Nateglinide belongs to the group of medications known as oral hypoglycemics or oral antidiabetic agents. Nateglinide is used to control blood glucose for people with type 2 diabetes.

In combination with exercise and a healthy diet, nateglinide works to control blood glucose by increasing the amount of insulin released from the pancreas. It is used when diet, exercise, and weight reduction have not been found to control blood glucose well enough on their own. Nateglinide can be used on its own or in combination with another antidiabetic medication, metformin.

Your doctor may have suggested this medication for conditions other than the ones listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

The usual dose of nateglinide is 120 mg, taken before meals. It is usually taken immediately before each meal, but may be taken up to 30 minutes before each meal. The dosage may be adjusted depending on your response to the medication and whether you reach your target blood sugar levels.

If a meal is skipped, the dose usually taken with that meal should not be taken.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

It is important to use this medication exactly as prescribed by the doctor. If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not take this mediction if you:

• are allergic to nateglinide or to any of the ingredients of the medication
• are pregnant
• have diabetic ketoacidosis
• have type 1 diabetes

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• abdominal or stomach pain
• back pain
• chills
• cough
• dizziness
• heartburn
• pain in the joints or muscles
• runny or stuffy nose
• sneezing
• sore throat
• swelling in the joints

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• symptoms of low blood glucose, including:

anxious feelings behaviour changes similar to being drunk blurred vision cold sweats confusion cool, pale skin difficulty thinking drowsiness excessive hunger

fast heartbeat headache nausea nervousness nightmares restless sleep shakiness slurred speech unusual tiredness or weakness

Stop taking the medication and seek immediate medical attention if any of the following occur:

• convulsions (seizures)
• signs of a severe allergic reaction (e.g., difficulty breathing, hives, swelling of the face or throat)
• unconsciousness

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Liver disease: If you have moderate-to-severe liver disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Low blood glucose: This medication may cause low blood glucose (hypoglycemia). Certain people are more sensitive to this effect, including seniors, people who are undernourished, and people who have exercised more strenuously than usual. If you are taking other diabetes medications, have consumed alcohol, or have other medical conditions that cause low blood glucose (e.g., an underactive pituitary or adrenal gland, or kidney problems), you may need to check your blood glucose levels more frequently. Consult your doctor for advice about whether any special monitoring is necessary.

Pregnancy: This medication should not be used during pregnancy. If you think you may be pregnant or if you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if nateglinide passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children.

There may be an interaction between nateglinide and any of the following:

• beta-adrenergic blockers (e.g., nadolol, propranolol, timolol)
• corticosteroids (e.g., prednisone)
• monoamine oxidase (MAO) inhibitors (e.g., tranylcypromine, phenelzine)
• nonsteroidal anti-inflammatories (NSAIDS; e.g., naproxen, ibuprofen)
• other diabetes medications (e.g., glyburide, metformin)
• salicylates (e.g., ASA)
• sympathomimetics (e.g., epinephrine, pseudoephedrine)
• thiazide diuretics (e.g., hydrochlorothiazide)
• thyroid medications (e.g., levothyroxine)

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.