Nateglinide

Indications
 Oral
Type 2 diabetes mellitus
Adult: 60-120 mg tid prior to each meal; may be increased to 180 mg tid if necessary.
Contraindications
 Diabetic ketoacidosis; IDDM. Lactation.
Warnings / 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 Reactions
 Dizziness; back pain; arthropathy; upper respiratory tract infection; flu-like symptoms; bronchitis; cough; hypoglycaemia; accidental trauma; diarrhoea.
Overdose Reactions
 Symptoms: Hypoglycaemia. Management: Use IV glucose in severe hypoglycaemic reactions. Dialysis is not effective.
Drug Interactions
 Increased levels/effects with enzyme inhibitors (e.g. fluconazole). Increased hypoglycaemic effects with salicylates, MAOIs, nonselective β-blockers, alcohol, NSAIDs. Decreased levels/effects with enzyme inducers (e.g. rifampicin). Decreased hypoglycaemic effects with thiazide diuretics, corticosteroids, thyroid products and sympathomimetic agents.
See Below for More nateglinide Drug Interactions
Food Interactions
 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.
Mechanism of Actions
 Nateglinide, a nonsulfonylurea hypoglycaemic agent, acts by stimulating insulin release from pancreatic β-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.
Administration
 Should be taken with food. (Take immediately before or up to ½ hr before meals.)
Storage Conditions
 Oral: Store at 25°C (77°F).
ATC Classification
 A10BX03 - nateglinide ; Belongs to the class of other blood glucose lowering drugs, excluding insulins. Used in the management of diabetes.
Storage
 Oral: Store at 25°C (77°F).
Available As
  • Nateglinide 120 mg
  • Nateglinide 60 mg

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