nateglinide at a glance
Medicine class
Rapid, short-acting oral insulin secretagogue
Licensed role
Added to metformin for inadequately controlled type 2 diabetes
Administration
Taken shortly before a main meal and omitted when that meal is skipped
Key risk
Low blood glucose, especially with additional risk factors
What is nateglinide used for?
The selected UK product is licensed only as combination therapy.
Type 2 diabetes in adults whose blood glucose remains inadequately controlled despite the maximum tolerated metformin treatment.
It is not licensed as nateglinide monotherapy in the selected product information.
How does nateglinide work?
Nateglinide closes ATP-sensitive potassium channels in functioning pancreatic beta cells. This opens calcium channels and triggers a rapid, glucose-sensitive release of insulin around meals, helping reduce the rise in blood glucose after eating.
How to take nateglinide
Follow the directions on the prescription label. Timing in relation to food is important because taking nateglinide during or after a meal may delay its effect.
Take it shortly before a main meal.
Do not take it when you are not going to eat that meal.
Swallow the film-coated tablet whole with water.
Continue the agreed diet and physical-activity plan.
nateglinide side effects
Common or expected effects
- Symptoms of low blood glucose, including sweating, shaking, dizziness, hunger, weakness, tiredness, palpitations or nausea
- Abdominal pain
- Diarrhoea
- Indigestion
- Nausea
Get urgent medical advice
- Severe hypoglycaemia causing confusion, seizure or loss of consciousness
- Allergic reaction with swelling or breathing difficulty
- Blistering rash affecting the lips, eyes or mouth
nateglinide in pregnancy
Nateglinide is contraindicated during pregnancy because human experience is lacking and animal studies identified developmental toxicity. Anyone planning pregnancy or who becomes pregnant while taking it should contact their diabetes team promptly so treatment can be reviewed; UK pregnancy information advises that diabetes medicines often need changing during pregnancy.
nateglinide while breastfeeding
The selected product information contraindicates nateglinide while breastfeeding because transfer into human milk is unknown and infant hypoglycaemia is possible. UK specialist guidance notes limited or absent breastfeeding evidence for most other glucose-lowering tablets and prefers insulin or metformin where clinically appropriate; treatment should be reviewed with a prescriber.
nateglinide interactions
Starting or stopping medicines that alter glucose control may require closer blood-glucose monitoring.
ACE inhibitors, NSAIDs, salicylates, monoamine oxidase inhibitors and anabolic hormones
May strengthen nateglinide's glucose-lowering effect and increase hypoglycaemia risk.
Non-selective beta blockers
May increase the glucose-lowering effect and make warning symptoms of hypoglycaemia harder to recognise.
Fluconazole, gemfibrozil and sulfinpyrazone
CYP2C9 inhibition may prolong nateglinide's effect and increase hypoglycaemia risk.
Common questions about nateglinide
Answers are fully visible for fast scanning and source review.
Why is nateglinide prescribed with metformin?
Its licensed role is to add rapid meal-related insulin release when metformin alone has not controlled type 2 diabetes adequately.
Is nateglinide a form of insulin?
No. It is a tablet that stimulates functioning pancreatic beta cells to release the body's own insulin.
What should I do with nateglinide if I skip a meal?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.