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Nateglinide: Brands, Price & Uses in Bangladesh
Nateglinide is indicated as an adjunct to diet and exercise to improve glycemic control, particularly after-meal (postprandial) blood glucose levels , in adults with type 2 diabetes mellitus .
About Nateglinide
Indications of Nateglinide
Nateglinide is indicated as an adjunct to diet and exercise to improve glycemic control, particularly after-meal (postprandial) blood glucose levels, in adults with type 2 diabetes mellitus.
- Established/approved use: Monotherapy in patients whose hyperglycemia cannot be controlled by diet and exercise alone.
- Guideline-supported combination use: In combination with metformin in patients who do not achieve adequate control with either drug alone, when metformin's action on fasting glucose is combined with the postprandial effect of Nateglinide.
- Not indicated for type 1 diabetes mellitus or diabetic ketoacidosis.
Nateglinide is typically used in patients whose predominant problem is elevated blood sugar after meals rather than fasting hyperglycemia.
Dosage & Administration of Nateglinide
Adult Dose - Type 2 Diabetes Mellitus
| Situation | Recommended Dose |
|---|---|
| Usual starting/maintenance dose | 120 mg orally, 1 to 30 minutes before each main meal (typically three times daily) |
| Patients close to their target HbA1c | 60 mg before each main meal may be used |
| Combination with metformin | Nateglinide 120 mg before meals added to existing metformin therapy, as advised by the physician |
Missed Meals
If a meal is skipped, the corresponding dose of Nateglinide should also be skipped to reduce the risk of hypoglycemia; a dose should not be taken without an accompanying meal.
Pediatric Dose
Not established (see Use in Special Populations).
Renal Impairment
No initial dose adjustment is generally required for mild-to-moderate renal impairment, but caution and closer monitoring are advised in significant renal impairment (see Precautions and Warnings).
Hepatic Impairment
Use with caution in hepatic impairment; not recommended in severe hepatic disease as it has not been adequately studied in this population (see Precautions and Warnings).
Side Effects of Nateglinide
The most common adverse effect of Nateglinide is hypoglycemia (see Precautions and Warnings for detail). Other reported side effects include:
- Upper respiratory tract infection, flu-like symptoms
- Dizziness
- Back pain
- Arthropathy/joint pain
- Diarrhea, other mild gastrointestinal upset
- Elevated uric acid (usually asymptomatic)
Most side effects are mild to moderate. Patients should seek prompt medical advice for symptoms of severe or persistent hypoglycemia or any signs of an allergic reaction.
Contraindications of Nateglinide
Nateglinide is contraindicated in:
- Patients with known hypersensitivity to Nateglinide or any component of the formulation.
- Patients with type 1 diabetes mellitus.
- Patients in diabetic ketoacidosis.
Nateglinide is not a substitute for insulin in these settings. Situations that require caution rather than outright avoidance (e.g., hepatic impairment, use with other antidiabetic drugs) are discussed under Precautions and Warnings.
Frequently Asked Questions about Nateglinide
When should I take Nateglinide?
Nateglinide should be taken 1 to 30 minutes before a main meal, typically before breakfast, lunch, and dinner. Take it only when you are about to eat; if you skip a meal, skip that dose of Nateglinide as well to lower the risk of low blood sugar.
What happens if I skip a meal after taking my dose?
Skipping a meal after taking Nateglinide increases the risk of hypoglycemia (low blood sugar), which can cause sweating, shakiness, confusion, or fainting. Always take Nateglinide together with food, and if you have already taken a dose and cannot eat, contact your physician for advice.
Can Nateglinide be used in type 1 diabetes?
No. Nateglinide is contraindicated in type 1 diabetes mellitus and in diabetic ketoacidosis because it relies on the pancreas being able to release insulin, and it is not a substitute for insulin therapy in these conditions.
Is Nateglinide safe during pregnancy?
Nateglinide should be used in pregnancy only if clearly needed, since data in pregnant women are limited and the potential benefit must be weighed against potential risk to the fetus. Insulin is generally the preferred treatment for blood sugar control during pregnancy, so your physician may switch you from Nateglinide to insulin if pharmacologic treatment is needed. Always consult your physician before using Nateglinide if you are pregnant or planning pregnancy.
Can Nateglinide be combined with other diabetes medicines?
Nateglinide is commonly combined with metformin under medical supervision when either drug alone does not give adequate control. Combining Nateglinide with other blood-glucose-lowering medicines, especially insulin or sulfonylureas, increases the risk of hypoglycemia, so this should only be done under a physician's guidance with appropriate monitoring.
What should I do if I think I have taken too much Nateglinide?
An overdose of Nateglinide can cause severe, prolonged low blood sugar. If you suspect an overdose, seek immediate medical attention or contact emergency services/a poison control center right away. If the person is conscious and able to swallow, giving a sugary drink or food while awaiting medical help may be advised, but this does not replace urgent medical care.
Disclaimer
The information provided is accurate to the best of our knowledge, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy, and the absence of specific information about a drug should not be taken as an endorsement. We are not responsible for any consequences arising from this information, so please consult a healthcare professional for any concerns or questions.