Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes Starlix (Nateglinide). If you are concerned about side effects, discuss the risks and benefits of Starlix (Nateglinide) with your doctor.

The following side effects have been reported by at least 1% of people taking Starlix (Nateglinide). Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• abdominal or stomach pain
• back pain
• chills
• cough
• dizziness
• heartburn
• pain in the joints or muscles
• runny or stuffy nose
• sneezing
• sore throat
• swelling in the joints

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• symptoms of low blood glucose, including:

anxious feelings behaviour changes similar to being drunk blurred vision cold sweats confusion cool, pale skin difficulty thinking drowsiness excessive hunger

fast heartbeat headache nausea nervousness nightmares restless sleep shakiness slurred speech unusual tiredness or weakness

Stop taking the medication and seek immediate medical attention if any of the following occur:

• convulsions (seizures)
• signs of a Anaphylaxis (severe allergic reaction) (e.g., difficulty breathing, Hives, swelling of the face or throat)
• unconsciousness

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Starlix (Nateglinide).

Do not take this mediction if you:

• are allergic to Starlix (Nateglinide) or to any of the ingredients of the medication
• are pregnant
• have diabetic ketoacidosis
• have Type 1 Diabetes

There may be an interaction between Starlix (Nateglinide) and any of the following:

• beta-adrenergic blockers (e.g., Nadolol, Propranolol, Timolol)
• corticosteroids (e.g., Prednisone)
• monoamine oxidase (MAO) inhibitors (e.g., Tranylcypromine, Phenelzine)
• nonsteroidal anti-inflammatories (NSAIDS; e.g., Naproxen, Ibuprofen)
• other diabetes medications (e.g., Glyburide, metformin)
• salicylates (e.g., Asa)
• sympathomimetics (e.g., Epinephrine, Pseudoephedrine)
• thiazide diuretics (e.g., Hydrochlorothiazide)
• Thyroid medications (e.g., Levothyroxine)

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Starlix (Nateglinide). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Starlix (Nateglinide).

Liver disease: If you have moderate-to-severe liver disease, discuss with your doctor how Starlix (Nateglinide) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Starlix (Nateglinide), and whether any special monitoring is needed.

Low blood glucose: Starlix (Nateglinide) may cause low blood glucose (Hypoglycemia). Certain people are more sensitive to this effect, including seniors, people who are undernourished, and people who have exercised more strenuously than usual. If you are taking other diabetes medications, have consumed alcohol, or have other medical conditions that cause low blood glucose (e.g., an underactive pituitary or adrenal gland, or kidney problems), you may need to check your blood glucose levels more frequently. Consult your doctor for advice about whether any special monitoring is necessary.

Pregnancy: Starlix (Nateglinide) should not be used during pregnancy. If you think you may be pregnant or if you become pregnant while taking Starlix (Nateglinide), contact your doctor immediately.

Breast-feeding: It is not known if Starlix (Nateglinide) passes into breast milk. If you are a breast-feeding mother and are taking Starlix (Nateglinide), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Starlix (Nateglinide) have not been established for children.