Starlix: Advanced Postprandial Glucose Control for Type 2 Diabetes
| Product dosage: 120mg | |||
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Synonyms | |||
Starlix (nateglinide) is a rapid-acting insulin secretagogue specifically designed to address the critical challenge of postprandial hyperglycemia in the management of type 2 diabetes mellitus. By stimulating immediate, glucose-dependent insulin release from pancreatic beta cells, it provides a targeted physiological response to meals, helping to restore a more natural prandial insulin profile. This mechanism offers a distinct therapeutic advantage for patients requiring precise control over meal-related blood sugar spikes, complementing broader glycemic management strategies. Its rapid onset and short duration of action minimize the risk of prolonged hypoglycemia, making it a valuable option for individuals with irregular meal schedules or those seeking flexible dosing.
Features
- Active pharmaceutical ingredient: Nateglinide
- Pharmacological class: Meglitinide analog
- Rapid onset of action: begins working within 20 minutes of administration
- Short duration of effect: approximately 4 hours
- Administration: Oral tablet formulation
- Available strengths: 60 mg and 120 mg tablets
- Specific mechanism: Blocks ATP-sensitive potassium channels in pancreatic beta cells
- Glucose-dependent insulin secretion: activity is potentiated by elevated blood glucose levels
Benefits
- Provides rapid reduction of postprandial glucose excursions, helping to achieve target HbA1c levels
- Minimizes risk of interprandial and fasting hypoglycemia due to short duration of action
- Offers dosing flexibility that can be adapted to meal patterns and timing
- May help preserve beta-cell function through reduced glucose toxicity
- Supports comprehensive diabetes management when used in combination with other antidiabetic agents
- Enables patients to maintain better quality of life through reduced dietary restrictions
Common use
Starlix is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. It is particularly beneficial for patients who experience significant postprandial hyperglycemia and those with irregular meal patterns. The medication may be used as monotherapy or in combination with metformin or other insulin-sensitizing agents when additional glycemic control is required. Clinical use typically involves patients who have not achieved adequate glucose control through lifestyle modifications alone and require targeted prandial glucose management.
Dosage and direction
The recommended dosage of Starlix is 120 mg three times daily, taken 1-30 minutes before meals. For patients near their glycemic goals, a starting dose of 60 mg three times daily may be appropriate. Administration should typically occur before main meals, and the medication should be omitted if a meal is skipped. Dosage adjustments may be necessary based on glycemic response, renal function, and concomitant medications. Healthcare providers should individualize therapy based on regular blood glucose monitoring results and HbA1c levels.
Precautions
Patients should be advised to monitor blood glucose regularly, especially when initiating therapy or changing dosage. Caution is recommended in elderly patients and those with hepatic impairment, as metabolism may be affected. Starlix should be used cautiously in patients with adrenal or pituitary insufficiency, as these conditions may affect glucose regulation. Patients should be educated about recognizing and managing hypoglycemia, particularly when combining Starlix with other glucose-lowering agents. Regular monitoring of renal function is advised, though dosage adjustment is generally not required for mild to moderate renal impairment.
Contraindications
Starlix is contraindicated in patients with known hypersensitivity to nateglinide or any component of the formulation. It should not be used in patients with type 1 diabetes mellitus or for the treatment of diabetic ketoacidosis. The medication is contraindicated in combination with gemfibrozil due to significant drug interaction potential. Use is not recommended during pregnancy unless potential benefits justify potential risks to the fetus. Starlix is not indicated for use in pediatric patients.
Possible side effects
The most common adverse reactions include hypoglycemia, which may manifest as dizziness, sweating, tremor, hunger, and palpitations. Upper respiratory infection symptoms and flu-like syndrome have been reported. Gastrointestinal effects such as nausea, diarrhea, and abdominal pain may occur. Less frequently, patients may experience arthralgia, back pain, or elevated liver enzymes. Allergic reactions including rash and urticaria have been reported in some patients. Transient visual disturbances may occur due to rapid changes in blood glucose levels.
Drug interaction
Significant interactions occur with drugs that affect cytochrome P450 2C9 metabolism. Gemfibrozil contraindicated due to dramatic increase in nateglinide exposure. NSAIDs, sulfonamides, and warfarin may increase nateglinide levels. Rifampin, barbiturates, and carbamazepine may decrease efficacy. Beta-blockers may mask hypoglycemia symptoms. Thiazide diuretics, corticosteroids, and sympathomimetics may reduce hypoglycemic effect. Close monitoring required when adding or discontinuing any medication that affects glucose metabolism or CYP2C9 activity.
Missed dose
If a dose is missed and the meal has already been consumed, the missed dose should be skipped. The patient should take the next scheduled dose with the subsequent meal. Doubling of doses is not recommended. If a meal is delayed, the dose should be taken immediately before the meal when it occurs. Patients should maintain regular meal patterns to optimize therapeutic effect and minimize hypoglycemia risk.
Overdose
Symptoms of overdose primarily consist of hypoglycemia, which may be severe and require immediate intervention. Management includes glucose administration orally or intravenously depending on severity and consciousness level. Continuous glucose monitoring and supportive care are essential. In cases of intentional overdose, gastric lavage may be considered if presentation is early. Hospital observation is recommended for significant overdoses, as hypoglycemia may recur due to the drug’s pharmacokinetic profile.
Storage
Store at controlled room temperature between 20°C and 25°C (68°F and 77°F). Excursions permitted between 15°C and 30°C (59°F and 86°F). Keep container tightly closed and protect from moisture. Dispense in original container with desiccant. Keep out of reach of children. Do not use if tablets appear discolored or show signs of deterioration. Properly dispose of expired or unused medication according to local regulations.
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. Treatment decisions should be made by qualified healthcare professionals based on individual patient circumstances. Patients should not alter their medication regimen without consulting their healthcare provider. The prescribing physician should be consulted for complete prescribing information, including boxed warnings and full adverse reaction profile.
Reviews
Clinical studies demonstrate Starlix effectively reduces postprandial glucose excursions by 40-50 mg/dL on average. In combination trials with metformin, HbA1c reductions of 1.5-2.0% have been observed. Patients report appreciation for the flexibility in meal timing and reduced incidence of between-meal hypoglycemia compared to longer-acting secretagogues. Healthcare providers note the particular utility in patients with erratic schedules or renal impairment where other medications may be less suitable. Long-term studies show maintained efficacy with weight-neutral effects in most patients.