nateglinide
Brand names: Starlix
Nateglinide (Starlix) helps control blood sugar in adults with type 2 diabetes. It should be used with diet and exercise.
Drug Pricing (NADAC)
Generic Price
$0.27/unit
Generic Available
Yes (5 manufacturers)
Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →
What it does
Nateglinide is used to help lower blood sugar in adults who have type 2 diabetes.
Common side effects
Upper respiratory infection, Back pain, Flu symptoms
Key warnings
Nateglinide can cause low blood sugar (hypoglycemia).
How It Works
Nateglinide helps your pancreas release insulin after you eat. Insulin helps move sugar from your blood into your cells. This lowers your blood sugar levels after meals.
How to Take It
Take nateglinide 3 times a day, before meals. Take it 1 to 30 minutes before you eat. The usual dose is 120 mg, but your doctor may prescribe 60 mg if your blood sugar is almost at your goal. If you skip a meal, skip your dose of nateglinide to avoid low blood sugar.
Pregnancy & Breastfeeding
It is not known if nateglinide can harm your unborn baby. Talk to your doctor if you are pregnant or plan to become pregnant. Nateglinide is not recommended if you are breastfeeding because it may cause low blood sugar in the baby.
Missed Dose
If you miss a meal, skip your scheduled dose of nateglinide. Do not take an extra dose.
Storage
Store nateglinide at room temperature (between 59°F and 86°F) in a tightly closed, light-resistant container.
Side Effects (from patient reports)
Based on 562 FDA adverse event reports.
FDA Adverse Event Report Analysis
Detailed analysis of 1,302 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2004–2025.
Total Reports
1,302
Death-Related Reports
141
Hospitalization Reports
532
Top Indication
Product Used For Unknown Indication
Gender Distribution
Age Distribution
Most Reported Adverse Reactions (FAERS)
| # | Reaction | Reports |
|---|---|---|
| 1 | BLOOD GLUCOSE INCREASED | 76 |
| 2 | DRUG INEFFECTIVE | 65 |
| 3 | DIARRHOEA | 63 |
| 4 | DYSPNOEA | 62 |
| 5 | FATIGUE | 56 |
| 6 | NAUSEA | 54 |
| 7 | RENAL FAILURE | 51 |
| 8 | DEATH | 47 |
| 9 | DECREASED APPETITE | 46 |
| 10 | DIZZINESS | 43 |
| 11 | VOMITING | 42 |
| 12 | CHRONIC KIDNEY DISEASE | 41 |
| 13 | ACUTE KIDNEY INJURY | 38 |
| 14 | HYPOGLYCAEMIA | 36 |
| 15 | LACTIC ACIDOSIS | 36 |
Reactions in Death Reports
Reactions in Hospitalization Reports
Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation
Serious Warnings
Nateglinide can cause low blood sugar (hypoglycemia). Take it before meals and skip the dose if you skip the meal to help prevent this. There have been no studies showing that nateglinide lowers your risk of heart or blood vessel problems.
Known Drug Interactions
Gastroprokinetic Agents: Cisapride Contraindicated Cisapride: [See Contraindications ( 4.2 )] Lipid-lowering agents: Lomitapide Lovastatin Simvastatin Contraindicated Lomitapide, Lovastatin, Simvastatin: Clarithromycin may increase the exposure of these drugs by inhibition of CYP3A metabolism, thereby increasing the risk of toxicities from these drugs [see Contraindications ( 4.5 ) and Warnings and Precautions ( 5.4 )] Atorvastatin, Pravastatin, Fluvastatin: [See Warnings and Precautions ( 5.4 )] Atorvastatin Pravastatin Use With Caution Fluvastatin No Dose Adjustment Hypoglycemic Agents: N...
Mechanism: Clarithromycin can increase the amount of this diabetes medicine in your blood by slowing down how your body processes it.
What to do: Monitor your blood sugar levels closely and watch for signs of low blood sugar while taking these drugs together.
Drugs That May Blunt Signs and Symptoms of Hypoglycemia Drugs: beta-blockers, clonidine, guanethidine, and reserpine Intervention: Increased frequency of glucose monitoring may be required when nateglinide is coadministered with these drugs.
Mechanism: Clonidine can hide the normal warning signs of low blood sugar, such as a racing heart or shakiness. This makes it difficult to tell if your blood sugar has dropped to a dangerous level.
What to do: You should check your blood sugar levels more frequently when taking these two medications together.
Table 2: Clinically Significant Drug Interactions with Nateglinide Drugs That May Increase the Blood-Glucose-Lowering Effect of Nateglinide and Susceptibility to Hypoglycemia Drugs: Nonsteroidal anti-inflammatory drugs (NSAIDs), salicylates, monoamine oxidase inhibitors, non-selective beta-adrenergic-blocking agents, anabolic hormones (e.g., methandrostenolone), guanethidine, gymnema sylvestre, glucomannan, thioctic acid, and inhibitors of CYP2C9 (e.g., amiodarone, fluconazole, voriconazole, sulfinpyrazone) or in patients known to be poor metabolizers of CYP2C9 substrates, alcohol.
Mechanism: Fluconazole stops the body from breaking down nateglinide properly. This can lead to higher levels of the drug in your blood and cause your blood sugar to drop too low.
What to do: Your doctor may need to adjust your medication dose or have you monitor your blood sugar more closely for signs of hypoglycemia.
Drugs and Herbals That May Reduce the Blood-Glucose-Lowering Effect of Nateglinide and Increase Susceptibility to Hyperglycemia Drugs: Thiazides, corticosteroids, thyroid products, sympathomimetics, somatropin, somatostatin analogues (e.g., lanreotide, octreotide), and CYP inducers (e.g., rifampin, phenytoin and St John's Wort).
Mechanism: Rifampin causes your body to process and remove nateglinide faster than normal. This can make the medicine less effective at lowering your blood sugar, leading to high blood sugar levels.
What to do: Your doctor may need to increase your nateglinide dose or monitor your blood sugar levels more often.
Table 2: Clinically Significant Drug Interactions with Nateglinide Drugs That May Increase the Blood-Glucose-Lowering Effect of Nateglinide and Susceptibility to Hypoglycemia Drugs: Nonsteroidal anti-inflammatory drugs (NSAIDs), salicylates, monoamine oxidase inhibitors, non-selective beta-adrenergic-blocking agents, anabolic hormones (e.g., methandrostenolone), guanethidine, gymnema sylvestre, glucomannan, thioctic acid, and inhibitors of CYP2C9 (e.g., amiodarone, fluconazole, voriconazole, sulfinpyrazone) or in patients known to be poor metabolizers of CYP2C9 substrates, alcohol.
Mechanism: Voriconazole slows down the process your body uses to get rid of nateglinide. This can cause the medicine to build up in your system and make your blood sugar drop too low.
What to do: Watch closely for signs of low blood sugar and ask your doctor if your dosage needs to be changed while taking these drugs together.
Common Questions
What should I do if I feel like my blood sugar is low?
Can I drink alcohol while taking nateglinide?
Will nateglinide cause me to gain weight?
What other medicines can affect nateglinide?
How often should I check my blood sugar?
What are the signs of high blood sugar?
Can I drive while taking nateglinide?
What if I have kidney or liver problems?
How will I know if nateglinide is working?
Can I stop taking nateglinide if I feel better?
What are the common side effects of nateglinide?
Does nateglinide interact with other medications?
What drug class is nateglinide?
Is nateglinide safe during pregnancy?
Related Medications in Meglitinide
Other drugs grouped near nateglinide — same-class peers and common alternatives.
acarbose
Precose
Acarbose is a medicine that helps lower blood sugar levels in people with type 2 diabetes.
Compare with nateglinide →
alogliptin
Nesina
Alogliptin and Metformin HCl is a drug that helps lower blood sugar in adults with type 2 diabetes.
Compare with nateglinide →
bromocriptine
Cycloset
Bromocriptine (Cycloset) is a medicine that acts like dopamine in your body.
Compare with nateglinide →
canagliflozin
Invokana
Invokana is a medicine used with diet and exercise to lower blood sugar in adults with type 2 diabetes.
Compare with nateglinide →
colesevelam
Welchol
Colesevelam is a medicine that helps lower bad cholesterol (LDL-C) and control blood sugar in adults.
Compare with nateglinide →
Medication Guides
Understanding Drug Interactions
How CYP450 enzymes, inhibitors, and inducers affect your medications
Generic vs Brand Name Drugs
FDA requirements, cost savings, and when the difference matters
Narrow Therapeutic Index Drugs
Why some drugs demand precise dosing and monitoring
Common Drug Interactions
Dangerous medication combinations and how to protect yourself
Related Health & Safety Data
🩺 Find a Doctor
Search prescribers for Meglitinide
🏨 Hospital Quality
CMS hospital ratings, safety scores & patient outcomes
💊 Supplement Data
NIH DSLD — check supplement ingredients & label claims
🍽️ Food Safety Alerts
FDA recalls, inspections & outbreak investigations
⚠️ Product Recalls
FDA, CPSC & NHTSA recall search
💉 Procedure Costs
Medicare procedure pricing for 9,297 procedures
Save on nateglinide
Compare prices and find discounts at pharmacies near you. Free coupons can save up to 80% on prescriptions.
Disclosure: This link may earn us a commission at no extra cost to you. See our terms.
What the FDA Data Shows for nateglinide
The FDA label for nateglinide (sold under brand names such as Starlix) classifies it as a prescription-only medication in the Meglitinide class. Nateglinide is used to help lower blood sugar in adults who have type 2 diabetes. Official labeling lists 6 commonly reported side effects, including Upper respiratory infection, Back pain, Flu symptoms.
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 562 voluntary reports. The database also lists 9 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated major severity. NADAC pricing from CMS shows a generic unit cost of $0.27.
Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.
Last updated: February 24, 2025
Read our methodology — how this data is sourced, computed, and verified.
All federal data sources used on this page
- FDA Orange Book — approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed — NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) — post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm — standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files — federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database — current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages