While Using This Medicine:

• Make sure your doctor knows if you are pregnant or breastfeeding, or if you have kidney problems, liver disease, congestive heart failure, heart disease, adrenal or pituitary problems, anemia, or vitamin B12 deficiency.
• Do not use this medicine to treat type 1 diabetes.
• Rarely, this medicine may cause a serious condition called lactic acidosis. Stop taking this medicine and call your doctor right away if you feel sick, drowsy, or you have muscle pain, trouble breathing, or an upset stomach. Lactic acidosis could happen if you have kidney or liver problems, a severe infection (sepsis), hypoxemia (low oxygen levels in your blood), or are dehydrated. Tell your doctor if you get sick and have a fever, vomiting, or diarrhea, because these could cause dehydration. Drink plenty of fluids, especially if you exercise or are active in hot weather.
• Tell any doctor or dentist who treats you that you are using this medicine. You may need to stop using this medicine several days before you have surgery or medical tests. This medicine may interact with the dye used for an X-ray or CT scan.
• You may develop low blood sugar while you are taking this medicine. You may feel weak, drowsy, confused, anxious, or very hungry. You may have trouble seeing or have a headache that won't go away. Ask your doctor what you should do if this happens. Low blood sugar may be caused by exercising more than normal or waiting too long to eat.
• Your blood sugar level may be harder to control if you are injured, sick, or having surgery. You may need to stop using this medicine and use insulin if your blood sugar cannot be controlled. Tell your doctor if you have trouble controlling your blood sugar level when you are injured or sick, especially if you have a fever.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments. You will also need to check your blood sugar regularly at home.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blistering, peeling, or red skin rash
• Chest pain
• Dizziness, shakiness, hunger, lightheadedness, faint, fast heartbeat, cold sweats, extreme weakness, tiredness, or confusion
• Fever, chills, runny or stuffy nose, cough, sore throat, and body aches
• Lightheadedness or fainting
• Rapid or troubled breathing, ill feeling, muscle pain, drowsiness, stomach upset

If you notice these less serious side effects, talk with your doctor:

• Mild diarrhea, nausea, vomiting
• Headache

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088