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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.
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.



Pharmacologic class: Amino acid derivative

Therapeutic class: Hypoglycemic

Pregnancy risk category C


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


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


• Hypersensitivity to drug or its components

• Diabetic ketoacidosis

• Type 1 (insulin-dependent) diabetes mellitus


Use cautiously in:

• renal or hepatic impairment, adrenal or pituitary insufficiency

• elderly or malnourished patients

• pregnant or breastfeeding patients.


• 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


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.

McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved


An oral hypoglycemic drug, C19H27NO3, that stimulates the release of insulin from the pancreas and is used to treat type 2 diabetes.
The American Heritage® Medical Dictionary Copyright © 2007, 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved.
References in periodicals archive ?
carried out a work on spectrophotometric determination of nateglinide in bulk and tablet dosage forms [9].
Hayashi, "Inhibition of human liver microsomal CYP by nateglinide," Journal of Pharmacy and Pharmacology, vol.
Regarding medication, there are several pharmacological options, which can be used individually or in association, such as insulin action sensitisers (metformin, thiazolidinediones), anti-hyperglicemic agents (acarbose), secretagogues (sulfonylureas, repaglinide, nateglinide), anti-obesity drugs and/or insulin (ARAUJO et al., 2000).
Table 1: Antidiabetes Medications with Their Reductions in A1C and Effects on Weight Reduction Weight Drug Class in A1C (%) Effects (lb) Insulin >2.5 +8.8-11.0 Inhaled insulin 1-2 +2.2-4.4 Sulfonylureas 1.6 +3.5-5.7 Repaglinide and nateglinide 0.8-1.5 +1.54-3.9 Metformin 1.5 -10.1-+0.88 Thiazolidinediones 0.8-1.0 +9.2-10.6 [alpha]-Glucosidase inhibitors 0.5-0.8 +0.0-0.44 DPP-IV inhibitors 0.5-1.0 +0.0-0.88 GLP-1 mimetic 0.6-0.8 -2.8-6.6 Amylin analogs 0.6 -3.1 Source: Hollander P.
Repaglinide and Nateglinide: They are expensive and have very limited use.
The pharmacodynamic study was performed in GK rats, a spontaneous type 2 diabetic animal model, and insulinotropic drug nateglinide was chosen as positive control drug.
Eto, "Nateglinide stimulates glucagon-like peptide-1 release by human intestinal L cells via a K(ATP) channel-independent mechanism," Biological and Pharmaceutical Bulletin, vol.
Therapeutic Class Medication Second-generation sulfonylureas Glyburide, glipizide, glimepiride Alpha-glucosidase inhibitors Acarbose, miglitol Biguanides Metformin Meglitinides Repaglinide, nateglinide Thiazolidinediones Rosiglitazone, pioglitazone DPP-4 inhibitors ([double dagger]) Sitagliptin DPP-4: Dipeptidyl peptidase inhibitor-4 ([double dagger]) Saxagliptin and linagliptin were not included in the NKF guideline.
Coadministration of gemfibrozil and itraconazole has only a minor effect on the pharmacokinetics of the CYP2C9 and CYP3A4 substrate nateglinide. Br J Clin Pharmacol.
A 59-year-old obese female patient had been diagnosed with type II DM 15 years previously, and she was taking metformin 11 g 2x1/day), sitagliptin (100 mg/day), and nateglinide (120 mg 3x1/day).
The drugs in this class are repaglinide (Prandin) and nateglinide (Starlix).
Repaglinide and nateglinide are non-sulfonylurea secretagogues which act on the ATP-dependent K-channel in the pancreatic beta cells thereby stimulating the release of insulin from the beta cells, similar to sulfonylurea, though the binding site is different.