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Indications and Dosage
Oral
Type 2 diabetes mellitus Adult: Initially, 25 mg tid. Increase if necessary after 4-8 wk to 50 mg tid and continue for 3 mth. Max: 100 mg tid.
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Administration
Should be taken with food. Take w/ 1st bite of each main meal.
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Contraindications
Patient w/ diabetic ketoacidosis, inflammatory bowel disease, colonic ulceration, partial intestinal obstruction or predisposition to this condition, chronic intestinal diseases associated w/ marked disorders of digestion or absorption and co-existing conditions that may deteriorate as a result of increased intestinal gas formation.
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Special Precautions
Patient exposed to stress (e.g. fever, trauma, infection, surgery). Renal impairment. Pregnancy and lactation.
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Adverse Reactions
Abdominal pain or discomfort, diarrhoea, flatulence, skin rash.
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Patient Counseling Information
Adhere to diet and exercise regimen.
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Monitoring Parameters
Periodic monitoring of blood glucose tests. Measure glycosylated Hb to monitor long term glycaemic control.
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Drug Interactions
Concomitant use w/ insulin increases the risk of hypoglycaemia. Intestinal adsorbents (e.g. charcoal) and carbohydrate-splitting digestive enzyme supplements (e.g. amylase, pancreatin) may reduce glycaemic effects. May significantly reduce the bioavailability of ranitidine and propranolol.
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Action
Description:
Mechanism of Action: Miglitol reversibly inhibits membrane-bound intestinal α-glucosidase enzymes which hydrolyse oligosaccharides and disaccharides to glucose and other monosaccharides in the small intestinal brush border. It delays carbohydrate breakdown, glucose absorption and reduces postprandial hyperglycaemia. Pharmacokinetics: Absorption: Absorption from GI tract is saturable at high doses. Bioavailability: 50-70% (100 mg); 100% (25 mg). Time to peak plasma concentration: W/in 2-3 hr. Distribution: It crosses the placenta and enters breast milk (small amounts). Volume of distribution: 0.18 L/kg. Plasma protein binding: <4%. Metabolism: Not metabolised. Excretion: Via urine (95%) as unchanged drug. Elimination half-life: Approx 2 hr. |
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Chemical Structure
 Source: National Center for Biotechnology Information. PubChem Database. Miglitol, CID=441314, https://pubchem.ncbi.nlm.nih.gov/compound/Miglitol (accessed on Jan. 22, 2020) |
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Storage
Store at 25°C.
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MIMS Class
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References
Anon. Miglitol. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 13/08/2014. Buckingham R (ed). Miglitol. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 13/08/2014. Glycet Tablets. U.S. FDA. https://www.fda.gov/. Accessed 13/08/2014. Glyset Tablet, Film Coated (Pharmacia and Upjohn Company). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 13/08/2014. McEvoy GK, Snow EK, Miller J et al (eds). Miglitol. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 13/08/2014.
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