nateglinide (oral)

What is the most important information I should know about nateglinide?

Do not use this medication if you are allergic to nateglinide, if you have type 1 diabetes, or if you are in a state of diabetic ketoacidosis (call your doctor for treatment with insulin).

Take care not to let your blood sugar get too low. Low blood sugar (hypoglycemia) can occur if you skip a meal, exercise too long, drink alcohol, or are under stress. Symptoms include headache, hunger, weakness, sweating, tremors, irritability, or trouble concentrating. Carry hard candy or glucose tablets with you in case you have low blood sugar. Other sugar sources include orange juice and milk. Be sure your family and close friends know how to help you in an emergency.

Nateglinide is only part of a complete program of treatment that also includes diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely. Changing any of these factors can affect your blood sugar levels.

What is nateglinide?

Nateglinide is an oral diabetes medicine that helps control blood sugar levels. This medication helps your body respond better to insulin produced by your pancreas.

Nateglinide is used together with diet and exercise to treat type 2 diabetes. Other diabetes medicines are sometimes used in combination with nateglinide if needed.

Nateglinide may also be used for purposes not listed in this medication guide.

What should I discuss with my doctor before taking nateglinide?

Do not use this medication if you are allergic to nateglinide, if you have type 1 diabetes, or if you are in a state of diabetic ketoacidosis (call your doctor for treatment with insulin).

To make sure you can safely take nateglinide, tell your doctor if you have liver disease or gout.

FDA pregnancy category C. It is not known whether nateglinide will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

It is not known whether nateglinide passes into breast milk or if it could be harmful to a nursing baby. You should not breast-feed while you are taking nateglinide.

How should I take nateglinide?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Nateglinide is usually taken 3 times daily, within 30 minutes before eating a meal. Follow your doctor's instructions. If you skip a meal, do not take your dose of nateglinide. Wait until your next meal.

Your blood sugar will need to be checked often, and you may need other blood tests at your doctor's office. Visit your doctor regularly.

Know the signs of low blood sugar (hypoglycemia) and how to recognize them: headache, hunger, weakness, sweating, tremor, irritability, or trouble concentrating.

Always keep a source of sugar available in case you have symptoms of low blood sugar. Sugar sources include orange juice, glucose gel, candy, or milk. If you have severe hypoglycemia and cannot eat or drink, use an injection of glucagon. Your doctor can give you a prescription for a glucagon emergency injection kit and tell you how to give the injection.

Check your blood sugar carefully during a time of stress or illness, if you travel, exercise more than usual, drink alcohol, or skip meals. These things can affect your glucose levels and your dose needs may also change.

Your doctor may want you to stop taking nateglinide for a short time if you become ill, have a fever or infection, or if you have surgery or a medical emergency.

Ask your doctor how to adjust your nateglinide dose if needed. Do not change your medication dose or schedule without your doctor's advice.

Nateglinide is only part of a complete program of treatment that also includes diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely. Changing any of these factors can affect your blood sugar levels.

Use nateglinide regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember, but only if you are getting ready to eat a meal. . Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

You may have symptoms of severe hypoglycemia such as extreme weakness, blurred vision, sweating, trouble speaking, tremors, stomach pain, confusion, and seizure (convulsions).

What should I avoid while taking nateglinide?

Avoid drinking alcohol. It lowers blood sugar and may interfere with your diabetes treatment.

What are the possible side effects of nateglinide?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect such as:

• seizure (convulsions); or
• jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

• runny or stuffy nose, sneezing, cough, cold or flu symptoms;
• diarrhea, nausea;
• back pain;
• dizziness; or
• joint pain or stiffness.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect nateglinide?

Using a beta-blocker can make it harder for you to tell when you have low blood sugar. Tell your doctor if you take atenolol (Tenormin, Tenoretic), carvedilol (Coreg), labetalol (Normodyne, Trandate), metoprolol (Lopressor, Toprol), nadolol (Corgard), propranolol (Inderal, InnoPran), sotalol (Betapace), and others;

You may be more likely to have hyperglycemia (high blood sugar) if you take nateglinide with other drugs that can raise blood sugar, such as:

• isoniazid;
• somatropin (Genotropin, Humatrope, Norditropin, Nutropin, Omnitrope, Saizen, Serostim, Zorbtive, and others);
• diuretics (water pills);
• steroids (prednisone and others);
• heart or blood pressure medication (Cartia, Cardizem, Covera, Isoptin, Verelan, and others);
• niacin (Advicor, Niaspan, Niacor, Simcor, Slo-Niacin, and others);
• phenothiazines (Compazine and others);
• thyroid medicine (Synthroid and others);
• birth control pills and other hormones;
• seizure medicines (Dilantin and others); and
• diet pills or medicines to treat asthma, colds or allergies.

You may be more likely to have hypoglycemia (low blood sugar) if you take nateglinide with other drugs that can lower blood sugar, such as:

• probenecid (Benemid);
• some nonsteroidal anti-inflammatory drugs (NSAIDs);
• aspirin or other salicylates (including Pepto-Bismol);
• antifungal medication such as fluconazole (Diflucan), miconazole (Oravig), or voriconazole (Vfend);
• a blood thinner (warfarin, Coumadin, Jantoven, and others);
• heart or blood pressure medication (Accupril, Altace, Cordarone, Lotensin, Pacerone, Prinivil, Vasotec, Zestril, and others);
• sulfa drugs (Bactrim, Septra, Sulfatrim, SMX-TMP, and others);
• a monoamine oxidase inhibitor (MAOI); or
• other oral diabetes medications, especially acarbose (Precose), metformin (Glucophage), miglitol (Glyset), pioglitazone (Actos), or rosiglitazone (Avandia).

These lists are not complete and there are many other medicines that can increase or decrease the effects of nateglinide on lowering your blood sugar. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

Your pharmacist can provide more information about nateglinide.