What is nateglinide, and how does it work (mechanism of action)?
Nateglinide is an oral drug used to lower blood sugar (glucose) levels in type 2 diabetes. It is in a class of drugs called meglitinides which also includes repaglinide (Prandin). Approximately 90% of patients with diabetes have type 2 diabetes. Type 2 diabetes usually occurs in adults and is associated with obesity and a strong family history of diabetes. Insulin is an important hormone that controls the blood level of glucose.
Type 2 diabetics have an inability to control blood glucose levels. This is caused by reduced secretion of insulin from the pancreas after meals and resistance of the body's cells to the effect of insulin which is to stimulate the cells to remove glucose from the blood. This leads to high levels of blood glucose. Nateglinide stimulates cells in the pancreas to produce insulin in a manner similar to the class of drugs called sulfonylureas, for example, glyburide (Diabeta, Glynase and Micronase), which also are used in type 2 diabetes. However, nateglinide appears to have a faster onset and a shorter duration of action than sulfonylureas. The benefit of this faster, shorter effect may be to prevent the rapid, transient rise in blood glucose that occurs in diabetics immediately following a meal.
- The brand name for netaglinide is Starlix.
- Starlix is available in generic form.
- You need a prescription for netaglinide.
- Nateglinide was approved by the FDA in December 2000.
What are the side effects of nateglinide?
The most common side effects of nateglinide therapy are:
- Runny nose,
- cough,
- upper respiratory infections,
- back pain,
- flu-like symptoms,
- dizziness, and
- joint pain are the most common side
Another important side effect of nateglinide therapy is hypoglycemia (low blood glucose levels with or
without symptoms) can occur.
Some symptoms of hypoglycemia include:
- hunger,
- nausea,
- tiredness,
- perspiration,
- headache,
- heart palpitations,
- numbness around the mouth,
- tingling in the fingers,
- tremors,
- muscle weakness,
- blurred vision,
- cold temperature,
- excessive yawning,
- irritability,
- confusion, or
- loss of consciousness.
What is the dosage for nateglinide?
- The recommended dose of nateglinide alone or in combination with metformin or thiazolidinediones is 120 mg three times daily with meals. T
- he 60 mg dose is used for patients who are close to their goal HbA1c when treatment is started.
- Nateglinide should be taken 30 minutes or less before a meal but should not be taken if a meal is skipped.
- Nateglinide is available in tablets of 60 and 120 mg.
- Nateglinide should be stored at room temperature, 15 C to 30 C (59 F to 86 F), in an air-tight container.
Which drugs or supplements interact with nateglinide?
Starting or stopping the following drugs may
increase the response to nateglinide and may require the dose of nateglinide to
be lowered: nonsteroidal anti-inflammatory agents (NSAIDs) like ibuprofen
(Motrin, etc.), aspirin and aspirin-like compounds, monoamine oxidase inhibitors
like phenelzine (Nardil), and beta-blocking drugs like propranolol (Inderal).
Starting or stopping the following drugs may decrease the response to
nateglinide and may require the dose of nateglinide to be increased: thiazide
diuretics such as hydrochlorothiazide, steroids such as prednisone, thyroid
hormone like levothyroxine, and drugs used in emergencies to regulate the
heartbeat or restore breathing when airways are blocked. Examples of these
latter drugs are epinephrine and albuterol (Ventolin).
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Is nateglinide safe to take if you are pregnant or breastfeeding?
- No safety and efficacy studies have been conducted in pregnant women taking nateglinide. Nateglinide should not be used during pregnancy.
- No safety and efficacy studies have been conducted in pregnant women taking nateglinide. Since many drugs are excreted in breast milk, the manufacturer recommends that nateglinide not be administered to nursing mothers.