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Nateglinide

Nateglinide

Uses

Nateglinide 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.

Side Effects

Weight gain may occur. If this effect persists or worsens, notify your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Nateglinide 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.

How should this medicine be used?

Nateglinide comes as a tablet to take by mouth. It is usually taken three times daily. Take nateglinide any time from 30 minutes before a meal to just before the meal. If you skip a meal, you need to skip the dose of nateglinide. If you add a meal, add a dose of nateglinide. Your doctor may gradually increase your dose, depending on your response to nateglinide. Monitor your blood glucose closely. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take nateglinide exactly as directed. Do not take more or less of it or take it more often than directed by the package label or prescribed by your doctor.

Nateglinide controls diabetes but does not cure it. Continue to take nateglinide even if you feel well. Do not stop taking nateglinide without talking with your doctor.

What special dietary instructions should I follow?

Be sure to follow all exercise and dietary recommendations made by your doctor or dietitian. Calorie reduction, weight loss, and exercise will help to control your diabetes. It is important to eat a healthful diet. Alcohol may cause a decrease in blood sugar. Ask your doctor about the safe use of alcoholic beverages while you are taking nateglinide.

What should I do if I forget a dose?

Before you start taking nateglinide, ask your doctor what to do if you forget to take a dose. Write these directions down so you can refer to them later. As a general rule, if 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.

Background

Nateglinide (na teg' li nide) is an insulin secretagogue that is similar in action but different in structure from the sulfonylureas.  It is a derivative of phenylalanine and stimulates insulin secretion by blocking ATP sensitive potassium channels in pancreatic beta-cells, causing cell membrane depolarization which results in calcium influx and insulin secretion.  Nateglinide has been shown to reduce the postprandial increase in glucose in patients with type 2 diabetes and improve glycemic control.  Nateglinide was approved for use in the United States in 2000.  The current indications are for management of type 2 diabetes used in combination with diet and exercise, with or without other oral hypoglycemic agents.  Nateglinide is available generically and under the brand name Starlix in tablets of 60 and 120 mg.  The typical initial dose in adults is 120 mg three times daily before meals.  Side effects of nateglinide include diarrhea, nausea, gastrointestinal upset, hypoglycemia, dizziness and rash.

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