nateglinide

nateglinide /na·teg·li·nide/ (nah-teg´lĭ-nīd) an agent that stimulates release of insulin from pancreatic islet beta cells, used in the treatment of type 2 diabetes.

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nateglinide

[näteg′lĭ-nīd]

an antidiabetic agent that lowers blood glucose concentrations by stimulating the release of insulin from pancreatic islet beta cells. It is administered orally in the treatment of type 2 diabetes mellitus, either alone or in combination with metformin.

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nateglinide Warning - High-alert drug!

Starlix

Pharmacologic class: Amino acid derivative

Therapeutic class: Hypoglycemic

Pregnancy risk category C

Action

Decreases blood glucose level by stimulating insulin secretion from pancreatic beta cells; interacts with calcium and potassium channels in pancreas

Availability

Tablets: 60 mg, 120 mg

⊘Indications and dosages

➣ To decrease glucose levels in type 2 (non-insulin-dependent) diabetes mellitus not adequately controlled by diet and exercise

Adults: 120 mg P.O. t.i.d. up to 30 minutes before meals, or 60 mg P.O. t.i.d. if patient is near glycosylated hemoglobin (HbA1c) goal

Contraindications

• Hypersensitivity to drug or its components
• Diabetic ketoacidosis
• Type 1 (insulin-dependent) diabetes mellitus

Precautions

Use cautiously in:
• renal or hepatic impairment, adrenal or pituitary insufficiency
• elderly or malnourished patients
• pregnant or breastfeeding patients.

Administration

• Give 30 minutes before meals. If meal is missed, don't give dose.
• Know that drug may be given alone or with metformin.

Route	Onset	Peak	Duration
P.O.	Rapid	Within 1 hr	4 hr

Adverse reactions

CNS: dizziness

GI: diarrhea

Metabolic: hypoglycemia

Musculoskeletal: back pain, joint pain

Respiratory: upper respiratory tract infection, bronchitis, coughing

Other: flulike symptoms, trauma

Interactions

Drug-drug. Beta-adrenergic blockers, MAO inhibitors, nonsteroidal anti-inflammatory drugs, salicylates: increased hypoglycemic effect

Corticosteroids, sympathomimetics, thiazides, thyroid products: reduced hypoglycemic effect

Drug-diagnostic tests. Glucose: decreased level

Patient monitoring

• Monitor blood glucose and HbA1c levels.
• Assess pulmonary status for bronchitis, upper respiratory infection, and flulike signs and symptoms.
• Monitor musculoskeletal status. Check for back pain and arthropathy.
• Note GI complaints, and identify nutritional deficiencies.

Patient teaching

• Instruct patient to take dose up to 30 minutes before each main meal.
• Advise patient not to skip a meal. If he does, tell him to also skip accompanying nateglinide dose, to prevent hypoglycemia.
• Teach patient how to monitor blood and urine for glucose and ketones, as prescribed.
• Instruct patient to report adverse CNS effects and signs and symptoms of respiratory infection.
• Caution patient to avoid driving and other hazardous activities until he knows how drug affects sensation and balance.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.