Brand names: Starlix
Starlix combats high blood sugar levels in people with type 2 diabetes (the kind that does not require insulin shots). Insulin speeds the transfer of sugar from the bloodstream to the body's cells, where it's burned to produce energy. In diabetes, the body either fails to make enough insulin, or proves unable to properly use what's available. Starlix attacks the problem from the production angle, stimulating the pancreas to secrete more insulin.
Starlix can be used alone or combined with another diabetes drug, such as Actos, Avandia, or Glucophage, that tackles the other part of the problem, working to improve the body's response to whatever insulin it makes. Starlix is prescribed only when diet and exercise—or the other drug alone—has failed to control blood sugar levels.
Always remember that Starlix is an aid to, not a substitute for, good diet and exercise. Failure to follow a sound diet and exercise plan can lead to serious complications, such as dangerously high or low blood sugar levels. Remember, too, that Starlix is not an oral form of insulin, and cannot be used in place of insulin shots.
Starlix should be taken before each meal, anywhere from 30 minutes to the moment before you begin to eat. If you skip a meal, skip your Starlix dose as well; wait until your next meal before taking the medication.
Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Starlix.
Starlix, like all oral diabetes drugs, can cause hypoglycemia (low blood sugar). This risk is increased by missed meals, alcohol, other diabetes medications, and excessive exercise. Hypoglycemia is more likely in older or malnourished people and those with poorly functioning adrenal or pituitary glands. To avoid low blood sugar, take Starlix only at meals and closely follow the dietary and exercise regimen suggested by your doctor.
Mild hypoglycemia can usually be corrected by eating sugar or a sugar-based product. If symptoms of severe low blood sugar develop, contact your doctor immediately. Severe hypoglycemia should be considered a medical emergency, and prompt medical attention is essential.
If you have type 1 (insulin-dependent) diabetes, you cannot use Starlix. The drug also cannot be used for diabetic ketoacidosis (a life-threatening medical emergency caused by insufficient insulin and marked by excessive thirst, nausea, fatigue, pain below the breastbone, and fruity-smelling breath).
If you are already taking a drug that promotes insulin secretion, such as Micronase, you should not switch to Starlix or add it to your current drug. In addition, Starlix is not for you if you have been taking other antidiabetic drugs for a long time, or if Starlix gives you an allergic reaction.
You should periodically test your blood or urine for abnormal sugar (glucose) levels. Even people with well-controlled diabetes may find that injury, infection, surgery, or fever results in a temporary loss of blood sugar control. At such times, the doctor may recommend that you take insulin instead of Starlix.
The effectiveness of any antidiabetic drug, including Starlix, may decrease with time. This may occur because of either a diminished responsiveness to the medication or a worsening of the diabetes.
If you have liver disease, use Starlix with caution. Also, be aware that dialysis treatments may reduce the effectiveness of the drug.
The safety and effectiveness of Starlix in children have not been established.
If Starlix is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Starlix with the following:Airway-opening drugs such as Alupent and ProventilAspirinBeta blockers such as the blood pressure medications Inderal and TenorminCorticosteroids such as prednisone (Deltasone)Decongestants such as SudafedMAO inhibitors such as the antidepressants Nardil and ParnateNonsteroidal anti-inflammatory drugs such as Advil, Motrin, and NaprosynSalicylates such as the arthritis drugs Disalcid and TrilisateThiazide diuretics such as the water pills Esidrix and HydroDIURILThyroid medications such as Synthroid
Be careful about drinking alcohol, since excessive alcohol consumption can cause low blood sugar. Also be careful when having a liquid meal; it could reduce the effectiveness of the drug.
Because the effects of Starlix on the unborn child have not been adequately studied, Nateglinide should not be used during pregnancy. Since studies suggest the importance of maintaining normal blood sugar levels during pregnancy, you may need to take insulin instead.
It is not known whether Starlix appears in breast milk. Because of potential harm to the baby, you'll need to choose between breastfeeding and continuing treatment with Starlix.
Take Starlix shortly before meals. The usual dose of Starlix, whether taken alone or combined with Actos, Avandia, or Glucophage, is 120 milligrams three times a day. If your doctor finds that your glycosylated hemoglobin (HbA1C) levels are near normal before you start taking the drug, you may use the lower dose of 60 milligrams three times a day.
An overdose of Starlix can cause low blood sugar. (For symptoms, see "What side effects may occur?") Mild hypoglycemia can usually be corrected by eating sugar or a sugar-based product. If your symptoms persist or worsen, seek medical attention immediately.