Miglitol

Indications

Miglitol is used for: Type 2 DM

Adult Dose

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. Hepatic Impairment No admustment necessary

Child Dose

Safety & efficacy not established

Renal Dose

Renal Impairment Mild-moderate impairment: No dosage adjustment Severe impairment: Not recommended

Administration

Should be taken with food. Take w/ 1st bite of each main meal.

Contra Indications

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.

Precautions

Patient exposed to stress (e.g. fever, trauma, infection, surgery). Renal impairment. Pregnancy and lactation. Patient Counselling Adhere to diet and exercise regimen. Monitoring Parameters Periodic monitoring of blood glucose tests. Measure glycosylated Hb to monitor long term glycaemic control. Lactation: Enters slightly into breast milk; nor recommended

Pregnancy-Lactation

Pregnancy Category: B Lactation: Enters slightly into breast milk; nor recommended

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.

Adverse Effects

Side effects of Miglitol : >10% Flatulence (42%), Diarrhea (29%), Abdominal pain (12%) 1-10% Rash (4.3%) Frequency Not Defined Low serum iron

Mechanism of Action

Miglitol reversibly inhibits membrane-bound intestinal ?-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.