Nateglinide
Nateglinide is an oral diabetes medicine (a glinide) used with diet and exercise to improve blood sugar control in adults with type 2 diabetes.
🧬 Where this information comes from Click to expand
The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 10 clinical label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →
Nateglinide (Starlix) is a short-acting type 2 diabetes medicine, used alongside diet and exercise, that prompts the pancreas to release a quick burst of insulin at mealtimes, more when blood sugar is high and less as it falls. It has been on the market since about 2000 and is available as a generic, but it is now less commonly prescribed and usually not a first choice. Most people tolerate it well; what they notice is usually mild lows, slight weight gain or dizziness. The one thing to watch for is low blood sugar, which can become severe enough to cause seizures, so learn its signs and check your sugar as your care team advises.
Clinical pearls
- Take it within 30 minutes before each meal, and skip that dose whenever you skip the meal.
- It works only if your pancreas still makes some insulin, which is why it is never used for type 1 diabetes.
- Fluconazole, voriconazole and amiodarone can strengthen its effect and cause lows, so mention nateglinide to any new prescriber.
- Beta-blockers can hide the warning signs of a low, and pain relievers like ibuprofen (NSAIDs) or alcohol make lows more likely.
Patient information guide A plain-language walkthrough of Nateglinide, written from its FDA label.
What Nateglinide is used for
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Nateglinide is a glinide used for one main purpose.
- Nateglinide tablets (including film-coated and coated tablets) are used with diet and exercise to improve blood sugar control in adults with type 2 diabetes.
- Not for type 1 diabetes.
- Not for treating diabetic ketoacidosis.
How Nateglinide works
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Nateglinide stimulates your pancreas to release insulin. It acts on potassium channels on the pancreas’s beta-cells, which triggers calcium to enter the cell and insulin to be released. This only works if your beta-cells are functioning.
The amount of insulin released depends on your blood sugar and drops when sugar is low. The drug is highly selective and has low affinity for heart and skeletal muscle.
Nateglinide dosage
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Nateglinide tablets are taken by mouth three times a day before meals. Take each dose 1 to 30 minutes before eating.
- If you skip a meal, skip that scheduled dose to lower the risk of low blood sugar.
- Some people who are already near their blood sugar goal may be started on a lower dose.
- Follow your prescriber’s instructions and your pharmacy label.
Dosing details from the FDA-approved label
From the Nateglinide prescribing information (“Dosage and Administration”). Doses are set by your prescriber for your product, condition, kidney function and age — never change a dose on your own.
- Recommended dose
- 120 mg orally three times daily before meals
- Take 1 to 30 minutes before meals; if a meal is skipped, skip the scheduled dose to reduce the risk of hypoglycemia
- Patients who are near glycemic goal when treatment is initiated
- 60 mg orally three times daily before meals
- Take 1 to 30 minutes before meals; if a meal is skipped, skip the scheduled dose to reduce the risk of hypoglycemia
Read the label’s full dosing text
2 DOSAGE & ADMINISTRATION The recommended dose of nateglinide tablets is 120 mg orally three times daily before meals. The recommended dose of nateglinide tablets is 60 mg orally three times daily before meals in patients who are near glycemic goal when treatment is initiated. Instruct patients to take nateglinide tablets 1 to 30 minutes before meals. In patients who skip meals, instruct patients to skip the scheduled dose of nateglinide tablets to reduce the risk of hypoglycemia [ see Warnings and Precautions ( 5.1 ) ]. • Recommended dose is 120 mg three times daily. ( 2 ) • In patients who are near glycemic goal when treatment is initiated, 60 mg three times daily may be administered. ( 2 ) • Administer 1 to 30 minutes before meals. ( 2 ) • If a meal is skipped, skip the scheduled dose to reduce the risk of hypoglycemia. ( 2 , 5.1 )
Read the full Dosage and Administration section on DailyMed →
Nateglinide side effects
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The most common side effects reported in studies were:
Common side effects
- Upper respiratory infection (cold-like symptoms)
- Back pain
- Flu symptoms
- Dizziness
- Joint problems (arthropathy)
- Diarrhea
- Mild low blood sugar
- Weight gain
When to get medical help
- Call your doctor if you have symptoms of low blood sugar (hypoglycemia) that keep coming back or are hard to manage.
- Get emergency help for severe low blood sugar, which can cause seizures, can be life-threatening, and can lead to death.
- Call your doctor if you develop rash, itching or hives (an allergic reaction).
- Call your doctor if you notice yellowing of the skin or eyes (jaundice) or other signs of liver problems.
Nateglinide warnings and precautions
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- Hypoglycemia: Can be severe, causing seizures, and can be life-threatening.
- It can affect concentration and reaction time, so be careful driving or using machinery.
- Awareness of lows may be reduced with long-standing diabetes, diabetic neuropathy (nerve disease), beta-blocker use, or frequent lows.
- Risk rises with changes in meals or activity, other diabetes medicines, and kidney or liver problems.
- No studies have conclusively shown reduced heart and blood vessel complications.
Nateglinide interactions
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Several medicines can raise or lower your blood sugar effect, so tell your pharmacist about everything you take.
- NSAIDs, salicylates, MAO inhibitors, non-selective beta-blockers and alcohol: may increase low blood sugar risk.
- CYP2C9 inhibitors (amiodarone, fluconazole, voriconazole, sulfinpyrazone): may increase low blood sugar risk.
- Thiazides, corticosteroids, thyroid products, sympathomimetics, somatropin, octreotide and lanreotide: may raise blood sugar.
- Rifampin, phenytoin and St John’s Wort: may weaken the effect.
- Beta-blockers, clonidine, guanethidine and reserpine: may hide signs of low blood sugar.
Interactions listed in the FDA-approved label
From the Nateglinide prescribing information (“Drug Interactions”): what the manufacturer studied or reported to the FDA.
- NSAIDs, salicylates, monoamine oxidase inhibitors, non-selective beta-adrenergic-blocking agents, anabolic hormones (e.g. methandrostenolone), guanethidine, gymnema sylvestre, glucomannan, thioctic acid, CYP2C9 inhibitors (e.g. amiodarone, fluconazole, voriconazole, sulfinpyrazone), poor metabolizers of CYP2C9 substrates, alcohol: May increase the blood-glucose-lowering effect of nateglinide and susceptibility to hypoglycemia. Dose reductions and increased frequency of glucose monitoring may be required when coadministered.
- Thiazides, corticosteroids, thyroid products, sympathomimetics, somatropin, somatostatin analogues (e.g. lanreotide, octreotide), and CYP inducers (e.g. rifampin, phenytoin, St John's Wort): May reduce the blood-glucose-lowering effect of nateglinide and increase susceptibility to hyperglycemia. Dose increases and increased frequency of glucose monitoring may be required when coadministered.
- Beta-blockers, clonidine, guanethidine, and reserpine: May blunt signs and symptoms of hypoglycemia. Increased frequency of glucose monitoring may be required when coadministered.
Read the label’s full interactions text
7 DRUG INTERACTIONS Table 2 includes a list of drugs with clinically important drug interactions when concomitantly administered or withdrawn with nateglinide tablets and instructions for managing or preventing them. 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. Intervention: Dose reductions and increased frequency of glucose monitoring may be required when nateglinide tablets are coadministered with these drugs. 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). Intervention: Dose increases and increased frequency of glucose monitoring may be required when nateglinide tablets are coadministered with these drugs. 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 tablets are co-administered with these drugs.Drugs: beta-blockers, clonidine, guanethidine, and reserpine Intervention: Increased frequency of glucose monitoring may be required when nateglinide tablets are coadministered with these drugs.
Excerpted — the section continues on the label. Read the full Drug Interactions section on DailyMed →
Not a complete list. The label covers the interactions the manufacturer studied or reported, and our own interaction database does not cover every medicine either. Bring your full medication list, including vitamins and herbal products, to your pharmacist.
Before taking Nateglinide
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- Do not use with a past allergic reaction to nateglinide or its inactive ingredients.
- Not for type 1 diabetes or diabetic ketoacidosis.
- Pregnancy: use only if the benefit justifies the potential risk to the baby.
- Breastfeeding: not recommended, because of the potential for low blood sugar in nursing infants.
- Children: safety and effectiveness have not been established.
- Older adults: no overall differences seen, but some may be more sensitive.
- Liver: use caution in moderate-to-severe impairment.
- Kidney or liver problems may raise low blood sugar risk.
Nateglinide overdose
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Too much nateglinide may cause an exaggerated blood-sugar-lowering effect and symptoms of low blood sugar. Milder symptoms are treated with oral glucose and adjustments to dosing or meals. Severe reactions, such as coma or seizure, need intravenous glucose. Dialysis is not an efficient way to remove it.
What Nateglinide does in the body
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Nateglinide starts stimulating insulin release within 20 minutes of a dose. When taken before meals, insulin peaks about 1 hour later and returns to baseline by 4 hours.
How your body processes Nateglinide
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About 73% of a dose is absorbed, and blood levels typically peak within 1 hour when taken right before a meal. It is mostly broken down by the liver enzymes CYP2C9 (about 70%) and CYP3A4 (about 30%). The half-life is about 1.5 hours. Most is cleared through the urine (about 83%), with some in the stool (about 10%).
How to store Nateglinide
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Store at 20° to 25°C (68° to 77°F); excursions permitted between 15° to 30°C (59° to 86°F) Dispense in a tight container (USP).
Written from the FDA-approved label with AI and reviewed by our pharmacy team. How we use AI →
Supplements & herbs that interact with Nateglinide
290 supplements and herbal products have documented interactions with Nateglinide in the licensed clinical database we use. Most are manageable — but your pharmacist should know about everything you take, including vitamins and herbals.
- Major · 2
- Moderate · 241
- Minor · 47
Educational information from a licensed clinical database (Natural Medicines) — see our data sources & update cadence. Not medical advice: an interaction being documented does not mean it will happen to you; do not start or stop medications or supplements without professional guidance.
Nutrient depletion considerations
Nateglinide has been associated with lower levels of 1 nutrient in the clinical literature. This does not mean a deficiency will occur — it means these may be worth discussing with your pharmacist or healthcare provider, especially with long-term use.
Educational information from a licensed clinical database (Natural Medicines) — not medical advice. Do not start or stop medications or supplements without professional guidance.
Nateglinide: pharmacist answers to common questions
Quick, plain-English answers to the questions patients ask most about Nateglinide — the kind of thing our pharmacy team would talk through with you at the counter.
What is nateglinide for?
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When should I take it?
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What is the main risk?
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What side effects might I notice?
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Can I take it with other medicines?
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Is it safe in pregnancy or while breastfeeding?
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Is Nateglinide available over the counter?
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When was Nateglinide first available?
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Who makes Nateglinide?
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Answers drafted from the FDA-approved label with AI and reviewed by our pharmacy team. How we use AI →
More about Nateglinide on HelloPharmacist
Nateglinide forms and strengths (how it comes)
Nateglinide is available in 1 form. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.
Tablet
How this form is used
- Nateglinide tablets are used with diet and exercise to improve blood sugar control in adults with type 2 diabetes.
- Nateglinide tablets are not for type 1 diabetes or diabetic ketoacidosis.
- Nateglinide tablets are taken by mouth three times daily before meals.
- Nateglinide tablets are taken 1 to 30 minutes before a meal.
- If you skip a meal, skip the scheduled Nateglinide dose.
Nateglinide on the U.S. market: products, makers and brands
How Nateglinide appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.
9 companies list 18 Nateglinide product records with the FDA, mostly as tablet; the earliest marketing or approval year on record is 2000. Brand names on the directory include Starlix; the rest are generics.
Also listed with the FDA, not a patient dose form: Powder (6) — bulk drug substance sold to compounders/manufacturers and multi-item kits. These aren’t counted in the dose-form total above.
Share of FDA-listed product records by manufacturer — FDA National Drug Code Directory. Record counts are not sales or prescription volume.
How widely Nateglinide is used (Medicaid data)
A general measure of how commonly Nateglinide is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.
Think of this as a proxy for how widely Nateglinide is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.
How commonly is Nateglinide prescribed? Of the 1,601 medications we measure, Nateglinide ranks #903 by Medicaid prescriptions — more than 44% of them.
Utilization by Nateglinide product
Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.
nateglinide 120 MG Oral Tablet Most dispensed
Summed across the 6 of 37 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 311919
nateglinide 60 MG Oral Tablet
Summed across the 5 of 37 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 314142
Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.
Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Nateglinide, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 11 of 74 listed Nateglinide NDCs with Medicaid activity.
Compare Nateglinide products
A representative set of FDA-listed product records for Nateglinide — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)
| Strength | Route | Manufacturer / Labeler | Category ⓘ | Details |
|---|---|---|---|---|
| 💊Tablet | ||||
| 60 mg | Oral | American Health Packaging | ANDA | View NDC → |
| 120 mg | Oral | American Health Packaging | ANDA | View NDC → |
| 60 mg | Oral | Cadila Pharmaceuticals Limited | ANDA | View NDC → |
| 120 mg | Oral | Cadila Pharmaceuticals Limited | ANDA | View NDC → |
| 60 mg | Oral | Dr. Reddy's Laboratories Limited | ANDA | View NDC → |
| 120 mg | Oral | Dr. Reddy's Laboratories Limited | ANDA | View NDC → |
| 60 mg | Oral | Golden State Medical Supply, Inc. | ANDA | View NDC → |
| 120 mg | Oral | Golden State Medical Supply, Inc. | ANDA | View NDC → |
| 60 mg | Oral | Modavar Pharmaceuticals LLC | ANDA | View NDC → |
| 120 mg | Oral | Modavar Pharmaceuticals LLC | ANDA | View NDC → |
| 60 mg | Oral | Rising Pharma Holdings, Inc. | ANDA | View NDC → |
| 120 mg | Oral | Rising Pharma Holdings, Inc. | ANDA | View NDC → |
| 60 mg | Oral | Strides Pharma Science Limited | ANDA | View NDC → |
| 120 mg | Oral | Strides Pharma Science Limited | ANDA | View NDC → |
| 60 mg | Oral | Zydus Lifesciences Limited | ANDA | View NDC → |
| 120 mg | Oral | Zydus Lifesciences Limited | ANDA | View NDC → |
| 60 mg | Oral | Zydus Pharmaceuticals USA Inc. | ANDA | View NDC → |
| 120 mg | Oral | Zydus Pharmaceuticals USA Inc. | ANDA | View NDC → |
Showing 18 of 18 products — FDA National Drug Code Directory. See every product, package size and price: browse all 18 Nateglinide NDCs →
Nateglinide side effects reported to the FDA (FAERS)
After a medicine reaches the market, patients, doctors and drugmakers can send the FDA reports of problems they think may be linked to it. Here’s what’s been reported for Nateglinide — a signal of what to watch for, not proof the drug caused it.
Source: openFDA, from the FDA Adverse Event Reporting System (FAERS). These are voluntary reports — they don’t prove the drug caused the effect, and counts reflect how often something was reported, not how often it actually happens. Reports also often name the very problem the medicine is taken for — a common reason to file one is that the drug didn’t help — so for a pain reliever you may see “pain” high on the list; that points to why the report was filed, not to the drug causing the symptom. This counts every report that lists Nateglinide in any role, so the total runs higher than the FDA’s official dashboard, which counts only cases where the drug is the suspect. For the authoritative figures, see the FDA FAERS Public Dashboard. Always talk to your pharmacist or doctor.
Nateglinide FDA approval history
How Nateglinide went from FDA review to the pharmacy shelf — the key milestones in its regulatory journey.
Source: Drugs@FDA.
Nateglinide recall history
A recall is when a specific batch of a medicine is pulled from the market — usually a manufacturing issue, not a problem with the drug itself. Class I is most serious, Class III least.
The FDA’s enforcement reports list no Nateglinide recalls since July 2021.
✅No Nateglinide recalls on record since July 2021Source: FDA enforcement (recall) reports, via openFDA; our copy was last updated Sep 24, 2026.
RxNorm Concept Web — From Ingredient to Every Form and Strength
This page starts with one ingredient concept (IN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). Combination products remain separate concepts with their own pages.
RxCUI 274332 1 dose form · 3 strengths
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Dose form (SCDF) Oral Tablet RxCUI 374648In current FDA listings
Look up RxCUI 274332 in the RxCUI Atlas →
RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.
Nateglinide supply and shortage status
Whether Nateglinide is in short supply in the U.S. right now, plus any shortage history the FDA has on record. A shortage usually reflects a manufacturing or demand issue — not a safety problem with the drug.
Source: openFDA, from the FDA Drug Shortages database.
💵 What Nateglinide costs pharmacies (NADAC benchmark)
The national average invoice price pharmacies pay for the drug itself, from CMS's NADAC survey (data as of Sep 30, 2026). This is a supply-cost benchmark — not a retail price and not what you'd pay at the counter.
| Form | Strength | Pharmacy acquisition benchmark | |
|---|---|---|---|
| Tablet · Oral | 60 mg | $0.179 per tablet | NDC details & price history |
| Tablet · Oral | 120 mg | $0.222 per tablet | NDC details & price history |
| Tablet, Film Coated · Oral | 60 mg | $0.179 per tablet | NDC details & price history |
| Tablet, Film Coated · Oral | 120 mg | $0.222 per tablet | NDC details & price history |
Source: CMS National Average Drug Acquisition Cost (NADAC), a survey of retail pharmacy invoice prices. Benchmarks shown are the range across package sizes of a representative product for each form and strength — other manufacturers' products may differ.
Nateglinide brand names
Nateglinide is sold under one brand name in the FDA directory — Starlix. A brand and its generic contain the same active ingredient; the brand name belongs to one company's product.
Who makes Nateglinide: manufacturers and labelers
9 companies list Nateglinide products with the FDA. By number of product records, the largest are American Health Packaging, Cadila Pharmaceuticals Limited, Dr. Reddy's Laboratories Limited. Labelers include manufacturers and repackagers; the product in your bottle depends on which one your pharmacy stocks.
Nateglinide drug class (RxNorm)
Nateglinide belongs to the Glinide class.
Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.
Sources for this Nateglinide page
Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.
How this page is built
HelloPharmacist combines public FDA and NLM records and does not author the underlying clinical facts. The plain-language sections are written with AI from the FDA-approved label text and reviewed by our pharmacy team before publication. American Health Packaging is the representative DailyMed label linked for verification and dates. This is general education, not medical advice: always talk to your doctor or pharmacist about your own medicines. How we build and review drug pages →