Nopik

Indications

Nateglinide is used, together with diet and exercise, to control blood sugar in adults with type 2 diabetes. It is especially useful for controlling the rise in blood sugar after meals. It may be used alone or with Metformin when one medicine is not enough.

How It Works

Nateglinide belongs to the meglitinide group. It acts quickly on the insulin-making beta cells of the pancreas, closing potassium channels so that the cells release a short burst of insulin. Because it works fast and for a short time, it is taken just before meals to match the rise in blood sugar from food.

Dosage and Administration

The usual adult dose is 120 mg three times a day, taken 1 to 30 minutes before each main meal. A dose of 60 mg three times a day may be used in people whose blood sugar is close to target. If you skip a meal, skip that dose; if you add a meal, ask your doctor. Follow your doctor's instructions and check your blood sugar as advised.

Interactions

• Medicines that may increase the sugar-lowering effect (risk of low blood sugar): other diabetes medicines, Fluconazole, Gemfibrozil, NSAIDs, salicylates, MAO inhibitors and non-selective beta blockers.
• Medicines that may reduce its effect: corticosteroids, thiazide diuretics, thyroid hormones and sympathomimetics.
• Beta blockers can hide warning signs of low blood sugar.
• Alcohol can increase the risk of low blood sugar.

Contraindications

• Type 1 diabetes or diabetic ketoacidosis.
• Allergy to nateglinide.
• Severe liver disease.

Side Effects

The main side effect is low blood sugar (hypoglycaemia), with shakiness, sweating, hunger, fast heartbeat, dizziness or confusion. Others include cold-like symptoms, back pain, joint pain, diarrhoea and weight gain.

Get urgent medical help if low blood sugar does not improve after taking sugar, or if there is fainting, seizures, severe confusion, or swelling of the face or throat with difficulty breathing.

Pregnancy and Lactation

Nateglinide is not recommended in pregnancy; insulin is usually used to control diabetes in pregnancy. It is not recommended while breastfeeding.

Precautions and Warnings

• Carry a source of sugar (glucose tablets, sugar or juice) to treat low blood sugar quickly.
• Older or underweight people, and those with adrenal, pituitary, liver or kidney problems, are more prone to low blood sugar.
• Illness, infection, surgery or stress may upset blood sugar control; your doctor may switch you to insulin for a time.
• Take care when driving if you are at risk of low blood sugar.

Overdose

Overdose can cause severe low blood sugar. Mild cases are treated with sugar by mouth; if the person is drowsy, confused or unconscious, call emergency services at once. Do not give food or drink to an unconscious person.

Therapeutic Class

Oral antidiabetic; meglitinide (insulin secretagogue).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.