(nuh tay' gli nide)
P : Caution when used during pregnancy
L : Contraindicated in lactation
||See TERMINOLOGY & ABBREVIATIONS ||
|Indication(s) & Dosage||Type 2 diabetes mellitus
Adult: 60-120 mg tid prior to each meal; may be increased to 180 mg tid if necessary.
|Administration||May be taken with or without food. May be taken w/ meals for better absorption & to
reduce GI discomfort.
|Overdosage||Symptoms: Hypoglycaemia. Management: Use IV glucose in severe hypoglycaemic reactions. Dialysis is not effective.|
|Contraindications||Diabetic ketoacidosis; IDDM. Lactation.|
|Special Precautions||Geriatric patients, debilitated and malnourished patients; adrenal or pituitary insufficiency, moderate to severe hepatic impairment; severe renal impairment. Monitor glycaemic levels during periods of stress. Pregnancy.|
|Adverse Drug Reaction(s)||Dizziness; back pain; arthropathy; upper respiratory tract infection; flu-like symptoms; bronchitis; cough; hypoglycaemia; accidental trauma; diarrhoea.|
|Drug Interactions||Increased levels/effects with enzyme inhibitors (e.g. fluconazole). Increased hypoglycaemic effects with salicylates, MAOIs, nonselective Î²-blockers, alcohol, NSAIDs. Decreased levels/effects with enzyme inducers (e.g. rifampicin). Decreased hypoglycaemic effects with thiazide diuretics, corticosteroids, thyroid products and sympathomimetic agents.|
|Food Interaction||Absorption delayed with food. Hypoglycaemic effects may be increased with alfalfa, aloe, bilberry, bitter melon, burdock, celery, damiana, fenugreek, garcinia, garlic, ginger, American ginseng, gymnema, marshmallow and stinging nettle. Levels/effects may be reduced with St. John's wort.|
|Pregnancy Category (FDA)||Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.|
|Storage||Store at 25Â°C (77Â°F).|
|Pharmacology||Nateglinide, a nonsulfonylurea hypoglycaemic agent, acts by stimulating insulin release from pancreatic Î²-cells to
reduce postprandial hyperglycaemia. This action depends on the amount of existing glucose levels.
Onset: Approx 20 min.
Duration: 4 hr.
Absorption: Rapidly absorbed; peak plasma concentrations within 1 hr (oral).
Distribution: Protein-binding: 98%, primarily to albumin.
Metabolism: Hepatic via hydroxylation followed by glucuronidation; converted to metabolites.
Excretion: Via urine (16% unchanged drug); faeces (10%). Elimination half-life: 1.5 hr.
|ATC Classification||A10BX03 - nateglinide; Belongs to the class of other oral blood glucose lowering drugs. Used in the treatment of diabetes.|
Why is Nateglinide prescribed?
Nateglinide is used alone or in combination with other medications to treat type 2 diabetes (condition in which the body does not use insulin normally and therefore cannot control the amount of sugar in the blood) in people whose diabetes cannot be controlled by diet and exercise alone. Nateglinide belongs to a class of drugs called meglitinides. Nateglinide helps your body regulate the amount of glucose (sugar) in your blood. It decreases the amount of glucose by stimulating the pancreas to release insulin.
How should Nateglinide 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.
Other uses for Nateglinide
- inform your doctor if you are allergic to nateglinide or any other drugs.
- inform your doctor what prescription and nonprescription medications you are taking, especially albuterol (Ventolin); allergy or cold medications; aspirin and nonsteroidal anti-inflammatory drugs such as ibuprofen or naproxen; beta-blockers such as propranolol; chloramphenicol; chlorpromazine; corticosteroids such as dexamethasone, methylprednisolone, or prednisone; diuretics ('water pills'); epinephrine; estrogens; fluphenazine; isoniazid; medications that contain alcohol or sugar; mesoridazine; niacin; oral contraceptives (birth control pills); perphenazine; phenelzine; probenecid; prochlorperazine; promazine; promethazine; terbutaline; thioridazine; thyroid medication; tranylcypromine; trifluoperazine; triflupromazine; trimeprazine; and vitamins or herbal products.
- inform your doctor if you have or have ever had liver or pituitary disease, adrenal insufficiency, diabetic ketoacidosis, neuropathy (disease of the nervous system), or if you have been told you have type 1 diabetes mellitus (condition in which the body does not produce insulin and therefore cannot control the amount of sugar in the blood) .
- inform your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking nateglinide, call your doctor.
- if you are having surgery, including dental surgery, inform the doctor or dentist that you are taking nateglinide.
- inform your doctor if you have fever, infection, injury, or illness with vomiting or diarrhea. These may affect your blood sugar level.
What special dietary instructions to follow?
dizziness or lightheadedness
nervousness or irritability
sudden changes in behavior or mood
numbness or tingling around the mouth
- clumsy or jerky movements
If hypoglycemia is not treated, severe symptoms may develop. Be sure that your family, friends, and other people who spend time with you know that if you have any of the following symptoms, they should get medical treatment for you immediately.
- loss of consciousness
Call your doctor immediately if you have any of the following symptoms of hyperglycemia (high blood sugar):
- blurred vision
If high blood sugar is not treated, a serious, life-threatening condition called diabetic ketoacidosis could develop. Call your doctor immediately if you have any of the these symptoms:
nausea and vomiting
shortness of breath
breath that smells fruity
- decreased consciousness
Nateglinide may cause side effects. inform your doctor if any of these symptoms are severe or do not go away:
Nateglinide may cause other side effects. Consult your doctor if you have any unusual problems while taking this.
What other information to know?
Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to Nateglinide.
Do not let anyone else use your medication. If you still have symptoms and need further treatment, consult your doctor.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
Ref: MedlinePlus, U.S. Natl. Library of Medicine
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