Do not take NovoNorm:
- If you are hypersensitive (allergic) to repaglinide or any of the other components of the medicine
- If you have type 1 diabetes ( insulin-dependent diabetes)
- If the acid level in your body is raised (diabetic ketoacidosis)
- If you have a severe liver disease
- If you take gemfibrozil (a medicine used to lower increased fat levels in the blood).
If any of these apply to you, tell your doctor and do not take NovoNorm.
Take special care with NovoNorm:
- If you have liver problems. NovoNorm is not recommended in patients with moderate liver disease. NovoNorm should not be taken if you have a severe liver disease (see Do not take NovoNorm).
- If you have kidney problems. NovoNorm should be taken with caution.
- If you are about to have major surgery or you have recently suffered a severe illness or infection. At such times diabetic control may be lost.
- If you are under 18 or over 75 years of age. NovoNorm is not recommended. It has not been studied in these age groups.
Talk to your doctor if any of the above applies to you. NovoNorm may not be suitable for you. Your doctor will advise you.
If you get a hypo
You may get a hypo (short for a hypoglycaemic reaction and is symptoms of low blood sugar) if your blood sugar gets too low. This may happen:
- If you take too much NovoNorm
- If you exercise more than usual
- If you take other medicines or suffer from liver or kidney problems (see other sections of 2. Before you take NovoNorm).
The warning signs of a hypo may come on suddenly and can include: cold sweat; cool pale skin; headache; rapid heart beat; feeling sick; feeling very hungry; temporary changes in vision; drowsiness; unusual tiredness and weakness; nervousness or tremor; feeling anxious; feeling confused; difficulty in concentrating.
If your blood sugar is low or you feel a hypo coming on: eat glucose tablets or a high sugar snack or drink, then rest.
When symptoms of hypoglycaemia have disappeared or when blood sugar levels are stabilised continue NovoNorm treatment.
Tell people you have diabetes and thatif you pass out (become unconscious) due to a hypo, they must turn you on your side and get medical help straight away. They must not give you any food or drink.It could choke you.
- If severe hypoglycaemia is not treated, it can cause brain damage (temporary or permanent) and even death.
- If you have a hypo that makes you pass out, or a lot of hypos, talk to your doctor. The amount of NovoNorm, food or exercise may need to be adjusted.
If your blood sugar gets too high
Your blood sugar may get too high (hyperglycaemia). This may happen:
- If you take too little NovoNorm
- If you have an infection or a fever
- If you eat more than usual
- If you exercise less than usual.
The warning signs appear gradually. They include: increased urination; feeling thirsty; dry skin and dry mouth. Talk to your doctor. The amount of NovoNorm, food or exercise may need to be adjusted.
Using other medicines
You can take NovoNorm with metformin, another medicine for diabetes, if your doctor prescribes it. If you take gemfibrozil (used to lower increased fat levels in the blood) you should not take NovoNorm.
Your body?s response to NovoNorm may change if you take other medicines, especially these:
- Monoamine oxidase inhibitors (MAOI) (used to treat depression)
- Beta blockers (used to treat high blood pressure or heart conditions)
- ACE-inhibitors (used to treat heart conditions)
- Salicylates (e.g. aspirin)
- Octreotide (used to treat cancer)
- Nonsteroidal anti-inflammatory drugs (NSAID) (a type of painkillers)
- Steroids (anabolic steroids and corticosteroids ? used for anemia or to treat inflammation)
- Oral contraceptives (birth control pills)
- Thiazides (diuretics or ?water pills?)
- Danazol (used to treat breast cysts and endometriosis)
- Thyroid products (used to treat low levels of thyroid hormones)
- Sympathomimetics (used to treat asthma)
- Clarithromycin, trimethoprim, rifampicin (antibiotic medicines)
- Itraconazole, ketokonazole (antifungal medicines)
- Gemfibrozil (used to treat high blood fats)
- Ciclosporin (used to suppress the immune system)
- Phenytoin, carbamazepine, phenobarbital (used to treat epilepsy)
- St. John?s wort (herbal medicine).
Tell your doctor if you have recently taken or are planning to take any of these medicines, or any medicines obtained without a prescription.
Using NovoNorm with food and drink
Take NovoNorm before main meals. Alcohol can change the ability of NovoNorm to reduce the blood sugar. Watch for signs of a hypo.
Pregnancy and breast-feeding
You should not take NovoNorm if you are pregnant or you are planning to become pregnant. See your doctor as soon as possible if you become pregnant or are planning to become pregnant during treatment.
You should not take NovoNorm if you are breast-feeding.
Driving and using machines
Your ability to drive or operate a machine may be affected if your blood sugar is low or high. Bear in mind that you could endanger yourself or others. Please ask your doctor whether you can drive a car if you:
- Have frequent hypos
- Have few or no warning signs of hypos.