nateglinide.txt

CLINICAL USE

Treatment of type 2 diabetes in combination with metformin

DOSE IN NORMAL RENAL FUNCTION

60–180 mg 3 times daily

PHARMACOKINETICS

Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :317.4

%Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :97–99

%Excreted unchanged in urine &nbsp &nbsp : 6–16

Volume of distribution (L/kg) &nbsp &nbsp &nbsp :0.17–0.2

half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :1.5/Unchanged

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

30–50 Dose as in normal renal function15–30 Dose as in normal renal function<15 Start at a low dose and increase according to response

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Not dialysed. Dose as in GFR<15 mL/min

HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Not dialysed. Dose as in GFR<15 mL/min

HDF/high flux &nbsp :Not dialysed. Dose as in GFR<15 mL/min

CAV/VVHD &nbsp &nbsp &nbsp:Not dialysed. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

Antibacterials: concentration reduced by rifampicin

Antifungals: hypoglycaemic effect possibly enhanced by fluconazoleLipid-lowering agents: hypoglycaemic effect possibly enhanced by gemfibrozil

ADMINISTRATION

Reconstition

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Route

Oral

Rate of Administration

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Comments

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OTHER INFORMATION

Although there is a 49% decrease in Cmax of nateglinide in dialysis patients, the systemic availability and half-life in diabetic subjects with moderate to severe renal insufficiency (creatinine clearance=15–50 mL/min) was comparable between renal subjects requiring haemodialysis and healthy subjects. Although safety was not compromised in this population, dose adjustment may be required in view of low Cmax Metabolite removed by dialysis

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