Classifications: hormone; antidiabetic; meglitinide; Therapeutic: antidiabetic; meglitinide
Pregnancy Category: C
60 mg, 120 mg tablets
Lowers blood glucose levels by stimulating the release of insulin from the pancreatic cells of a type 2 diabetic. Significantly
reduces postprandial blood glucose in type 2 diabetics and improves glycemic control when given before meals. There is minimal
risk of hypoglycemia.
Effectiveness is indicated by preprandial blood glucose between 80 and 120 mg/dL and HbA1C ≤6.5%.
Alone or in combination with metformin for the treatment of non-insulin-dependent diabetes mellitus.
Prior hypersensitivity to nateglinide. Type 1 (insulin-dependent) diabetes mellitus, diabetic ketoacidosis; hypoglycemia;
pregnancy (category C).
Renal impairment; liver dysfunction; adrenal or pituitary insufficiency; malnutrition; infection, trauma, surgery or unusual
stress; concurrent therapy of drugs which inhibit cytochrome P450-3A4 (e.g., erythromycin, ketoconazole); concurrent therapy
with drugs which are inducers of cytochrome P450-3A4 (e.g., rifampin); other medications, especially beta-adrenergic blocking
agents; surgery; trauma; lactation.
Route & Dosage
Adult: PO 60120 mg t.i.d. 130 min prior to meals
- Give, preferably, 10 min before meals. Omit the dose if the meal is skipped. Add a dose if an extra meal is eaten. Never
double the dose.
- Store at 15°30° C (59°86° F).
Adverse Effects (≥1%)Body as a Whole:
Back pain, flu-like symptoms
Dizziness. GI: Diarrhea
. Metabolic: Hypoglycemia
Upper respiratory infection
, mao inhibitors
, beta-adrenergic blockers
, may potentiate hypoglycemic effects; thiazide diuretics
, thyroid preparations
, sympathomimetic agents
may attenuate hypoglycemic effects. Herbal: Garlic, ginseng
may potentiate hypoglycemic effects.
Rapidly absorbed, 73% bioavailability. Peak:
1 h. Distribution:
98% protein bound. Metabolism:
In liver by CYP2C9 (70%) and CYP3A4 (30%). Elimination:
Primarily in urine. Half-Life:
Assessment & Drug Effects
- Lab tests: Frequent FBS monitoring and HbA1C q3mo to determine effective dose.
- Monitor carefully for S&S of hypoglycemia especially during the one-week period following transfer from a longer acting
sulfonylurea such as chlorpropamide.
Patient & Family Education
- Take only before a meal to lessen the chance of hypoglycemia.
- When transferred to nateglinide from another oral hypoglycemia drug, start nateglinide the morning after the other agent
is stopped, unless directed otherwise by physician.
- Watch for S&S of hyperglycemia or hypoglycemia (see Appendix F); report poor blood glucose control to physician.
- Report gastric upset or other bothersome GI symptoms to physician.