Take nateglinide 1-30 minutes before each of your three main meals.
The most common side-effects are feeling shaky, feeling hungry, palpitations, feeling dizzy (hypoglycaemia) and stomach upset (nausea, diarrhoea, indigestion).
Remember to follow any advice you have been given about your diet.
|Type of medicine||An antidiabetic medicine|
|Used for||Type 2 diabetes mellitus|
Insulin is a hormone which is made naturally in your body, in the pancreas. It helps to control the levels of sugar (glucose) in your blood. If your body does not make enough insulin, or if it does not use the insulin it makes effectively, this results in the condition called sugar diabetes (diabetes mellitus).
People with diabetes need treatment to control the amount of glucose in their blood. This is because good control of blood sugar levels reduces the risk of complications later on. Some people can control the sugar in their blood by making changes to the food they eat but, for other people, medicines like nateglinide are given alongside the changes in diet.
Nateglinide lowers blood sugar by encouraging your pancreas to produce more insulin. It starts to work quickly so it is particularly helpful in controlling blood sugar levels straight after a meal. Nateglinide will be prescribed for you alongside another antidiabetic medicine called metformin.
Before taking nateglinide
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking nateglinide it is important that your doctor knows:
- If you are under 18 or over 75 years of age.
- If you are pregnant, trying for a baby or breast-feeding.
- If you have any problems with the way your liver works.
- If you have a severe illness or infection.
- If you have ever had an allergic reaction to a medicine.
- If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
How to take nateglinide
- Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about nateglinide tablets and will provide you with a full list of the side-effects which you may experience from taking them.
- Take nateglinide exactly as your doctor tells you to. The dose is one tablet three times daily, before your main meals (usually breakfast, lunch and dinner). It is best to take the tablet immediately before you eat your meal, but it can be taken up to 30 minutes before a meal. If you miss a meal, do not take a tablet.
- There are three strengths of tablet - 60 mg, 120 mg, 180 mg. You will be prescribed the lower-strength tablet to begin with. If it becomes necessary, your doctor may later increase the strength of the tablet you are prescribed.
- Swallow the tablet with a drink of water. Do not break or crush the tablets.
- If you forget to take a dose, do not worry, just take your next dose at the next mealtime. Do not take two doses together to make up for a forgotten dose, and do not take the tablets between meals.
Getting the most from your treatment
- It is important that you keep your regular doctor's and clinic appointments. This is so your progress can be monitored. You will need regular check-ups with an eye clinic and a foot clinic as well as with your doctor and diabetes clinic.
- Your doctor may recommend that you test for sugar (glucose) in your blood or urine regularly to check that your diabetes is being controlled. Your doctor or diabetes nurse will show you how to do this.
- Drinking alcohol is not recommended with nateglinide as it can affect the control of your blood sugar.
- If you are a driver you should take special care, as your ability to concentrate may be affected if your diabetes is not well-controlled. You may be advised to check your blood sugar levels before you travel and to have a snack with you on long journeys.
- If you have been given advice by your doctor about changes to your diet, stopping smoking or taking regular exercise, it is important for you to follow the advice you have been given.
- Check with your doctor before taking up any new physical exercise, as this will have an effect on your blood sugar levels and you may need to check your blood or urine levels more regularly.
- Make sure you know what it feels like if your blood sugar is low. This is known as hypoglycaemia, or a 'hypo'. The first signs of hypoglycaemia are feeling shaky or anxious, sweating, looking pale, feeling hungry, having a feeling that your heart is pounding (palpitations), and feeling dizzy.
- If you are due to have an operation or dental treatment, you should tell the person carrying out the treatment that you have diabetes and that you are taking nateglinide. This is because if you are not able to eat for a time, you will be advised to skip your doses until you are eating normally again.
- If you get unusually thirsty, pass urine more frequently, and feel very tired, you should let your doctor know. These are signs that there is too much sugar in your blood and your treatment may need adjusting.
- Treatment for diabetes is usually lifelong. Continue to take the tablets unless you are advised otherwise by your doctor.
Can nateglinide cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with nateglinide. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Common nateglinide side-effects (these affect less than 1 in 10 people)||What can I do if I experience this?|
|Symptoms of hypoglycaemia: feeling shaky or anxious, sweating, looking pale, feeling hungry, having a feeling of a pounding heart (palpitations), feeling dizzy||Eat something containing sugar, such as a biscuit or a sugary drink (not diet), and follow this up with a snack such as a sandwich. Do not drive or use tools or machines until you feel better. Tell your doctor if you notice these symptoms frequently|
|Diarrhoea, tummy (abdominal) pain, indigestion, feeling sick||Let your doctor know if any of these become severe or troublesome|
If you experience any other symptoms which you think may be due to the tablets, speak with your doctor or pharmacist for further advice.
How to store nateglinide
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
|If you buy any medicines, always check with a pharmacist that they are safe to take with your other medicines.|
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading & references
- Manufacturer's PIL, Starlix® 60 mg, 120 mg, 180 mg film-coated tablets; Manufacturer's PIL, Novartis Pharmaceuticals UK Ltd, The electronic Medicines Compendium. Dated November 2013.
- British National Formulary; 67th Edition (March 2014) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
Prof Cathy Jackson