Nateglinide

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Generic Name of Nateglinide - Learn More

Nateglinide

Nateglinide Precaution - What You Need to Know

Before using Nateglinide, it is important to consult a healthcare provider, especially if any of the following conditions apply:

- Hypoglycemia risk: Nateglinide is a rapid-acting oral antidiabetic medication that stimulates insulin secretion. It can cause hypoglycemia (low blood sugar), especially when taken with meals that are delayed or skipped, or in conjunction with other antidiabetic agents such as sulfonylureas or insulin. Patients should closely monitor their blood sugar levels to avoid dangerously low glucose levels.

- Renal impairment: Caution is required when using Nateglinide in patients with renal dysfunction. Although Nateglinide is metabolized in the liver, it is cleared from the body through the kidneys. Dosage adjustments may be necessary in patients with mild to moderate renal impairment, and it should be used cautiously in severe renal insufficiency.

- Pregnancy and breastfeeding: Nateglinide should be used with caution during pregnancy (category C), and the risks and benefits must be weighed. It is not known if Nateglinide is excreted in breast milk, so patients who are breastfeeding should consult their healthcare provider before use.

- Liver impairment: Although Nateglinide is primarily metabolized by the liver, caution should be exercised in patients with liver disease. Liver function should be monitored, and adjustments to the medication regimen might be necessary depending on the severity of liver impairment.

- Alcohol: Alcohol consumption can increase the risk of hypoglycemia and should be monitored closely while on Nateglinide.

Nateglinide Indication - Uses and Benefits

Nateglinide is indicated for the management of type 2 diabetes mellitus (non-insulin-dependent diabetes) in combination with diet and exercise. It helps control blood sugar levels by:

- Postprandial hyperglycemia: Nateglinide is particularly effective at controlling postprandial (after-meal) blood glucose spikes. It works by stimulating the pancreas to release insulin in response to meals.

- Adjunct to diet and exercise: It is prescribed as part of a comprehensive treatment plan that includes proper diet and physical activity.

- Monotherapy or combination therapy: Nateglinide may be used alone or in combination with other antidiabetic medications such as metformin, thiazolidinediones, or insulin when blood sugar is not adequately controlled by diet and exercise alone.

Nateglinide Contraindications - Important Warnings

Nateglinide is contraindicated in the following situations:

- Hypersensitivity: It should not be used by individuals who have shown a hypersensitivity or allergic reaction to Nateglinide or any of its components. Signs of an allergic reaction may include rash, swelling, or difficulty breathing.

- Type 1 diabetes mellitus: Nateglinide is not indicated for the treatment of type 1 diabetes, as it is ineffective in patients who do not produce insulin at all.

- Diabetic ketoacidosis: Nateglinide should not be used in patients with diabetic ketoacidosis (DKA), a serious complication of diabetes, as it will not address the underlying metabolic derangements associated with DKA.

- Severe renal impairment: It should not be used in patients with severe renal dysfunction (e.g., eGFR < 30 mL/min/1.73m²) due to the risk of accumulation and increased risk of adverse effects.

Nateglinide Side Effects - What to Expect

Common side effects of Nateglinide include:

- Hypoglycemia: The most common side effect is low blood sugar, especially when meals are delayed or skipped, or if the patient engages in excessive physical activity. Symptoms of hypoglycemia may include shakiness, sweating, confusion, and dizziness.

- Headache: Some patients may experience headaches, which can be mild to moderate in intensity.

- Nausea: Nausea and mild gastrointestinal upset may occur, especially when starting the medication.

- Weight gain: Although less common, some patients may experience weight gain with long-term use of Nateglinide.

- Upper respiratory symptoms: In rare cases, patients may experience nasal congestion, sore throat, or other upper respiratory symptoms.

Severe side effects include:

- Severe hypoglycemia: Severe or prolonged hypoglycemia can result in seizures, unconsciousness, and death. Immediate medical treatment is necessary if severe hypoglycemia occurs.

- Allergic reactions: Severe allergic reactions (e.g., anaphylaxis) can occur, with symptoms such as swelling, difficulty breathing, or a rash. If these occur, seek immediate medical attention.

- Liver dysfunction: Though rare, there have been reports of liver enzyme elevation or hepatitis. Monitoring of liver function is recommended, especially for long-term use.

Nateglinide Pregnancy Category ID - Safety Information

3

Nateglinide Mode of Action - How It Works

Nateglinide is a meglitinide-class oral antidiabetic drug that works by stimulating the pancreas to release insulin in response to meals.

- Insulin secretion: Nateglinide binds to specific sites on the ATP-sensitive potassium channels in pancreatic beta cells, leading to the opening of calcium channels, which in turn stimulates the release of insulin.

- Postprandial glucose control: Nateglinide specifically targets postprandial hyperglycemia (high blood sugar after eating) by enhancing insulin release during meals, which helps lower blood sugar levels and improve glucose control in patients with type 2 diabetes.

- Rapid onset and short duration: Nateglinide has a rapid onset of action (about 30 minutes after ingestion) and a short duration of action, making it particularly effective for controlling the post-meal spikes in blood sugar.

Nateglinide Drug Interactions - What to Avoid

Nateglinide may interact with several medications, which could affect its efficacy or lead to adverse effects. Notable interactions include:

- Insulin: When used with insulin or other sulfonylureas, the risk of hypoglycemia (low blood sugar) increases. Patients should be monitored closely for signs of hypoglycemia, and dosages of insulin or sulfonylureas may need to be adjusted.

- CYP3A4 inhibitors and inducers: Nateglinide is metabolized by the CYP3A4 enzyme. Drugs that inhibit CYP3A4 (e.g., ketoconazole, itraconazole) may increase Nateglinide levels, raising the risk of side effects such as hypoglycemia. Conversely, CYP3A4 inducers (e.g., rifampin, carbamazepine) may reduce Nateglinide's effectiveness by decreasing its levels.

- Beta-blockers: Beta-blockers, such as propranolol, can mask the symptoms of hypoglycemia (e.g., tachycardia, tremors), which may delay the detection of low blood sugar. Caution is required when these medications are used in combination with Nateglinide.

- Alcohol: Alcohol can enhance the blood sugar-lowering effects of Nateglinide and increase the risk of hypoglycemia. Patients should be advised to limit or avoid alcohol consumption.

- Other antidiabetic agents: Nateglinide can interact with other oral antidiabetic medications (e.g., metformin, thiazolidinediones). The combination can help better control blood glucose but may increase the risk of hypoglycemia and require closer monitoring of blood sugar levels.

Nateglinide Adult Dose - Recommended Dosage

The recommended adult dose for Nateglinide is:

- 90 mg taken orally 3 times a day before each main meal (e.g., breakfast, lunch, and dinner).
- The dose should be taken within 30 minutes before meals. Adjustments to the dose can be made based on the patient's blood glucose levels and individual needs.

- The maximum recommended dose is 120 mg three times a day, depending on the patient's response and tolerability.

Patients should be monitored closely for signs of hypoglycemia, particularly after meals.

Nateglinide Child Dose - Dosage for Children

Nateglinide is not approved for use in children under the age of 18 years for the treatment of type 2 diabetes. Safety and efficacy in pediatric populations have not been established.

Patients under 18 years should consult with their healthcare provider for appropriate treatment options.

As always, it is essential to consult with a healthcare provider before starting any new medication, including Nateglinide, to ensure it is suitable for the individual's health needs and to address any potential risks or concerns.

Nateglinide Renal Dose - Dosage for Kidney Conditions

For patients with mild to moderate renal impairment (eGFR 30-60 mL/min/1.73 m²), the starting dose may be 60 mg before each meal, as clearance of Nateglinide is reduced in such patients. Severe renal impairment (eGFR < 30 mL/min/1.73 m²) is a contraindication for using Nateglinide, as its metabolism and elimination may be significantly altered.

Close monitoring of blood glucose and renal function is recommended in patients with renal impairment.