Nateglinide

Trade Names

Starlix, Trazec.

Class and Category

Hypoglycemic agent; meglitinide drug class.

Indications

Oral antidiabetic agent used in the management of type 2 diabetes. Indicated for use as monotherapy or in conjunction with metformin. Appears to have a greater effect on postprandial hyperglycemia but a weaker effect on fasting glucose levels than glyburide.

Dosage

60–120 mg orally three times per day 30 minutes prior to meals.

Contraindications

Type 1 diabetes or diabetic ketoacidosis. Should be used with caution in patients with hepatic impairment.

Adverse Reactions

As with sulfonylureas, hypoglycemic episodes more likely with nateglinide, particularly in patients without a regularly predictable diet and exercise regimen.

Drug Interactions

Drugs which are associated with hyperglycemia, including glucocorticoids, thyroid products, and thiazides may reduce the hypoglycemic effects of nateglinide. Concomitant use of beta blockers may mask the symptoms of hypoglycemia.

Mechanism of...