miglitol

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miglitol

 [mig´lĭ-tol]
an antidiabetic agent that by inhibiting α-glucosidases of the intestinal brush border delays the breakdown of ingested sugars, slowing the absorption of glucose into the bloodstream and reducing postprandial hyperglycemia; used in the treatment of type 2 diabetes mellitus, administered orally.

miglitol

Glyset

Pharmacologic class: Alpha-glucosidase inhibitor

Therapeutic class: Hypoglycemic

Pregnancy risk category B

Action

Inhibits alpha-glucosidases, which convert oligosaccharides and disaccharides to glucose. This inhibition causes blood glucose reduction (especially in postprandial hyperglycemia).

Availability

Tablets: 25 mg, 50 mg, 100 mg

Indications and dosages

Adjunct to diet in non-insulin-dependent (type 2) diabetes mellitus or combined with a sulfonylurea when diet plus either miglitol or a sulfonylurea alone doesn't control hyperglycemia

Adults: 25 mg P.O. t.i.d. with first bite of each main meal. After 4 to 8 weeks, may increase to 50 mg P.O. t.i.d. After 3 months, adjust dosage further based on glycosylated hemoglobin (HbA1c) level, to a maximum of 100 mg P.O. t.i.d.

Contraindications

• Hypersensitivity to drug or its components
• Insulin-dependent (type 1) diabetes mellitus, diabetic ketoacidosis
• Chronic intestinal disorder associated with marked digestive or absorptive disorders or conditions that may deteriorate due to increased gas formation
• Inflammatory bowel disease, colonic ulceration, partial intestinal obstruction, or predisposition to intestinal obstruction

Precautions

Use cautiously in:
• significant renal impairment (safety not established)
• fever, infection, trauma, stress
• pregnant or breastfeeding patients
• children (safety not established).

Administration

• Give with first bite of three main meals.

Adverse reactions

GI: abdominal pain, diarrhea, flatulence

Skin: rash

Interactions

Drug-drug.Digestive enzyme preparations (such as amylase), intestinal absorbents (such as charcoal): reduced miglitol efficacy

Digoxin, propranolol, ranitidine: decreased bioavailability of these drugs

Drug-diagnostic tests.Serum iron: below-normal level

Drug-food.Carbohydrates: increased diarrhea

Patient monitoring

• Monitor CBC, blood glucose, and HBA1c levels.
• Watch for hyperglycemia or hypoglycemia, especially if patient also takes insulin or oral sulfonylureas.

Patient teaching

• Instruct patient to take drug three times daily with first bite of three main meals.
• Advise patient to take drug as prescribed. If appropriate, tell him he may need insulin during periods of increased stress, infection, or surgery.
• Teach patient about diabetes. Stress importance of proper diet, exercise, weight control, and blood glucose monitoring.
• Inform patient that sucrose (as in table sugar) and fruit juice don't effectively treat miglitol-induced hypoglycemia. Advise him to use dextrose or glucagon instead to raise blood glucose level quickly.
• Tell patient drug may cause abdominal pain, diarrhea, and gas. Reassure him that these effects usually subside after several weeks.
• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs, tests, and foods mentioned above.

miglitol

/mig·li·tol/ (mig´lĭ-tol) an enzyme inhibitor that slows the absorption of glucose into the bloodstream and reduces postprandial hyperglycemia; used in the treatment of type 2 diabetes.

miglitol

(mĭg′lĭ-tôl′)
n.
A drug, C8H17NO5, that reduces blood glucose levels by inhibiting the breakdown of complex carbohydrates in the intestine and is used to treat type 2 diabetes.

miglitol

an oral hypoglycemic.
indication It is used to treat type 2 diabetes mellitus.
contraindications Factors that prohibit its use include known hypersensitivity to miglitol, diabetic ketoacidosis, cirrhosis, inflammatory bowel disease, colonic ulceration, partial intestinal obstruction, and chronic intestinal disease.
adverse effects Hepatotoxicity is a life-threatening side effect. Other adverse effects are low iron and rash. Common side effects are abdominal pain, diarrhea, and flatulence.
References in periodicals archive ?
Other Names for This Medicine Generic Name Brand Name acarbose Precose miglitol Glyset
Precose and Glyset are also insulin-sparing agents with a modest effect on HgA1c, but they require careful titration because of their excessive flatulence and laxative effect.
Generic name Brand name acarbose Precose miglitol Glyset
For example, Tier 3 drugs to treat diabetes moved to Tier 2 status include Byetta, Fortamet, Glucagen, Glumetza, Glyset, Prandin, Riomet, Starlit and Symlin.
Generic name Trade name Mechanism of action Repaglinide Prandin [up arrow] Insulin secretion Sulfonylureas Amaryl [up arrow] Insulin secretion Glucotrol XL Glynase [alpha]-Glucosidase Precose Delays digestion and absorption of complex inhibitors Glyset carbohydrates Metformin Glucophage Insulin sensitizes (liver > muscle) Thiazolidinedione Rezulin Insulin sensitizes (Troglitazone) (muscle > liver) Effects on glycemia Generic name FPG, (a) mg/L [HbA.
Administration (FDA) has granted market clearance for Glyset (miglitol)
Glyset has received marketing clearance in the United States, Australia, New Zealand and Canada.
During the third quarter, the company further strengthened its diabetes portfolio with the acquisition of rights to Glyset Tablets in the U.
As part of its aggressive Medication Dedication program, Blue Cross and Blue Shield of North Carolina not only waived copayment for generics but also moved more than 40 drugs to treat chronic diseases, such as Glyset and GlucaGen for diabetes, from tier 3 to tier 2.
xx Actos, Amaryl, Avandamet, Avandia, chlorpropamide, Diabeta, Diabinese, Fortamet, Glipizide, Glipizide ER, Glipizide XL,Glucophage, Glucophage XR, Glucotrol, Glucotrol XL, Glucovance, glyburide, glyburide micronized, glyburide-metformin, Glynase, Glyset, Humalog, Humalog Mix 75/25, Humulin 50/50, Humulin 70/30, Humulin L, Humulin N, Humulin R, Humulin U, Iletin II Lente Pork, Iletin II NPH Pork, Iletin II Regular Pork, Iletin NPH, Lantus, Metaglip, metformin, metformin ER, Micronase, Novolin 70/30, Novolin L, Novolin N, Novolin R, Novolog, Novolog Mix 70/30, Prandin, Precose, Riomet, Starlix, tolazamide, tolbutamide, Tolinase, Velosulin Human BR ED = Erectile dysfunction; ICD-9-CM = International Classification of Diseases, 9th Edition, Clinical Modification; HCTZ = hydrochlorothiazide.
Imino sugars have shown therapeutic potential as drugs for a number of medical uses (the marketed drugs Zavesca and Glyset are imino sugars for example) but their development has been hampered by the challenges in identification and isolation resulting in very few being available for study as potential pharmaceuticals.
The Diabetes-related drugs included in the analysis were: Actos (pioglitazone), Amaryl (glimepiride), Avandia (rosiglitazone), Byetta (eventide), DiaBeta (glyburide), Glucophage (metformin), Glucovance (glyburide and metformin), Glynase (glyburide), Glyset (miglitol), Humalog (insulin lispro), Insulin Isophane, Invokana (canaglifozin), Januvia (sitagliptin), Kazano (alogliptin and metformin), Lantus (insulin glargine), Nesina (alogliptin), NovoLog (insulin aspart), Onglyza (saxagliptin), Oseni (alogliptin0.