Miglitol

Acarbose and Miglitol These agents are specific inhibitors of intestinal glucosidases and reduce the conversion of sucrose and starch to glucose. Their main effect is a delay, not a complete inhibition, of the absorption of carbohydrates. Postprandial blood sugar excursions are effectively reduced. Because a small portion of the carbohydrates enters the colon, their microbial degradation frequently causes flatulence or... 

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

The a-glucosidase inhibitors, acarbose (Precose) and miglitol (Glyset), lower blood sugar by delaying die digestion of carbohydrates and absorption of carbohydrates in the intestine. 

The a-glucosidase inhibitors are contraindicated in patients with a hypersensitivity to the drug, diabetic ketoacidosis, cirrhosis, inflammatory bowel disease, colonic ulceration, partial intestinal obstruction or predisposition to intestinal obstruction, or chronic intestinal diseases. Acarbose and miglitol are used cautiously in patients with renal impairment or pre-existing gastrointestinal (GI) problems such as irritable... 

C jHi20ft 50-99-7) see Ascorbic acid Metaraminol Miglitol Sorbitol... 

Acarbose (Precose) and miglitol (Glyset) are dosed similarly. Therapy is initiated with a very low dose (25 mg with one meal a day) and increased very gradually (over several months) to a maximum of 50 mg three times daily for patients weighing 60 kg or more, or 100 mg three times daily for patients above 60 kg. The drugs should be taken with the first bite of the meal so that the drug is present to inhibit enzyme activity. 

Glyset 25-100 mg (miglitol) One tab tid with the first bite of each meal... 

Miglitol (Glyset) Hypoglycemic Tab 25, 50,100 mg 25 mg tid, then 50-100 mg tid with the first bite of each meal. Delays carbohydrate absorption. Rash, Gl upset... 

Combination therapy - In combination with a sulfonylurea when diet plus either miglitol or a sulfonylurea alone do not result in adequate glycemic control. The effect of miglitol to enhance glycemic control is additive to that of sulfonylureas when used in combination, presumably because the mechanism of action is different. 

The use of miglitol must be viewed as a treatment in addition to diet and not as a substitute for diet or as a convenient mechanism for avoiding dietary restraint. 

In contrast to sulfonylureas and thiazolidinediones, miglitol does not enhance insulin secretion. Miglitol has minor inhibitory activity against lactase and, at recommended doses, would not be expected to induce lactose intolerance. 

Absorption - Absorption of miglitol is saturable at high doses a dose of 25 mg is completely absorbed, whereas a dose of 100 mg is only 50% to 70% absorbed. Peak concentrations are reached in 2 to 3 hours. 

Distribution - The protein binding of miglitol is negligible (less than 4%). Miglitol has a volume of distribution of 0.18 L/kg, consistent with distribution primarily into the extracellular fluid. 

Excretion - Miglitol is eliminated by renal excretion as unchanged drug. Following a 25 mg dose, more than 95% of the dose is recovered in the urine within 24 hours. The elimination half-life from plasma is approximately 2 hours. 

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