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Starlix
Class: Antidiabetic

 Action Lowers blood glucose levels by stimulating insulin secretion from the pancreas.

 Indications As monotherapy to lower blood glucose in patients with type 2 diabetes mellitus (noninsulin dependent diabetes mellitus) whose hyperglycemia cannot be adequately controlled by diet and exercise and who have not been chronically treated with other antidiabetic agents; in combination with metformin, but not substituted for metformin, in patients whose hyperglycemia is not adequately controlled with metformin alone.

 Contraindications Type 1 diabetes; diabetic ketoacidosis.

 Route/Dosage

ADULTS: PO 120 mg tid, 1 to 30 min before meals, alone or in combination with metformin. The 60 mg dose of nateglinide may be used, alone or in combination with metformin, in patients near goal glycosylated hemoglobin when treatment is initiated.

 Interactions

Monoamine oxidase inhibitors, nonselective beta-adrenergic blocking agents, nonsteroidal anti-inflammatory drugs, salicylates: May potentiate the hypoglycemic effects of nateglinide. Corticosteroids, sympathomimetics, thiazide diuretics, thyroid products: May reduce the hypoglycemic effects of nateglinide.

 Lab Test Interferences Uric acid levels may be increased.

 Adverse Reactions

CNS: Dizziness. GI: Diarrhea. META: Hypoglycemia. RESPIRATORY: Upper respiratory infection; bronchitis; coughing. OTHER: Back pain; flu symptoms; arthropathy; accidental trauma.

 Precautions

Pregnancy: Category C. Lactation: Undetermined. Children: Safety and efficacy not established. Hepatic impairment: Use with caution in patients with moderate-to-severe or chronic liver disease. Secondary failure: Transient loss of glycemic control may occur in patients with fever, infection, trauma, or surgery. Special populations: Patients with type 2 diabetes and renal failure on dialysis may exhibit reduced overall drug exposure.

PATIENT CARE CONSIDERATIONS

 Administration/Storage

 Assessment/Interventions

OVERDOSAGE: SIGNS & SYMPTOMS
  Exaggerated glucose lowering with hypoglycemic symptoms, coma, seizure, neurological symptoms

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