Nateglinide
STARLIX
Pronunciation: na-TAY-gli-nide
What it isMeglitinide that closes beta-cell KATP channels; mealtime control in type 2 diabetes.
Why this oneIts rapid, brief action targets postprandial glucose more tightly than a sulfonylurea.
What limits itHypoglycemia follows a dose without a meal, and glucose lowering is weaker than with a sulfonylurea.
FDA-approved for
- type 2 diabetes (2000)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Type 2 diabetes mellitus | Adults | 120 mg TID before meals (60 mg TID if near glycemic goal at initiation) | 120 mg TID | 120 mg TID |
Renal No adjustment recommended (mild to severe impairment)
Hepatic No adjustment in mild impairment; use with caution in moderate-severe (not studied)
Skip the scheduled dose if a meal is skipped
Instructions
- Take 1 to 30 minutes before meals
- If a meal is skipped, skip that dose to reduce hypoglycemia risk
Available strengths
- tab 60, 120 mg
Cautions
- Hypoglycemia (can be severe/life-threatening; higher risk with renal/hepatic impairment, beta-blockers, other antidiabetics)
- No conclusive evidence of macrovascular risk reduction
Adverse reactions
- Upper respiratory infection
- Back pain
- Flu symptoms
- Dizziness
- Arthropathy
- Diarrhea
- Weight gain
- Hypoglycemia
Pregnancy Data insufficient; use only if potential benefit justifies risk to fetus
Lactation Not recommended while breastfeeding (hypoglycemia risk in infant)
Cost
Generic entry2009
NO BOXED WARNINGS
Principal riskHypoglycemia; weaker than a sulfonylurea
Classes and tags
Clinical profile
Legacy pregnancy categoryMultiple / indication-, trimester- or formulation-dependent
Defining liabilityAgent-specific hypoglycemia, ketoacidosis, volume, renal or gastrointestinal toxicity.