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(nategilnide, Novartis)
An oral antidiabetic agent for use as monotherapy, with diet and exercise to improve glycemic control in people with type 2 diabetes. Also approved for use in combination with metformin (Glucophage) when that drug does not adequately control hyperglycemia.
* Dosage: 60-mg or 120-mg tablets taken 1-30 minutes before all three daily meals, skipping a dose when meals are skipped (120 mg recommended as the starting and maintenance dose; 60 mg can be used for people near their target Hp[A.sub.1c] when starting treatment).
* Special Considerations: No dose adjustments necessary for elderly. Use cautiously in people with chronic liver disease. Hypoglycemia a potential risk, but labeling says hypoglycemia was "relatively uncommon" in clinical trials. In monotherapy trials, 2.4% of 1,441 patients on Starlix had hypoglycemia, vs. 0.4% of 458 on placebo.
* Comment: Starlix, an amino acid derivative, stimulates pancreatic insulin secretion within 20 minutes of administration; plasma insulin levels peak after about 1 hour and drop to baseline after 4 hours. The drug "is ...