Products
Miglitol was commercially available in tablet form (Diastabol). It was approved in many countries in 1997 and went out of commerce in 2011. It is still available in some countries. Acarbose (Glucobay) can be used as a possible alternative.
Structure and properties
Miglitol (C8H17NO5, Mr = 207.2 g/mol) is an analog of glucose and a derivative of deoxynojirimycin isolated from bacteria of the genus. It exists as a white to slightly yellowish powder that is soluble in water.
Effects
Miglitol (ATC A10BF02) is antidiabetic. It inhibits the digestion of carbohydrates in the intestine into monosaccharides that can be absorbed. The effects are due to inhibition of α-glucosidases. This reduces the rise in blood glucose after meals and balances blood glucose fluctuations. Miglitol acts locally in the intestine but is also absorbed but excreted again unchanged by the kidneys.
Indications
For the treatment of patients with type 2 diabetes mellitus.
Dosage
According to the SmPC. The drug is taken three times daily chewed with the first bite of the meal or unchewed immediately before the meal with liquid.
Contraindications
Miglitol is contraindicated in hypersensitivity, children and adolescents under 18 years of age, during lactation, inflammatory bowel disease, colonic ulcers, intestinal obstruction, chronic bowel disease with digestive and absorption disorders, conditions that may be worsened by increased gas formation in the intestine, and impaired renal function. For complete precautions, see the drug label.
Interactions
Drug-drug interactions have been described with activated charcoal and related substances, digestive enzymes (eg, pancreatin), laxatives, propranolol, and digoxin.
Adverse effects
Adverse effects are a consequence of the increased amount of undigested carbohydrate in the intestine. The most common potential adverse effects include increased gas, flatulence, diarrhea, abdominal pain, nausea, constipation, and dyspepsia.
