Miglitol Metformin

Other combination options Metformin or a Sulfonylurea plus Acarbose/Miglitol, or Pioglitazone/ Rosiglitazone or Repaglinide (with metformin), or Insulin... 

Drugs that may affect miglitol include digestive enzymes and intestinal adsorbents. Drugs that may be affected by miglitol include digoxin, glyburide, metformin, propranolol, and ranitidine. 

Metformin can be effectively combined with miglitol (SEDA-25, 514) but metformin may accumulate in the gastrointestinal wall, and the combination of metformin... 

Acarbose reduces the absorption of metformin (79), as does miglitol (77). 

Chiasson JL, Naditch LMiglitol Canadian University Investigator Group. The synergistic effect of miglitol plus metformin combination therapy in the treatment of type 2 diabetes. Diabetes Care 2001 24(6) 989-94. 

Van Gaal L, Maislos M, Schemthaner G et al. Miglitol combined with metformin improves gly-caemic control in type 2 diabetes. Diabetes Obes Metab 2001 3 326-331. 

Another study in 19 diabetic patients given acarbose 50 or 100 mg three times daily and metformin 500 mg twice daily, also found that acarbose lowered metformin levels (AUC reduced by 12 to 13%, maximum plasma levels reduced by 17 to 20%). Nevertheless, the drug combination reduced the postprandial glucose concentration at 3 hours by 15% mote than metformin alone. Similarly, the manufacturer notes that, in a study in healthy subjects, miglitol 100 mg three times daily for 7 days reduced the AUC and maximum level of a single 1-g dose of metformin by 12% and 13%, respectively, although this difference was not statistically significant. ... 

Cimetidine appears to reduce the clearance of metformin, and may have contributed to a case of metformin-associated lactic acidosis. Cimetidine did not alter repaglinide pharmacokinetics, and ranitidine did not alter pioglitazone or rosiglitazone pharmacokinetics. Acarbose did not alter ranitidine pharmacokinetics, but miglitol decreased the AUC of ranitidine by 60%. 

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