Nitamoon Plus 60
Nitamoon Plus 60 - Image 2
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Nitamoon Plus 60

Contains:

  • Nateglinide USP 60 mg

  • Metformin Hydrochloride IP 500 mg

  • Voglibose IP 0.2 mg
    Therapeutic Class:

  • Insulin Secretagogue (Meglitinide) + Insulin Sensitizer (Biguanide) + α-Glucosidase Inhibitor
    Schedule: Schedule H (Prescription Drug)

Nitamoon Plus 60 is a triple oral antidiabetic combination that targets the three major pathophysiological defects in Type 2 Diabetes Mellitus (T2DM):

  1. Nateglinide stimulates rapid, glucose-dependent early-phase insulin release, thereby lowering postprandial glucose spikes.

  2. Metformin decreases hepatic glucose output and improves insulin sensitivity, primarily reducing fasting glucose.

  3. Voglibose, an α-glucosidase inhibitor, delays carbohydrate absorption in the intestine, smoothing post-meal glucose excursions.

This synergistic triple-action makes Nitamoon Plus 60 highly effective in early and moderate T2DM, especially in Indian patients with carbohydrate-heavy diets and pronounced postprandial hyperglycemia.

Usage of Nitamoon Plus 60

  • Type 2 Diabetes Mellitus:

    • In patients uncontrolled on dual therapy (e.g., Metformin + Sulfonylurea or Metformin + Voglibose)

    • In cases with significant post-meal sugar spikes

    • Patients with irregular meal patterns

    • Young diabetics, early-stage diabetics, or those reluctant for insulin

    • Obese patients needing weight-neutral glucose control

Mechanism of Action

  • 🟢 Nateglinide: Triggers early insulin release in response to food (mealtime coverage)

  • 🔵 Metformin: Reduces hepatic glucose production and increases peripheral glucose uptake

  • 🟣 Voglibose: Inhibits α-glucosidase enzymes, slowing glucose absorption in the small intestine

➡ Together, they control fasting, post-meal, and hepatic glucose levels—a full-spectrum glycemic approach.

Common Side Effects

  • Hypoglycemia (mild, especially if meal is delayed or skipped)

  • Flatulence, bloating, abdominal discomfort (mostly voglibose-related)

  • Nausea, metallic taste (metformin-related)

  • Headache, dizziness (nateglinide-related)

  • GI side effects usually improve over time or with gradual titration

Precautions

  • Avoid in Type 1 Diabetes, diabetic ketoacidosis

  • Use caution in renal impairment (eGFR <30 mL/min: contraindicated)

  • Avoid in hepatic impairment or history of lactic acidosis

  • Ensure regular meals to avoid hypoglycemia

  • Caution in elderly or malnourished patients

  • Monitor HbA1c, renal function, and vitamin B12 levels periodically

Drug Interactions

  • Alcohol: May potentiate lactic acidosis (avoid or limit)

  • Beta-blockers: May mask hypoglycemia symptoms

  • Rifampicin, corticosteroids, diuretics: May increase glucose levels

  • NSAIDs, salicylates, MAOIs: May increase hypoglycemia risk

  • Avoid combining with other secretagogues or insulin unless monitored closely

Dosage and Administration

  • One tablet twice or thrice daily, 15–30 minutes before major meals

  • If a meal is skipped, skip the dose to prevent hypoglycemia

  • Dose to be titrated based on glycemic response and tolerability

  • Start low and go slow, especially due to voglibose’s GI effects

Storage

  • Store below 25°C, away from light and moisture

  • Keep out of reach of children

Patient Counselling Tips

  • Must be taken before meals, not after

  • Don’t skip meals after taking the dose

  • GI side effects are common early on and typically settle

  • Maintain hydration and physical activity

  • Inform doctor if experiencing persistent GI discomfort or symptoms of hypoglycemia

  • Regular blood sugar monitoring and periodic labs (HbA1c, kidney, liver function)

Unique Advantages of Nitamoon Plus 60

✅ Targets all 3 core defects: insulin resistance, insulin secretion, and carb absorption
✅ Controls both fasting and postprandial sugars
✅ Low hypoglycemia risk vs sulfonylureas
✅ Weight neutral or minimal gain
✅ Excellent option for Asian diets rich in carbohydrates

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