nateglinide


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nateglinide

 [nah-teg´lĭ-nīd]
an antidiabetic agent that lowers blood glucose concentrations by stimulating the release of insulin from pancreatic islet beta cells; administered orally in the treatment of type 2 diabetes mellitus, either alone or in combination with metformin.

nateglinide

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.

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 antiinflammatory 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.

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.

nateglinide

(nə-tĕg′lĭ-nīd′)
n.
An oral hypoglycemic drug, C19H27NO3, that stimulates the release of insulin from the pancreas and is used to treat type 2 diabetes.

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.
References in periodicals archive ?
5% methylcellulose, GK rats, model control), nateglinide (50 mg/kg, GK rats, positive control) or AA (50 mg/kg, GK rats, sample) by oral gavage twice daily just before each meal for 12 weeks.
On the fifth day of treatment, nateglinide therapy was discontinued because the two-hour postprandial glucose levels were were found to be between 70 and 80 mg/dl.
Repaglinide (Gluconorm[R]) and nateglinide (Starlix[R])are both approved to be used in combination with metformin (Novartis Pharmaceuticals, 2009; Novo Nordisk, 2010).
Impairment of early insulin response after glucose load, rather than insulin resistance, is responsible for postprandial hyperglycaemia seen in obese, type 2 diabetics: Assessment using Nateglinide, a new insulin secretagogue.
Medications currently approved to treat type 2 diabetes, 2010 Mean Maximum daily daily Class Drugs doses doses Biguanide Metformin 850 mg (a) 2 550 mg Sulfonylureas Chlorpropamide 250 mg (b) 500 mg Glibenclamide 5 mg (a) 20 mg Glipizide 5 mg (a) 20 mg Glimepiride 4 mg (b) 8 mg Gliclazide 80 mg (a) 320 mg Gliclazide MR 60 mg (b) 120 mg Meglitinides Nateglinide 60 mg (c) 360 mg Repaglinide 2 mg (c) 12 mg Thiazolidinediones Rosiglitazone 4 mg (a) 8 mg Pioglitazone 30 mg (b) 45 mg a-glucosidase Acarbose 50 mg (c) 300 mg inhibitors Miglitol 25 mg (c) 100 mg DPP-4 inhibitors/ Sitagliptin 100 mg (b) 100 mg gliptines Vildagliptin 50 mg (a) 100 mg Saxaglipnin 5 mg (b) 5 mg Incretine analogues Exenatide 20 mcgr (a) 20 mcgr Liraglutide 1.
s Glucovance); and nateglinide (a generic version of Novartis' Starlix).
Repaglinide (Prandin[R]) and nateglinide (Starlix[R]) are short-acting nonsulfonylureas or glinides that are only used preprandially (before meals).
In a large medical trial, patients with pre-diabetes and patients with cardiovascular risk factors did not respond to nateglinide, which stimulates insulin secretion in the body.
Additionally, the blood sugar lowering drug nateglinide (Starlix) proved ineffective at halting progression to diabetes, and had no significant impact on reducing cardiovascular events.
Sulfonylureas, repaglinide, and nateglinide are insulin secretagogues that stimulate endogenous insulin secretion from the pancreas (Davies, 2002) and are used as hypoglycemic agents for the treatment of type 2 diabetes.
The study assessed whether valsartan or the oral anti-diabetic agent nateglinide could delay progression to diabetes or reduce the incidence of cardiovascular events in people with IGT and cardiovascular disease or risk factors.
Improved prandial glucose control with lower risk of hypoglycemia with nateglinide than with glibenclamide in patients with maturity-onset diabetes of the young type 3.