Nateglinide is an add-on medication to diet and exercise to control blood sugar in people with Type 2 diabetes. This medication comes as a tablet that's taken by mouth. It must be taken three times a day, which might be inconvenient for some people.
Type 2 diabetes
Nateglinide belongs to the meglitinide class of medications. It works by making your pancreas release more insulin into your body. Insulin is a hormone that helps your body use sugar for energy and store any extra sugar for later use. This keeps your blood sugar from getting too high.
Source: DailyMed
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Less common
Convulsions (seizures)
unconsciousness
Check with your doctor as soon as possible if any of the following side effects occur:
Less common
Low blood sugar, including anxious feeling, behavior change similar to being drunk, blurred vision, cold sweats, confusion, cool pale skin, difficulty in thinking, drowsiness, excessive hunger, fast heartbeat, headache, nausea, nervousness, nightmares, restless sleep, shakiness, slurred speech, or unusual tiredness or weakness
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Helps release insulin into the body within 20 minutes of taking
Good option if you can't take metformin because of side effects or poor kidney function
Lower-cost generic available
Need to take 1 to 30 minutes before each meal
Must take 3 times a day, which can be inconvenient
Might be more likely to cause weight gain than other diabetes medications
Not for people with Type 1 diabetes
It's important to take nateglinide 1 to 30 minutes before meals. If you skip a meal, skip your dose. Don't take two doses at the same time for any reason. Taking nateglinide without eating a meal or taking two doses at the same time can lead to low blood sugar.
Keep a consistent diet and exercise schedule to avoid low blood sugar while you're taking nateglinide. Having a healthy diet and exercise plan will also help you get the most out of this medication.
Sometimes, nateglinide can cause your blood sugar to get too low. Symptoms of low blood sugar include feeling shaky, nervous, anxious, confused, sleepy, weak, or very hungry and having a fast heartbeat, sweating, or body chills. If you experience these symptoms, test your blood sugar right away.
If your blood sugar ever becomes too low (between 50 mg/dL and 70 mg/dL), it's important that you know how to get your sugars back up quickly. Eat 15 grams of fast-acting sugar to bring your blood sugar back above 70 mg/dL. Some examples of fast-acting sugar include: 4 glucose (sugar) tablets, 3 to 4 pieces of hard candy, one-half cup of fruit juice, or one-half can of regular soda. Then, wait 15 minutes and recheck your blood sugar. If it's still low, repeat these steps and call 911.
Don't drive if your blood sugar gets low. Since you might feel dizzy, shaky, and confused, there might be a greater chance of getting into an accident.
Discuss the risks and benefits of taking nateglinide if you become pregnant. There isn't enough information to know if the medication is safe to take during pregnancy.
Because of the risk of low blood sugar in nursing babies, nateglinide isn't recommended if you're breastfeeding. Talk with your provider about safer alternatives.
Nateglinide can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: Changes in meal pattern | Drinking alcohol | Changes in how much exercise you do | Taking other medications that lower blood sugar | Poor liver or kidney function
Nateglinide can cause low blood sugar, which can be life-threatening. It's important to eat a meal before taking your dose to avoid low blood sugar. Some signs of low blood sugar include dizziness, headache, feeling sleepy or weak, shaking, fast heartbeat, confusion, or sweating. Check your blood sugar and call your provider right away if you have any of these signs. Make sure to take a few glucose tablets, drink some juice or soda, or eat a couple hard candies to bring your blood sugar up quickly. Talk to your provider or pharmacist if you have questions about the risk of having low blood sugar and how to recognize and treat it.
The typical dose is 120 mg by mouth three times a day before meals.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
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ElSayed, N. E., et al. (2022). Pharmacologic approaches to glycemic treatment: Standards of care in diabetes—2023. Diabetes Care.
InformedHealth.org. (2020). Medication for type 2 diabetes. Institute for Quality and Efficiency in Health Care (IQWiG).
Sherifali, D., et al. (2010). The effect of oral antidiabetic agents on A1C levels: A systematic review and meta-analysis. Diabetes Care.
Cadila Pharmaceuticals Limited. (2022). NATEGLINIDE tablet, coated [package insert]. DailyMed.
You and Your Hormones. (2021). Insulin.
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