Indications
Miglitol is used together with diet and exercise to control blood sugar in adults with type 2 diabetes. It mainly lowers the rise in blood sugar that happens after meals. It can be used alone or with other diabetes medicines such as sulfonylureas.
How It Works
Miglitol is an alpha-glucosidase inhibitor. It blocks enzymes in the small intestine that break down starches and table sugar into glucose. As a result, carbohydrates are digested and absorbed more slowly, so blood sugar does not rise as sharply after eating.
Dosage and Administration
Adults: the usual starting dose is 25 mg three times a day, taken with the first bite of each main meal. The doctor may increase this after 4 to 8 weeks to 50 mg three times a day. The maximum is 100 mg three times a day. If you skip a meal, skip that dose. Follow your doctor’s instructions.
Interactions
- With Insulin or sulfonylureas such as Gliclazide or Glimepiride, low blood sugar can occur. Treat it with glucose (dextrose) tablets or drink, not table sugar, because Miglitol slows the digestion of table sugar.
- It can reduce the absorption of Propranolol and Ranitidine.
- Digestive enzyme supplements and charcoal tablets may reduce its effect.
- Steroids, thiazide diuretics and thyroid medicines can raise blood sugar.
Contraindications
- Allergy to miglitol
- Diabetic ketoacidosis
- Inflammatory bowel disease, bowel ulcers or bowel blockage, or a tendency to bowel blockage
- Long-term bowel conditions affecting digestion or absorption
- Conditions that may get worse with extra gas in the bowel, such as large hernias
Side Effects
The most common effects are wind (gas), bloating, stomach discomfort and loose stools or diarrhoea. These often lessen over time and are reduced by avoiding very sugary foods. Skin rash can occur occasionally. On its own it rarely causes low blood sugar.
Get urgent medical help if you have severe stomach pain with a swollen belly, persistent vomiting or cannot pass stool or wind, or symptoms of very low blood sugar (shaking, sweating, confusion, fainting) that do not improve with glucose.
Pregnancy and Lactation
Not recommended in pregnancy; insulin is usually preferred to control blood sugar. Miglitol passes into breast milk in small amounts, so it is not recommended during breastfeeding.
Precautions and Warnings
- Keep glucose tablets or glucose drink with you if you also use Insulin or a sulfonylurea.
- Not recommended in significant kidney impairment.
- During illness, injury or surgery, blood sugar control may change; your doctor may switch you to insulin temporarily.
- Check blood sugar regularly as advised.
Overdose
Overdose is unlikely to cause low blood sugar on its own, but may cause wind, bloating and diarrhoea. Avoid carbohydrate-rich foods for 4 to 6 hours and contact a doctor if symptoms are severe.
Therapeutic Class
Antidiabetic, alpha-glucosidase inhibitor.
Storage
Store below 30°C in a dry place, away from light and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.