Nateglinide Brand Name– Starlix
What is Nateglinide
Nateglinide is a meglitinide oral hypoglycemic agent given before meals as an adjunct to diet and exercise in adults with type 2 diabetes mellitus (DM).
Meglitinides stimulate insulin secretion, and agents in this class are pharmacologically similar to one another and the sulfonylureas.
Nateglinide has a rapid onset and shorter duration of action than sulfonylureas and replicates physiological insulin profiles when taken before meals. Clinically, mean final reductions for A1C appear to be greater for repaglinide monotherapy than nateglinide monotherapy (A1C reductions -1.57% vs. -1.04%; p = 0.002).
However, the meglitinide agents are considered therapeutically similar in clinical use.
Metformin is first-line in the treatment of type 2 DM.
In patients with established cardiovascular (CV) disease, heart failure (HF), or chronic kidney disease (CKD), a sodium-glucose co-transporter 2 (SGLT2) inhibitor or glucagon-like peptide-1 receptor agonist (GLP-1 RA) with proven CV benefit and reduction of CKD progression is recommended for add-on therapy, independent of baseline A1C or individualized A1C target. In patients without indicators of high-risk or established CVD, HF, or CKD, nateglinide is an option that has a neutral impact on CV health and HF.
Indications
- type 2 diabetes mellitus
For the treatment of type 2 diabetes mellitus that is not controlled by diet and exercise alone
Side Effects
- arthropathy
- back pain
- cough
- diarrhea
- dizziness
- elevated hepatic enzymes
- hepatitis
- hypoglycemia
- infection
- jaundice
- nausea
- peripheral edema
- pruritus
- rash
- urticaria
- weight gain
Dizziness (3.6% vs 2.2% placebo) has been reported in patients receiving nateglinide
Monitoring Parameters
- blood glucose
- glycosylated hemoglobin A1c (HbA1c)
Contraindications
- breast-feeding
- children
- diabetic ketoacidosis
- fever
- geriatric
- hepatic disease
- hypoglycemia
- infants
- infection
- poor metabolizers
- pregnancy
- surgery
- trauma
- type 1 diabetes mellitus
Interactions
- Acebutolol
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
- Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
- Acetaminophen; Dextromethorphan; Phenylephrine
- Acetaminophen; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Dichloralphenazone; Isometheptene
- Acetaminophen; Guaifenesin; Phenylephrine
- Acetaminophen; Propoxyphene
- Acetaminophen; Pseudoephedrine
- Acetazolamide
- Acrivastine; Pseudoephedrine
- Alogliptin; Metformin
- Amiodarone
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Amphetamine
- Amphetamine; Dextroamphetamine
- Amprenavir
- Androgens
- Angiotensin II receptor antagonists
- Angiotensin-converting enzyme inhibitors
- Apalutamide
- Articaine; Epinephrine
- Atazanavir
- Atazanavir; Cobicistat
- Atenolol
- Atenolol; Chlorthalidone
- atypical antipsychotic
- Bendroflumethiazide; Nadolol
- Benzphetamine
- Beta-blockers
- Betaxolol
- Bexarotene
- Bisoprolol
- Bisoprolol; Hydrochlorothiazide, HCTZ
- Bortezomib
- Bosentan
- Brimonidine; Timolol
- Brompheniramine; Carbetapentane; Phenylephrine
- Brompheniramine; Dextromethorphan; Phenylephrine
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Brompheniramine; Pseudoephedrine
- Canagliflozin; Metformin
- Cannabidiol
- Capecitabine
- Carbetapentane; Chlorpheniramine; Phenylephrine
- Carbetapentane; Diphenhydramine; Phenylephrine
- Carbetapentane; Guaifenesin; Phenylephrine
- Carbetapentane; Phenylephrine
- Carbetapentane; Phenylephrine; Pyrilamine
- Carbetapentane; Pseudoephedrine
- Carbinoxamine; Dextromethorphan; Pseudoephedrine
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Carbinoxamine; Phenylephrine
- Carbinoxamine; Pseudoephedrine
- Carteolol
- Carvedilol
- Ceritinib
- Cetirizine; Pseudoephedrine
- Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
- Chlophedianol; Guaifenesin; Phenylephrine
- Chloroquine
- Chlorpheniramine; Dextromethorphan; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Phenylephrine
- Chlorpheniramine; Pseudoephedrine
- Chlorpromazine
- Chlorthalidone; Clonidine
- Chromium
- Cisapride
- Clarithromycin
- Clonidine
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- Conjugated Estrogens
- Conjugated Estrogens; Bazedoxifene
- Conjugated Estrogens; Medroxyprogesterone
- Corticosteroids
- Cyclosporine
- Dabrafenib
- Daclatasvir
- Danazol
- Dapagliflozin; Metformin
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Desloratadine; Pseudoephedrine
- Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
- Dexmethylphenidate
- Dextroamphetamine
- Dextromethorphan; Diphenhydramine; Phenylephrine
- Dextromethorphan; Guaifenesin; Phenylephrine
- Dextromethorphan; Guaifenesin; Pseudoephedrine
- Dextromethorphan; Promethazine
- Diazoxide
- Dienogest; Estradiol valerate
- Diethylpropion
- Diethylstilbestrol, DES
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Diphenhydramine; Hydrocodone; Phenylephrine
- Diphenhydramine; Phenylephrine
- Disopyramide
- Dobutamine
- Dopamine
- Dorzolamide; Timolol
- Drospirenone
- Drospirenone; Estradiol
- Drospirenone; Ethinyl Estradiol
- Drospirenone; Ethinyl Estradiol; Levomefolate
- Elagolix; Estradiol; Norethindrone acetate
- Elbasvir; Grazoprevir
- Elexacaftor; tezacaftor; ivacaftor
- Eltrombopag
- Elvitegravir
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Empagliflozin; Linagliptin; Metformin
- Empagliflozin; Metformin
- Enzalutamide
- Ephedrine
- Epinephrine
- Ertugliflozin; Metformin
- Erythromycin; Sulfisoxazole
- Esmolol
- Esterified Estrogens
- Esterified Estrogens; Methyltestosterone
- Estradiol
- Estradiol Cypionate; Medroxyprogesterone
- Estradiol; Levonorgestrel
- Estradiol; Norethindrone
- Estradiol; Norgestimate
- Estradiol; Progesterone
- Estramustine
- Estrogens
- Estropipate
- Ethanol
- Ethinyl Estradiol
- Ethinyl Estradiol; Desogestrel
- Ethinyl Estradiol; Ethynodiol Diacetate
- Ethinyl Estradiol; Etonogestrel
- Ethinyl Estradiol; Levonorgestrel
- Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
- Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
- Ethinyl Estradiol; Norelgestromin
- Ethinyl Estradiol; Norethindrone
- Ethinyl Estradiol; Norethindrone Acetate
- Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
- Ethinyl Estradiol; Norethindrone; Ferrous fumarate
- Ethinyl Estradiol; Norgestimate
- Ethinyl Estradiol; Norgestrel
- Etonogestrel
- Exenatide
- Fenofibrate
- Fenofibric Acid
- Fexofenadine; Pseudoephedrine
- Fibric acid derivatives
- Fluconazole
- Fluoxetine
- Fluoxetine; Olanzapine
- Fluoxymesterone
- Fluphenazine
- Fosamprenavir
- Garlic, Allium sativum
- Gemfibrozil
- Glecaprevir; Pibrentasvir
- Glipizide; Metformin
- Glyburide; Metformin
- Green Tea
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Guaifenesin; Phenylephrine
- Guaifenesin; Pseudoephedrine
- Hydantoins
- Hydrochlorothiazide, HCTZ; Metoprolol
- Hydrochlorothiazide, HCTZ; Propranolol
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Hydroxychloroquine
- Hydroxyprogesterone
- Ibuprofen; Pseudoephedrine
- Indapamide
- Indinavir
- Insulin Glargine; Lixisenatide
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Isoproterenol
- Ivacaftor
- Labetalol
- Lanreotide
- Ledipasvir; Sofosbuvir
- Leflunomide
- Leuprolide; Norethindrone
- Levobetaxolol
- Levobunolol
- Levonorgestrel
- Levothyroxine
- Levothyroxine; Liothyronine (Porcine)
- Levothyroxine; Liothyronine (Synthetic)
- Linagliptin; Metformin
- Linezolid
- Liothyronine
- Lisdexamfetamine
- Lithium
- Lixisenatide
- Lomefloxacin
- Loop diuretics
- Lopinavir; Ritonavir
- Loratadine; Pseudoephedrine
- Lorcaserin
- Lovastatin; Niacin
- Lumacaftor; Ivacaftor
- Lumacaftor; Ivacaftor
- Mecasermin rinfabate
- Mecasermin, Recombinant, rh-IGF-1
- Medroxyprogesterone
- Meperidine; Promethazine
- Mepivacaine; Levonordefrin
- Mesoridazine
- Mestranol; Norethindrone
- Metformin
- Metformin; Pioglitazone
- Metformin; Repaglinide
- Metformin; Rosiglitazone
- Metformin; Saxagliptin
- Metformin; Sitagliptin
- Methamphetamine
- Methazolamide
- Methylphenidate
- Methyltestosterone
- Metoprolol
- Metreleptin
- Metyrapone
- Midodrine
- Monoamine oxidase inhibitors
- Nadolol
- Nandrolone Decanoate
- Naproxen; Pseudoephedrine
- Nebivolol
- Nebivolol; Valsartan
- Nelfinavir
- Niacin, Niacinamide
- Niacin; Simvastatin
- Nicotine
- Norepinephrine
- Norethindrone
- Norgestrel
- Octreotide
- Ombitasvir; Paritaprevir; Ritonavir
- Orlistat
- Oxandrolone
- Oxymetholone
- Pasireotide
- Pegvisomant
- Pemoline
- Penbutolol
- Pentamidine
- Pentoxifylline
- Perphenazine
- Perphenazine; Amitriptyline
- Phendimetrazine
- Phenothiazines
- Phentermine
- Phentermine; Topiramate
- Phenylephrine
- Phenylephrine; Promethazine
- Pindolol
- Prasterone, Dehydroepiandrosterone, DHEA (Dietary Supplements)
- Prasterone, Dehydroepiandrosterone, DHEA (FDA-approved)
- Prilocaine; Epinephrine
- Prochlorperazine
- Progesterone
- Progestins
- Promethazine
- Propoxyphene
- Propranolol
- Protease inhibitors
- Pseudoephedrine
- Pyrimethamine; Sulfadoxine
- Quinolones
- Racepinephrine
- Reserpine
- Rifampin
- Rifapentine
- Ritodrine
- Ritonavir
- Rucaparib
- Salicylates
- Saquinavir
- Segesterone Acetate; Ethinyl Estradiol
- Sofosbuvir
- Sofosbuvir; Velpatasvir
- Sofosbuvir; Velpatasvir; Voxilaprevir
- Somatropin, rh-GH
- Sotalol
- St. John’s Wort, Hypericum perforatum
- Sulfadiazine
- Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
- Sulfasalazine
- Sulfinpyrazone
- Sulfisoxazole
- Sulfonamides
- Sympathomimetics
- Tacrolimus
- Tegaserod
- Teriflunomide
- Testolactone
- Testosterone
- Tezacaftor; Ivacaftor
- Thiazide diuretics
- Thiethylperazine
- Thioridazine
- Thyroid hormones
- Timolol
- Tipranavir
- tobacco
- Tolvaptan
- Toremifene
- Trifluoperazine
- Vemurafenib
- Vigabatrin
- Voriconazole
- Zafirlukast
