How does it work?

People with type 2 diabetes (non-insulin dependent diabetes) have a deficiency of a hormone called insulin. Insulin is produced by the pancreas and is the main hormone responsible for controlling sugar levels in the blood. It normally makes the cells of the body remove excess sugar from the blood. In type 2 diabetes the cells of the body are also resistant to the action of insulin, which means that blood sugar levels can become too high. Nateglinide is an antidiabetic medicine that is used to help lower blood sugar in people with type 2 diabetes. It works by acting on the cells in the pancreas that produce insulin. These cells are called beta cells. Nateglinide causes the beta cells to produce more insulin. Nateglinide is taken before meals so that insulin production is enhanced immediately after eating. This is called early or first phase insulin secretion, and does not normally happen in people with with type 2 diabetes. The enhanced insulin production starts about 15 minutes after taking the dose of nateglinide, and the result is a blood sugar lowering effect throughout and following the meal, as occurs naturally in non-diabetic people. Nateglinide is used in combination with metformin, in people whose type 2 diabetes is not controlled by the maximum dose of metformin alone. Since metformin mainly helps reduce blood sugar levels between meals (fasting blood sugar levels), and nateglinide reduces mealtime blood sugar levels, the combination of the two provides an additive effect on blood sugar control.

What is it used for?

Additional treatment of type 2 diabetes that is poorly controlled by metformin alone

Warning!

This medicine is not recommended for children and adolescents under 18 years of age, as there is no information regarding its safety and efficacy in this age group.

This medicine should not be used by itself to treat type 2 diabetes. It should only be used in combination with metformin.

Taking this medicine in combination with metformin is more likely to cause low blood sugar levels (hypoglycaemia) than metformin alone. It is important that you take precautions to avoid hypoglycaemia when driving or operating machinary. You should also be aware that the risk of hypoglycaemia is increased by strenuous physical exercise and drinking alcohol.

This medicine should be taken up to half an hour before meals.

If you experience stress such as trauma, surgery, infection or fever while stabilised on an oral antidiabetic medicine, your blood sugar control may be reduced or lost. In these cases your doctor may temporarily replace your treatment with insulin.

Use with caution in

Elderly people

Insufficient production of hormones by the pituitary gland (pituitary insufficiency)

Insufficient production of natural steroid hormones by the adrenal glands (adrenal insufficiency)

Malnutrition

Moderate to severely decreased kidney function

Moderately decreased liver function

Weak or debilitated people

Not to be used in

Breastfeeding

Diabetic keto-acidosis

Pregnancy

Severely decreased liver function

Type 1 (insulin dependent) diabetes

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

The safety of this medicine during pregnancy has not been established, therefore it should not be used by pregnant women. Consult your doctor.

It is not known whether this medicine passes into breast milk. It should not be used by breastfeeding women because of the potential harm it may cause to nursing infants. Seek medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Headache

Abdominal pain

Diarrhoea

Low blood glucose level (hypoglycaemia)

Indigestion (dyspepsia)

Alteration in results of liver function tests

Allergic skin reactions

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

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