Miglitol delays the digestion of carbohydrates (forms of sugar) in your body. This decreases the amount of sugar that passes into your blood after a meal and prevents periods of hyperglycemia (high blood sugar).
Compared to most other diabetes medications, it is one of the least potent drugs. It causes significant gastrointestinal side effects. However, it is associated with weight loss and may be used in individuals with prediabetes to prevent the development of diabetes.
Miglitol is used together with diet and exercise to improve blood sugar control in adults with type 2 diabetes.
Miglitol may also be used for purposes not listed in this medication guide.
Warnings
You should not use miglitol if you have inflammatory bowel disease (ulcerative colitis, Crohn's), a blockage in your intestines, a chronic intestinal disorder that affects digestion, or a stomach disorder that causes excess gas. Do not take miglitol if you are in a state of diabetic ketoacidosis.
Before taking this medicine
You should not use miglitol if you are allergic to it, or if you have:
an inflammatory bowel disease, ulcerative colitis, Crohn's disease;
a chronic intestinal disorder that affects your digestion;
blockage in your intestines;
a stomach disorder that causes excess gas; or
diabetic ketoacidosis (call your doctor for treatment with insulin).
To make sure miglitol is safe for you, tell your doctor if you have kidney disease.
Miglitol is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using miglitol.
Miglitol can pass into breast milk and may harm a nursing baby. You should not breast-feed while using this medicine.
Do not give this medication to anyone under 18 years old without medical advice.
Miglitol (Glyset) Uses:
Diabetes mellitus Type 2:
It is used as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus
Acarbose is another oral diabetes medicine that has a similar mechanism of action as miglitol.
Miglitol (Glyset) Dose in the treatment of Type 2 Diabetes mellitus:
Initial: 25 mg orally three times a day with the first bolus of each meal OR
25 mg once daily with the major meal and gradually titrating the dose to 25 mg thrice daily to minimize the gastrointestinal side effects.
The dose may then be titrated to a maintenance dose of 50 mg thrice daily and continued for about three months.
Patients whose glycemic control is not satisfactory may need to increase the dose to the maximum recommended dose of 100 mg thrice daily.
However, the lowest effective dose should be used.
Concomitant use with insulin and/or insulin secretagogues (eg, sulfonylurea):
Patients may need to reduce their insulin or other diabetes medications dose to avoid the risk of hypoglycemia.
Use in Children:
Not indicated.
Miglitol (Glyset) Pregnancy Risk Category: B
Poorly managed diabetics pose a greater risk for maternal and fetal complications.
Negative maternal and fetal outcomes include preeclampsia and preeclampsia as well as preterm and spontaneous abortions, complications of birth, stillbirths, macrosomia, and preeclampsia.
Patients with diabetes should plan their pregnancy. The target HbA level should be kept as close to the target as possible and as tight as possible, without increasing the chance of hypoglycemia.
Pregnancy should be a good time to use insulin and other drugs.
Use of Miglitol while breastfeeding
It is excreted from breast milk. A 100 mg dose of the drug has resulted in 0.4% infant exposure.
When the drug is given to lactating mothers, the manufacturer suggests that you avoid breastfeeding.
Miglitol (Glyset) Dose in Kidney Disease:
CrCl >=25mL/minute
It is not necessary to adjust the dose.
The drug is excreted unchanged in its simplest form, but the elevated plasma levels due to renal impairment do no affect the effectiveness or the clinical response. It primarily acts in your gastrointestinal tract.
CrCl >25 mL/minute, or SCr >2 mg/dL
It is not recommended for use in severe renal disease.
Miglitol (Glyset) Dose in Liver disease:
Adjustment in the dose is not necessary.
Common Side Effects of Miglitol (Glyset):
Gastrointestinal:
Flatulence
Diarrhea
Abdominal pain
Less Common Side Effects of Miglitol (Glyset):
Dermatologic:
Skin rash
Contraindications to Miglitol (Glyset):
Allergy reactions to miglitol and any component of the formulation
Diabetic ketoacidosis
Inflammatory bowel disease
Colonic ulceration
Patients with partial or predisposed to intestinal obstruction.
An excessive gas formation can lead to chronic gastrointestinal conditions such as malabsorption, maldigestion, or GI problems that are more severe.
Warnings and precautions
GI side effects:
Many patients experience gastrointestinal side effects.
With continued treatment, diarrhea and abdominal pain are less common.
Hypoglycemia:
Hypoglycemia is less common with monotherapy. However, it can occur when the drug is combined with insulin or sulfonylurea.
Miglitol-treated patients with mild to moderate hypoglycemia should be given oral glucose, instead of sucrose. Sucrose won’t be absorbed and will not be hydrolyzed into fructose or glucose.
For severe hypoglycemia episodes, intravenous glucose or glucagon may be required.
Renal impairment:
It is not recommended for patients suffering from severe kidney diseases, such as those with a CrCl less than 25ml/minute or creatinine greater than 2mg/dl.
Stress-related disorders:
In cases of stress-related conditions such as surgery, trauma, or severe medical condition, Miglitol could be stopped.
In these cases, insulin may be of benefit to patients.
Miglitol: Drug Interaction
Note: Drug Interaction Categories:
Risk Factor C: Monitor When Using Combination
Risk Factor D: Consider Treatment Modification
Risk Factor X: Avoid Concomitant Use
Risk Factor C (Monitor therapy)
Alpha-Lipoic Acid
May enhance the hypoglycemic effect of Antidiabetic Agents.
Androgens
May enhance the hypoglycemic effect of Blood Glucose Lowering Agents. Exceptions: Danazol.
Direct Acting Antiviral Agents (HCV)
May enhance the hypoglycemic effect of Antidiabetic Agents.
Guanethidine
May enhance the hypoglycemic effect of Antidiabetic Agents.
Hyperglycemia-Associated Agents
May diminish the therapeutic effect of Antidiabetic Agents.
Hypoglycemia-Associated Agents
Antidiabetic Agents may enhance the hypoglycemic effect of Hypoglycemia-Associated Agents.
Maitake
May enhance the hypoglycemic effect of Blood Glucose Lowering Agents.
Monoamine Oxidase Inhibitors
May enhance the hypoglycemic effect of Blood Glucose Lowering Agents.
Pegvisomant
May enhance the hypoglycemic effect of Blood Glucose Lowering Agents.
Prothionamide
May enhance the hypoglycemic effect of Blood Glucose Lowering Agents.
Quinolones
May enhance the hypoglycemic effect of Blood Glucose Lowering Agents. Quinolones may diminish the therapeutic effect of Blood Glucose Lowering Agents. Specifically, if an agent is being used to treat diabetes, loss of blood sugar control may occur with quinolone use.
Ritodrine
May diminish the therapeutic effect of Antidiabetic Agents.
Salicylates
May enhance the hypoglycemic effect of Blood Glucose Lowering Agents.
Selective Serotonin Reuptake Inhibitors
May enhance the hypoglycemic effect of Blood Glucose Lowering Agents.
Thiazide and Thiazide-Like Diuretics
May diminish the therapeutic effect of Antidiabetic Agents.
Monitoring parameters:
Monitor blood sugars and glycated hemoglobin.
Patients who have good glycemic control need to check their HbA at least every six months. Patients who fail to reach their HbA target should monitor it every three months.
How to administer Miglitol (Glyset)?
It should be administered at the start of each meal, usually with the first bolus of the meal.
Mechanism of action of Miglitol (Glyset):
It acts at the brush border of small intestinal membrane-bound enzymes alpha-glucosidase enzymes, which are normally responsible for hydrolyzing oligosaccharides or disaccharide glucose and other monosaccharides.
The inhibition of the enzyme causes the incomplete and delayed absorption of carbohydrates. This results in a decrease in post-prandial blood glucose. It is possible to reverse the inhibition of this enzyme.
It doesn’t cause hypoglycemia, as it doesn’t have an effect on insulin secretion like sulfonylurea.
Absorption:
The dose determines how much absorption is possible (it’s saturable at high doses).
It is fully absorbed when taken at 25 mg.
Only 50% to 70% of 100 mg doses are absorbed.
Protein binding:
< 4%
Metabolism:
It is not metabolized.
Half-life elimination:
~2 hours
Time to peak:
2-3 hours
Excretion:
It is excreted in urine as unchanged.
International Brands of Miglitol (Glyset):
Glyset
Darlibose
Diaban
Diamig
Diaset
Diastabol
Glitol
Litomen
Migbose
Plumarol
Seibule
join with us to know more drugs like this- whatsapp grp1
