Nateglinide
Pronunciation: (na-TEG-li-nide).
- Generic name
- Nateglinide
- Brand names
- Starlix
- Drug class
- Meglitinide analog (Oral hypoglycemic agent)
Availability and supply rules vary by country
Trade names by country:
Australia: · Full directory
What Nateglinide is and how it works
Uses, formulations, monitoring, and supply rules can differ by patient, product, and country. Follow the exact local product information and professional advice.
Mechanism of action: how Nateglinide works
Nateglinide is a rapid-acting insulin secretagogue belonging to the meglitinide class. It binds to the sulfonylurea receptor (SUR1) on pancreatic beta cells, leading to closure of ATP-dependent potassium channels, depolarization of the cell membrane, opening of calcium channels, and subsequent insulin release. Its effect is glucose-dependent and primarily targets postprandial hyperglycemia. (1)
What Nateglinide is used for
Type 2 Diabetes Mellitus
Type 2 Diabetes Mellitus (2)
Postprandial Hyperglycemia
Postprandial Hyperglycemia (2)
Before taking Nateglinide
Do not take / not appropriate for
- Contraindicated in type 1 diabetes, diabetic ketoacidosis, and hypersensitivity to nateglinide. (Contraindication) (2)
- Not recommended in severe renal impairment due to lack of data. (Contraindication) (2)
- Caution in elderly due to increased risk of hypoglycemia. (Contraindication) (2)
Tell your clinician about
(2)How to take Nateglinide
- General Instructions: Take nateglinide exactly as prescribed, usually 1 to 30 minutes before each main meal. Do not skip meals while taking this medication.. Adult Dosing: The typical starting dose is 120 mg orally three times daily before meals. Some patients may start at 60 mg if at risk for hypoglycemia.. Pediatric Dosing: Safety and efficacy in children under 18 years have not been established; use is not recommended.. Administration: Swallow the tablet whole with water, shortly before eating. If you skip a meal, skip that dose.. When To Stop: Do not stop taking nateglinide without consulting your doctor. If you develop a severe allergic reaction or signs of diabetic ketoacidosis, seek medical attention promptly.. Storage: Store at room temperature (20–25°C/68–77°F), away from moisture and heat. Keep out of reach of children.
- This page does not provide a dose calculator. Dosing must follow the prescriber, pharmacist, or product label.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (2)
Missed dose
If you miss a dose, skip it and take your next dose at the usual time before your next meal. Do not double up or take extra medicine to make up for a missed dose.
Overdose
Symptoms of overdose may include severe hypoglycemia (confusion, seizures, loss of consciousness). Seek emergency medical help immediately. Treatment includes administration of oral glucose or intravenous dextrose if necessary. (2)
Side effects
Side effects and their urgency vary; report severe, persistent, or concerning symptoms to a healthcare professional.
Hypoglycemia
Incidence: Reported in the clinician-authored database; frequency not established
Dizziness
Incidence: Reported in the clinician-authored database; frequency not established
Diarrhea
Incidence: Reported in the clinician-authored database; frequency not established
Upper respiratory tract infection
Incidence: Reported in the clinician-authored database; frequency not established
Back pain
Incidence: Reported in the clinician-authored database; frequency not established
Arthralgia
Incidence: Reported in the clinician-authored database; frequency not established
Flu-like symptoms
Incidence: Reported in the clinician-authored database; frequency not established
Serious warnings
May cause hypoglycemia, especially if meals are skipped — serious
Symptoms: May cause hypoglycemia, especially if meals are skipped. Not for use in type 1 diabetes or diabetic ketoacidosis. Use caution in patients with liver or kidney impairment. Monitor blood glucose regularly. Inform your doctor of all medications and supplements you are taking.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
Contraindications recorded in the clinician database — serious
Symptoms: Contraindications recorded in the clinician database: Contraindicated in type 1 diabetes, diabetic ketoacidosis, and hypersensitivity to nateglinide. Use with caution in patients with moderate to severe hepatic impairment, as metabolism may be impaired (not studied; no dose adjustment is needed for mild hepatic impairment). Caution in elderly due to increased risk of hypoglycemia. Note: the FDA label states no dose adjustment is needed for mild-to-severe renal impairment; only end-stage renal disease requiring dialysis (eGFR under 15) has a specific caution about slightly increased hypoglycemic effect from metabolite accumulation, which is a much narrower caveat than a blanket 'not recommended in severe renal impairment.'
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Recorded interactions | Nateglinide may interact with other diabetes medications, increasing the risk of hypoglycemia. Drugs such as gemfibrozil, NSAIDs, beta-blockers, and certain antifungals may alter its effects. Always inform your healthcare provider about all medicines, supplements, and herbal products you use. | (1) |
Pregnancy, breastfeeding, kidney/liver function, age
Pregnancy
Safety in pregnancy is not definitively established. Diabetes management in pregnancy typically requires careful, individualised planning with a clinician (insulin is often preferred). If you are pregnant, planning to become pregnant, or become pregnant during treatment, seek medical advice promptly. (2)
Breastfeeding
There is limited data on use while breastfeeding. Discuss feeding options and blood-sugar management with your healthcare provider before using nateglinide while breastfeeding. (2)
Children
Safety and efficacy in children under 18 years have not been established; use is not recommended in this age group. (2)
Renal Impairment
Renal impairment: per FDA labeling, no dose adjustment is recommended for mild-to-severe renal impairment; only end-stage renal disease requiring dialysis has a specific caution (slightly increased hypoglycemic effect from metabolite accumulation), which is a narrower caveat than a blanket restriction. Hepatic impairment: no adjustment needed for mild impairment; moderate-to-severe hepatic impairment has not been studied and requires caution and closer monitoring by the treating clinician. (2)
Hepatic Impairment
Renal impairment: per FDA labeling, no dose adjustment is recommended for mild-to-severe renal impairment; only end-stage renal disease requiring dialysis has a specific caution (slightly increased hypoglycemic effect from metabolite accumulation), which is a narrower caveat than a blanket restriction. Hepatic impairment: no adjustment needed for mild impairment; moderate-to-severe hepatic impairment has not been studied and requires caution and closer monitoring by the treating clinician. (2)
Monitoring
(2)Storage
Store at room temperature (20-25C/68-77F), away from moisture and heat. Keep out of reach of children.
Professional information
Clinician-facing context only. This section does not replace current product labeling.
General
Indication: Type 2 Diabetes Mellitus
Dose summary: Initial/typical dose is 120 mg orally three times daily, shortly before meals (some patients at higher risk of hypoglycemia may start at 60 mg three times daily).
Renal context: No dose adjustment is recommended for mild-to-severe renal impairment. Patients with end-stage renal disease on dialysis have a specific caution about slightly increased hypoglycemic effect from metabolite accumulation, requiring closer monitoring. (1)
Frequently asked questions
What is nateglinide used for?
Nateglinide is used to help control blood sugar levels in adults with type 2 diabetes, especially to reduce blood sugar spikes after meals.
How does nateglinide work?
It stimulates the pancreas to release insulin quickly after eating, helping to lower post-meal blood sugar levels.
Can nateglinide cause low blood sugar?
Yes, especially if you skip meals, exercise more than usual, or take it with other diabetes medications. Always monitor your blood sugar regularly.
Is nateglinide safe during pregnancy or breastfeeding?
There is limited data on safety in pregnancy and breastfeeding. Consult your doctor before use if you are pregnant or breastfeeding.
What should I do if I miss a dose?
Skip the missed dose and take your next dose before your next meal. Do not take two doses at once.
Can I take nateglinide with other diabetes medicines?
It may be used with other oral diabetes drugs or insulin, but this increases the risk of hypoglycemia. Your doctor will adjust your regimen as needed.
What are the signs of an allergic reaction to nateglinide?
Signs include rash, itching, swelling (especially of the face/tongue/throat), severe dizziness, and trouble breathing. Seek immediate medical help if these occur.
What happens if I take too much Nateglinide?
Taking too much Nateglinide can lead to severe hypoglycemia, characterized by symptoms such as dizziness, confusion, sweating, tremors, and even loss of consciousness. If you suspect an overdose, it is crucial to seek emergency medical help immediately. Prompt treatment is necessary to stabilize blood sugar levels and prevent serious complications.
Can I drink alcohol while taking Nateglinide?
Drinking alcohol while taking Nateglinide is generally not recommended. Alcohol can increase the risk of hypoglycemia, especially when consumed on an empty stomach or in large quantities. It can also interfere with the liver's ability to produce glucose, further exacerbating the blood sugar-lowering effects of Nateglinide. Always consult your healthcare provider regarding alcohol consumption.
Is Nateglinide safe during pregnancy?
Nateglinide's safety during pregnancy is not definitively established, and it falls under a pregnancy category that advises caution. The potential risks to the fetus and the benefits to the mother must be carefully weighed. Therefore, it is imperative to consult your healthcare provider immediately if you are pregnant, planning to become pregnant, or breastfeeding, to discuss alternative treatments or adjustments to your medication regimen.
What is the mechanism of action of Nateglinide?
Nateglinide is a rapid-acting insulin secretagogue belonging to the meglitinide class. It binds to the sulfonylurea receptor (SUR1) on pancreatic beta cells, leading to closure of ATP-dependent potassium channels, depolarization of the cell membrane, opening of calcium channels, and subsequent insulin release. Its effect is glucose-dependent and primarily targets postprandial hyperglycemia. (1)
What is the generic name of Nateglinide?
The generic name is Nateglinide. It is sold under brand names including Starlix.
What class of drug is Nateglinide?
Nateglinide is classed as: Meglitinide analog (Oral hypoglycemic agent).
References
- Nateglinide clinician-authored medicine recordMedGuideGlobal · Global (internal record) · accessed 2026-08-06 · source 1
- STARLIX (nateglinide) — prescribing informationU.S. Food and Drug Administration · United States · dated 2021 · accessed 2026-08-06 · source 2
- NATEGLINIDE TABLET [DR. REDDY'S LABORATORIES LIMITED] — US prescribing information (DailyMed SPL)U.S. National Library of Medicine (DailyMed) · US · accessed 2026-08-14 · source 3
- Nateglinide — patient drug information (MedlinePlus)U.S. National Library of Medicine (MedlinePlus) · US · accessed 2026-08-14 · source 4
- Nateglinide — FDA approval record (Drugs@FDA ANDA077463)U.S. Food and Drug Administration · US · accessed 2026-08-14 · source 5
- Nateglinide — RxNorm normalized drug concept (RXCUI 274332)U.S. National Library of Medicine (RxNorm) · US · accessed 2026-08-14 · source 6
Brand names by country
Single-ingredient Nateglinide names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.