Patient/caregiver was educated on how to take Nateglinide as follows:
- Nateglinide is absorbed quickly, completes the action, and gets eliminated quickly. Nateglinide starts acting in about 30 minutes, peaks in action in about an hour, and ceases to act by 4 hours after intake of the medication. Since it is very quick to act, nateglinide is to be taken no earlier than 30 minutes before the mealtime. Taking nateglinide as scheduled can lead to increased insulin secretion but observing noncompliance with timely intake of food can lead to severe lowering of blood sugars and episodes of dangerous hypoglycemia.
- Also, this medication can induce some nausea and vomiting, especially when taken on empty stomach. Taking the medication with a glass of water and along with the meal can help avoid these unpleasant gastrointestinal symptoms.
- Since nateglinide is quick to act and taken right before eating or along with the meal, it is helpful in individuals with irregular eating times. Observing compliance with the time of nutrition intake and the time of medication intake, as recommended, can help significantly with the goals of establishing a discipline with regards to eating habits, streamlining the timely insulin release, regulating blood sugar numbers at the desired level, and preventing development of undesired complications.
- Taking this medication at regularly spaced intervals along with compliance for recommended dietary measures helps to prevent any gross fluctuations in blood sugar numbers and maintain them in the target range. This can also help with preventing any undesired side-effects and toxicity with the medication.
- Maintain strict compliance with intake of the medication as ordered, with regards to dosage and frequency, to derive the benefit of the medication.
- Do not change the dose on nateglinide without consulting your physician.
- Discuss with your physician or nutritionist regarding your recommended diet plan and calorie intake limitations, if any. Observe compliance with any recommendations made to derive the benefit of nateglinide intake. Grossly overeating or undereating in comparison to the recommended calorie intake can lead to poor blood sugar control and compromise the therapeutic benefit of nateglinide.
- Determine your meal and snack times and strictly adhere to the time. Maintain good regular eating habits. Do not skip a meal, while taking any medications to regulate your blood sugars. Skipping a meal or undereating can bring the blood sugars down. Observing compliance with medication intake in the backdrop of skipped meal or undereating can lower the blood sugars to dangerous levels, thus precipitating an emergency.
- Take the regular tablet as a whole with a glass of water. If you encounter difficulty swallowing the whole regular tablet, check with your doctor if you may cut the pill and swallow it in pieces with a glass of water. Usually tablets that can be cut bear a scoreline, displaying the line of cut. Check if your tablet has any. For individuals with severe swallowing difficulties, check with your doctor if you may also crush the tablet and swallow the powder. Cutting or crushing the tablet can make it easier to swallow but could give very unpleasant taste in the mouth. Sprinkling the powder on a spoonful of soft jelly or applesauce and swallowing the jelly or sauce along with the medication could make it easier. Individuals with swallowing difficulties can check with their physician, if any other preparations of the medication are available to help an easy intake.
- Observe compliance with taking your daily blood sugar readings, as recommended. Log maintenance of all the blood sugar readings help for a comparative feedback. Maintaining a log of dietary items consumed on each meal and snack can provide input with regards to foods that help/harm your plan for blood sugar regulation.
- Nateglinide acts immediately with the first dose of medication, but it can take some time before complete stabilization of blood sugar readings is noticed. So, do not discontinue taking the medication without your physician’s consult.
- While taking nateglinide, notify your doctor of any continuing poorly controlled blood sugars. This can assist your doctor with increasing the dose of nateglinide or adding another medication to help better control your numbers on blood sugar. Also, notify your doctor regarding any continuing or worsening unpleasant side-effects of nateglinide use, so that, your dosage on the medication could be revised.
- If the blood sugars are getting too low with nateglinide use, despite compliance with recommended calorie intake, your dose of nateglinide may need to be revised or change of plan considered. Notify your physician regarding any overly corrected blood sugars with nateglinide use, resulting in episodes of hypoglycemia with extremely low blood sugars, confusion, and dizziness.
- Nateglinide is metabolized in the liver and mainly excreted by the kidneys. Individuals with compromised liver and/or renal disease cannot metabolize and/or excrete nateglinide and metabolites normally. This results in the medication staying in circulation for longer time than normal and can be toxic. Individuals with history of compromised liver or kidney functions must discuss with their physician regarding safety with nateglinide use. While taking nateglinide, periodical labs could be ordered for evaluation of liver and kidney functions. So, maintain compliance with follow-up physician appointments and lab draws ordered, if any, for evaluation of liver and kidney function. Be accommodative to the changes in dose of nateglinide or treatment plan accordingly, to achieve an optimum blood sugar control response and prevent development of any undesired side-effects.
- If you miss a dose, try taking it at the earliest notice of noncompliance. If it is time for the next dose, skip the missed dose and take the dose scheduled. Do not take an extra dose to try making up for the missed dose, which can result in toxicity and an episode of dangerous hypoglycemia. Notify your doctor and other health care personnel regarding your dose noncompliance.
