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Oral hypoglycemic agent, a derivative of phenylalanine. On chemical and pharmacological properties different from other hypoglycemic agents. Restores early insulin secretion, which leads to a decrease in postprandial blood glucose levels and glycated hemoglobin (HbA1c).
Under the influence of Starlix, taken before a meal, there is a restoration of early (or first) phase of insulin secretion. The mechanism of this phenomenon is the rapid and reversible interaction nateglinidStarlixavisimymi channel β-cells of the pancreas. The selectivity of nateglinide in otnosheniStarlixvisimyh channel β-cells of the pancreas is 300 times greater than the one in regard to channels of the heart and blood vessels.
Starlix, in contrast to other oral hypoglycemic agents, insulin secretion is expressed within the first 15 minutes after ingestion, thereby flatten postprandial fluctuations ("peaks"), the concentration of glucose in the blood. In the next 3-4 h insulin levels returned to baseline values, thus, avoids the development of postprandial hyperinsulinemia, which may lead to delayed hypoglycemia.
Insulin β-cells of the pancreas caused Starlix, depends on the level of glucose in the blood, that is, the lower the concentration of glucose decreased insulin secretion. On the contrary, the simultaneous ingestion or infusion of glucose leads to a pronounced increase in insulin secretion.
Dosage
Is the inside. Monotherapies - at 120-180 mg 3 times / day. In the combination therapy - to 60-120 mg 3 times / day.
Side Effects
Possible: symptoms, presumably indicating the development of hypoglycemia - increased sweating, tremor, dizziness, increased appetite, palpitations, nausea, weakness, malaise (generally, these phenomena were weakly expressed and easily stoped carbohydrate intake).
Rare: elevated liver enzymes in the blood (usually mild and transient), rash, itching, hives.
Statement
Diabetes mellitus type 2 (insulin-dependent) - with the ineffectiveness of diet and physical activity (as monotherapy or in combination with other hypoglycemic agents).
Contraindications
Diabetes mellitus type 1 (insulin-dependent), diabetic ketoacidosis, pronounced liver damage, pregnancy, lactation (breastfeeding), children's age, sensitivity to nateglinide.
Cautions
Risk of hypoglycemia in patients receiving Starlix (like other hypoglycemic agents) was higher in elderly patients with reduced body weight, in the presence of adrenal or pituitary insufficiency. Reducing the concentration of glucose in the blood can be triggered by alcohol, heavy exercise, as well as the simultaneous use of other hypoglycemic drugs.
Simultaneous treatment with beta-blockers may mask the manifestations of hypoglycemia.
Effects on ability to drive vehicles and management mechanisms
Patients who work with machinery and road manager, should take special precautions to prevent hypoglycemia.
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