Repaglinide

How Medicare covers it

Part D (forms used at home). Part A during a covered inpatient stay. No Part B clinician-administered form in the CMS Part B spending file.

What it treats

Type 2 diabetes in adults. It is used along with diet and exercise to improve blood sugar control. It is not for type 1 diabetes and not for diabetic ketoacidosis, a serious problem where the body makes too many acids.

What it is for, in depth

Repaglinide is for adults with type 2 diabetes, the kind where the body does not use insulin well and blood sugar runs high. The label says it is used as an add-on to diet and exercise to improve blood sugar control. It is a mealtime drug: because it makes the pancreas release insulin around a meal, it is taken before meals and skipped when a meal is skipped — that is where it fits in the treatment path, helping control the rise in blood sugar that comes with eating. It is not for people with type 1 diabetes, whose bodies make almost no insulin, and not for treating diabetic ketoacidosis. It comes as 0.5 mg, 1 mg, and 2 mg tablets. The starting dose depends on the A1C blood test: 0.5 mg before each meal if A1C is under 8%, and 1 mg or 2 mg if A1C is 8% or higher, with at least a week between dose increases to see how it works.

How it works

Repaglinide is in a group of drugs called glinides. It lowers blood sugar by making the pancreas release insulin. This only works if the pancreas still has working beta cells, and the release gets weaker when blood sugar is already low.

How it is taken

It is a tablet taken by mouth within 30 minutes before a meal. The usual dose range is 0.5 mg to 4 mg before meals, up to 16 mg in a day, in 0.5 mg, 1 mg, and 2 mg tablets. If you skip a meal, skip that dose. If you have low blood sugar, the dose should be lowered.

Common side effects

The most common side effects, seen in 5% or more of people in studies, were low blood sugar, upper respiratory infection (like a cold), headache, sinus infection, joint pain, nausea, diarrhea, and back pain. Other effects seen in at least 2% included rhinitis (stuffy or runny nose), constipation, vomiting, tingling, chest pain, bronchitis, indigestion, urinary tract infection, tooth problems, and allergy.

Serious warnings

This label has no boxed warning. The main serious warning is low blood sugar (hypoglycemia): skipping a meal dose lowers that risk, and the dose should be cut if low blood sugar happens. Repaglinide is not meant to be used with NPH insulin, because serious heart problems were a concern with that mix. No studies have proven that repaglinide lowers the risk of heart and blood vessel damage from diabetes.

Who should be careful

People with severe kidney problems (creatinine clearance 20 to 40 mL/min) should start at the lowest dose, 0.5 mg before each meal. People who are allergic to repaglinide or any ingredient in the tablet should not take it. It is not recommended while breastfeeding. Tell your doctor if low blood sugar happens often, because the dose may need to go down.

Major interactions

Never take it with gemfibrozil — that mix is not allowed, because gemfibrozil raises repaglinide levels about 8-fold. Avoid clopidogrel if possible; if it must be used, the dose is capped and blood sugar should be checked more often. Cyclosporine caps the daily dose at 6 mg. Drugs that block CYP2C8 or CYP3A4, such as ketoconazole, itraconazole, clarithromycin, and erythromycin, can raise its levels, and drugs that speed those enzymes up, such as rifampin, barbiturates, and carbamazepine, can lower them. Many other diabetes drugs, NSAID pain relievers, and some blood pressure drugs can raise the risk of low blood sugar, while steroids, water pills, thyroid drugs, and some others can make it work less well. Beta blockers, clonidine, guanethidine, and reserpine can hide the warning signs of low blood sugar.

Cost and saving notes

Repaglinide is sold as a generic tablet, and generic forms usually cost less than brand-name drugs. It is covered under Medicare Part D. If your plan's tier makes it hard to afford, you can ask your plan for a tier exception to pay a lower tier price. If you qualify for Extra Help, the Part D low-income help, your drug costs will be much lower.

Why it is in its tier

Repaglinide sits on Tier 1 in 79.47% of the plans that list it (4367 of 5495 listing plans). Tier 1 is the preferred generic tier — the lowest copays, often $0-$15. The data-visible drivers: It is a generic product, and the CMS dashboard puts its average Part D spending at about $128 per beneficiary for 2024 — a relatively low-cost drug, which matches where plans place it. It is listed by 100.0% of Part D plans. The tier shown is the most common one; individual plans vary.

Sources

• REPAGLINIDE TABLET [BRYANT RANCH PREPACK] — DailyMed
• MedlinePlus — National Library of Medicine
• MedlinePlus — Repaglinide

What official patient guides say

Repaglinide comes as a tablet to take by mouth (the oral tablet form in this package). Take it up to 30 minutes before meals, for up to 4 meals per day. If you skip a meal, you need to skip the dose of repaglinide for that meal. Take it at around the same times every day with your meals, exactly as directed — do not take more or less of it or take it more often than prescribed by your doctor. Your doctor may start you on a low dose of repaglinide and gradually increase your dose, not more than once every week. Repaglinide controls diabetes but does not cure it. Continue to take repaglinide even if you feel well, and do not stop taking it without talking with your doctor. If you miss a dose and you have just begun to eat a meal, take the missed dose as soon as you remember it. However, if you have finished eating, or if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one. Keep this medication in the container it came in, tightly closed and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Source: MedlinePlus — Repaglinide

Part D formulary coverage

Source: CMS Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information Files — Monthly file 2026-10-15 (plan year 2027), file 2027_20261008.zip (data.cms.gov dataset ed1496ea-23e7-41f1-9292-172fa842ccfb): basic drugs formulary file + plan information file, both dated 20261031 inside the zip; downloaded and aggregated 2026-10-30. Medication RxCUI sets resolved through the NLM RxNav (RxNorm) API.

What you pay

Without insurance, the cash benchmark is 0.08155 per unit (REPAGLINIDE 0.5 MG TABLET) — about nan for 30 units. NADAC benchmark — the average price pharmacies pay (CMS, as of 2026-11-04). Pharmacy shelf prices vary.

A tier is not a price; what you pay depends on your plan, pharmacy, and benefit stage; Extra Help or Medicaid can lower it further.

Sources: CMS Plan Benefit Package + formulary data; CMS NADAC · Checked 2026-11-08

Coverage by plan and tier

Of the 5,495 Medicare drug plans we track for 2027, 5,495 list Repaglinide — 100% of plans. Most of those plans put it on Tier 1: 4,367 plans, 79.5% of the plans that list it. Other plans place it on Tier 6 (660 plans), Tier 2 (462 plans) or Tier 4 (3 plans). For example: Aetna Medicare Dual Extra (HMO D-SNP) puts it on Tier 1; Aetna Medicare Dual Extra Care (PPO D-SNP) puts it on Tier 1; Aetna Medicare Value Plus (PPO) puts it on Tier 1. You can compare these plans side by side on our Medicare Advantage hub. A tier is not a price. What you pay also depends on whether you have met your plan';s deductible, whether the drug costs a flat copay or a share of the price, and whether you get Extra Help or Medicaid.

Read next

• Part D in 2027: The $700 Deductible, the $2,400 Cap, and the $35 Insulin Rule
• Extra Help in 2027: Lower Drug Copays and Who Qualifies
• Checking Medicare Savings Programs and Extra Help

Part D spending averages (2024)

Source: CMS Medicare Part D Spending by Drug (Drug Spending Dashboard), release RY26 P04 V10, data through 2024 (DSD_PTD_RY26_P04_V10_DY24_BGM.csv), downloaded 2026-10-30

Companies covering this drug

Part D and Medicare Advantage plan sponsors that list this drug on a formulary, 50 at a time.