Nateglinide oral (patient information)

# Why is this medication prescribed
Nateglinide is used alone or in combination with other medications to treat type 2 diabetes (condition in which the body does not use insulin normally and therefore cannot control the amount of sugar in the blood) in people whose diabetes cannot be controlled by diet and exercise alone. Nateglinide belongs to a class of drugs called meglitinides. Nateglinide helps your body regulate the amount of glucose (sugar) in your blood. It decreases the amount of glucose by stimulating the pancreas to release insulin.

# How should this medicine be used
Nateglinide comes as a tablet to take by mouth. It is usually taken three times daily. Take nateglinide any time from 30 minutes before a meal to just before the meal. If you skip a meal, you need to skip the dose of nateglinide. If you add a meal, add a dose of nateglinide. Your doctor may gradually increase your dose, depending on your response to nateglinide. Monitor your blood glucose closely. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take nateglinide exactly as directed. Do not take more or less of it or take it more often than directed by the package label or prescribed by your doctor.
Nateglinide controls diabetes but does not cure it. Continue to take nateglinide even if you feel well. Do not stop taking nateglinide without talking with your doctor.

# Other uses for this medicine
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

# What special precautions should I follow
Before taking nateglinide
- tell your doctor and pharmacist if you are allergic to nateglinide or any other drugs.
- tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially albuterol (Proventil, Ventolin); allergy or cold medications; aspirin and nonsteroidal anti-inflammatory drugs such as ibuprofen (Advil, Motrin) or naproxen (Aleve, Naprosyn); beta-blockers such as propranolol (Inderal); chloramphenicol (Chloromycetin); chlorpromazine (Thorazine); corticosteroids such as dexamethasone (Decadron), methylprednisolone (Medrol), or prednisone (Deltasone, Orasone); diuretics ('water pills'); epinephrine; estrogens; fluphenazine (Prolixin); isoniazid (Rifamate); medications that contain alcohol or sugar; mesoridazine (Serentil); niacin; oral contraceptives (birth control pills); perphenazine (Trilafon); phenelzine (Nardil); probenecid (Benemid); prochlorperazine (Compazine); promazine (Sparine); promethazine (Phenergan); terbutaline (Brethine, Bricanyl); thioridazine (Mellaril); thyroid medication; tranylcypromine (Parnate); trifluoperazine (Stelazine); triflupromazine (Vesprin); trimeprazine (Temaril); and vitamins or herbal products.
- tell your doctor if you have or have ever had liver or pituitary disease, adrenal insufficiency, diabetic ketoacidosis, neuropathy (disease of the nervous system), or if you have been told you have type 1 diabetes mellitus (condition in which the body does not produce insulin and therefore cannot control the amount of sugar in the blood).
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking nateglinide, call your doctor.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking nateglinide.
tell your doctor if you have fever, infection, injury, or illness with vomiting or diarrhea. These may affect your blood sugar level.

# What special dietary instructions should I follow
Be sure to follow all exercise and dietary recommendations made by your doctor or dietitian. Calorie reduction, weight loss, and exercise will help control your diabetes and will also make nateglinide work better. It is important to eat a healthful diet. Alcohol may cause a decrease in blood sugar. Ask your doctor about the safe use of alcoholic beverages while you are taking nateglinide..

# What should I do if I forget a dose
Before you start taking nateglinide, ask your doctor what to do if you forget to take a dose. Write these directions down so you can refer to them later. As a general rule, if you have just begun to eat a meal, take the missed dose as soon as you remember it. However, if you have finished eating, or if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

# Side effects
This medication may cause changes in your blood sugar. You should know the symptoms of low and high blood sugar and what to do if you have these symptoms.
You may experience hypoglycemia (low blood sugar) while you are taking this medication. Your doctor will tell you what you should do if you develop hypoglycemia. He or she may tell you to check your blood sugar, eat or drink a food or beverage that contains sugar, such as hard candy or fruit juice, or get medical care. Follow these directions carefully if you have any of the following symptoms of hypoglycemia:
- shakiness
- dizziness or lightheadedness
- sweating
- nervousness or irritability
- sudden changes in behavior or mood
- headache
- numbness or tingling around the mouth
- weakness
- pale skin
- hunger
- clumsy or jerky movements
If hypoglycemia is not treated, severe symptoms may develop. Be sure that your family, friends, and other people who spend time with you know that if you have any of the following symptoms, they should get medical treatment for you immediately.
- confusion
- seizures
- loss of consciousness
Call your doctor immediately if you have any of the following symptoms of hyperglycemia (high blood sugar):
- extreme thirst
- frequent urination
- extreme hunger
- weakness
- blurred vision
If high blood sugar is not treated, a serious, life-threatening condition called diabetic ketoacidosis could develop. Call your doctor immediately if you have any of the these symptoms:
- dry mouth
- upset stomach and vomiting
- shortness of breath
- breath that smells fruity
- decreased consciousness
Nateglinide may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- headache
- nasal congestion
- runny nose
- joint aches
- back pain
- constipation
- cough
- flu-like symptoms

# What storage conditions are needed for this medicine
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

# In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

# What other information should I know
Keep all appointments with your doctor and the laboratory. Your blood sugar and glycosylated hemoglobin (HbA1c) should be checked regularly to determine your response to nateglinide. Your doctor will also tell you how to check your response to this medication by measuring your blood or urine sugar levels at home. Follow these instructions carefully.
Keep yourself and your clothes clean. Wash cuts, scrapes, and other wounds quickly, and do not let them get infected.
You should always wear a diabetic identification bracelet to be sure you get proper treatment in an emergency.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

# Brand names
- Starlix