Miglitol pharmacokinetics

Schall R, Muller FO, Hundt HK, Duursema L, Groenewoud G, Middle MV. Study of the effect of miglitol on the pharmacokinetics and pharmacodynamics of warfarin in healthy males. Arzneimittelforschung 1996 46(l) 41-6. 

Ahr, H J, Boberg, M, Brendel, E, Krause, H P, Steinke, W, Pharmacokinetics of miglitol. Absorption, distribution, metabolism, and excretion following administration to rats, dogs, and man,... 

Pharmacokinetics. The mechanism of action of a-glucosidase inhibitors is limited to the luminal side of the intestine. Some metabolites of acarbose are systemically absorbed and renally excreted, whereas the majority of miglitol is absorbed and renally excreted unchanged. 

Acarbose, miglitol and voglibose did not appear to alter the pharmacokinetics or effects of warfarin. However, there are a few cases of reduced or increased INRs in patients given warfarin and acarbose. 

In a double-blind, randomised, placebo-controlled study, 24 healthy subjects were given miglitol 100 mg three times daily for 7 days, with a single 25-mg oral dose of warfarin on day 4. Neither the pharmacokinetics nor the pharmacodynamics ofR- or 5-warfarin was affected by the miglitol No special precautions would therefore appear to be needed if these two drugs are used concurrently. 

The pharmacokinetic changes seen are minor and unlikely to be clinically relevant. The manufacturers say that while alpha glucosidase inhibitors such as acarbose and miglitol do not cause hypoglycaemia when given alone, they may increase the blood glucose-lowering effects of insulin and... 

The manufacturer notes that an antacid (not specified) did not alter the pharmacokinetics of miglitol in healthy subjects. ... 

Pharmacokinetic studies. Acarbose 300 mg daily for one week had no effect on the pharmacokinetics or pharmacodynamics of a single 80-mg dose of propranolol in healthy subjects. Conversely, the manufacturer of miglitol notes that it reduced the bioavailability of propranolol by a... 

Aipha- ucosidase inhibitors The manufacturers of acarbose say that in a pilot study of a possible interaction with nifedipine, no significant or reproducible changes were seen in plasma nifedipine profiles. Similarly, the manufacturers of miglitol note that it had no effect on the pharmacokinetics and pharmacodynamics of nifedipine. ... 

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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