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Non-Sulfonylurea Insulin Secretagogues
Aka: Non-Sulfonylurea Insulin Secretagogues, Meglitinide, Repaglinide, Prandin, Nateglinide, Starlix- See Also
- Mechanism
- Insulin secretogogue
- Indication
- Early Type II Diabetes Mellitus Oral Agent
- Elevated postprandial Glucose
- Consider if only used intermittently pre-meal
- Contraindications
- Hypersensitivity Reaction to sulfa
- Category
- Mechanism
- Benzoic acid derivative
- Similar to Sulfonylurea
- Binds different sites from Sulfonylureas
- Closes ATP sensitive K+ channels
- Results in Insulin secretion
- Shorter duration of binding and shorter effect
- Predominately effects postprandial Glucose
- Advantages
- Low risk of Hypoglycemia (2.4%)
- Effect depends on Ambient Blood Glucose levels
- No significant gastrointestinal side effects
- Minimal weight gain
- No lab monitoring required
- No significant Drug Interactions
- No Lactic Acidosis
- No adjustments needed (other than per meal)
- No adjustment in Congestive Heart Failure
- No adjustment for age
- No adjustment in Renal Insufficiency
- Adverse Effects
- Hypoglycemia (lower risk of Sulfonylureas)
- Disadvantages
- Two to three times as expensive as Sulfonylureas
- Agents
- Repaglinide (Prandin)
- Nateglinide (Starlix)
- Significantly weaker activity compared with Prandin
- References
| Medication Costs | ||
|---|---|---|
| repaglinide (on 5/17/2017 at Medicaid.Gov Pharmacy Drug pricing) | ||
| REPAGLINIDE 0.5 MG TABLET | Generic | $0.25 each |
| REPAGLINIDE 1 MG TABLET | Generic | $0.24 each |
| REPAGLINIDE 2 MG TABLET | Generic | $0.23 each |
| nateglinide (on 5/17/2017 at Medicaid.Gov Pharmacy Drug pricing) | ||
| NATEGLINIDE 120 MG TABLET | Generic | $0.56 each |
| NATEGLINIDE 60 MG TABLET | Generic | $0.54 each |
| starlix (on 1/4/2017 at Medicaid.Gov Pharmacy Drug pricing) | ||
| STARLIX 120 MG TABLET | Generic | $0.56 each |
| FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information. | ||
Meglitinide (C0065880) |
|
|---|---|
| Definition (NCI) | A benzamide belonging to the meglitinide class of antidiabetic agents with hypoglycemic activity. Meglitinide represents the basic structure of the meglitinide-type agents and is not used therapeutically. |
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | C030516 |
| SnomedCT | 109075003, 372566000 |
| English | 4-(2-(5-chloro-2-methoxybenzamido)ethyl)benzoic acid, meglitinide, meglitinide [Chemical/Ingredient], meglitinides, Meglitinide, MEGLITINIDE, Meglitinide (product), Meglitinide (substance) |
| Spanish | meglitinida (producto), meglitinida (sustancia), meglitinida |
| Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
repaglinide (C0246689) |
|
|---|---|
| Definition (NCI) | A nonsulfonylurea insulin secretagogue belonging to the melgitinide class with hypoglycemic activity. Repaglinide is rapidly absorbed and has a rapid onset and short duration of action. This agent is metabolized in the liver by CYP2C8 and CYP3A4 and its metabolites are excreted in the bile. Repaglinide has a half-life of one hour. |
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | C072379 |
| SnomedCT | 109074004, 386964000 |
| LNC | LP34567-5, MTHU017515 |
| English | repaglinide, (+)-2-Ethoxy-alpha-(((S)-alpha-isobutyl-o-piperidinobenzyl)carbamoyl)-p-toluic Acid, Benzoic Acid, 2-ethoxy-4-(2-((3-methyl-1-(2-(1-piperidinyl)phenyl)butyl)amino)-2-oxoethyl)-,(S)-, repa-glinide, repaglinide (medication), REPAGLINIDE, repaglinide [Chemical/Ingredient], (S)-2-ethoxy-4-(2-((3-methyl-1-(2-(1-piperidinyl)-phenyl)butyl)amino)-2-oxoethyl)-benzoic acid, Repaglinide, Repaglinide (product), Repaglinide (substance) |
| Japanese | レパグリニド |
| Spanish | repaglinida (producto), repaglinida (sustancia), repaglinida |
| Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
Prandin (C0722725) |
|
|---|---|
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | C072379 |
| English | Prandin, repaglinide (Prandin), prandin, Novo Nordisk brand 2 of repaglinide |
| Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
nateglinide (C0903898) |
|
|---|---|
| Definition (NCI) | A phenylalanine derivative of the meglitinide class of agents with hypoglycemic activity. Nateglinide, compared to repaglitinide, binds with a higher affinity to the SUR1 subunit and with a faster onset of action and a shorter duration of action. This agent is metabolized by the cytochrome P450 isoenzyme CYP2C9, and, to a lesser extent, by CYP3A4. The parent drug and metabolites are mainly excreted in the urine and its half-life is about 1.5 hours. |
| Concepts | Pharmacologic Substance (T121) , Amino Acid, Peptide, or Protein (T116) |
| MSH | C060142 |
| SnomedCT | 129496008, 134604002, 387070004 |
| LNC | LP64443-2, MTHU026435 |
| English | IPCCPA, N-((4-isopropylcyclohexyl)carbonyl)phenylalanine, nate-glinide, nateglinide (medication), NATEGLINIDE, nateglinide [Chemical/Ingredient], nateglinide, D-phenylalanine, N-((trans-4-(1-methylethyl)cyclohexyl)carbonyl)-, senaglinide, Nateglinide (product), Nateglinide (substance), Nateglinide |
| Spanish | nateglinida (concepto no activo), nateglinida (producto), nateglinida (sustancia), nateglinida |
| Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
Starlix (C1323198) |
|
|---|---|
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | C060142 |
| English | starlix, Starlix, Novartis brand of nateglinide |
| Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
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