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The drug miglitol is considered as an oral anti-diabetic drug. Anti-diabetic drugs are drugs that are used primarily for the treatment of diabetes mellitus by lowering the patient’s glucose levels in the blood stream. These drugs are also called anti-hyperglycemic agents or anti-hypoglycemic agents.

The main action of miglitol is to establish greater glycemic control as it prevents the digestion of various carbohydrates such as polysaccharides, oligosaccharides and disaccharides into absorbable forms such as monosaccharides.

Miglitol is marketed under the brand name Glyset. It is indicated as an adjunct treatment with diet and exercise. It is used to improve a patient’s glycemic control as a way to treat diabetes mellitus Type 2.

No strict dosage is given for the administration of miglitol to Type 2 diabetes mellitus patients. However, doses are individualized based on the effectiveness of the drug and the tolerance of the patient. The dose must not exceed the maximum recommended dose of 100 mg three times a day.

Glyset is best taken three times a day, with the start of each main meal, at a starting dose of 25 mg, gradually increasing to prevent side effects and to identify the minimum dose for glycemic control.

The most common side effects of the drug include gastrointestinal problems. Abdominal pain, flatulence and diarrhea were the most common of the side effects. Skin rashes, and allergies were reported as side effects of the use of Glyset as well. Serious side effects, though very rarely experienced, include extreme hypoglycemia, as this is the main action of the drug.

Miglitol is contraindicated in patients with the following conditions:
➢ Patients with known serious gastrointestinal conditions such as inflammatory bowel disease, intestinal obstruction, colonic ulceration;
➢ Patients with diabetic ketoacidosis
➢ Hypersensitivity to the drug or its known components

Caution must be highly exercised if miglitol is to be given to patients with renal impairment, and those who are under stressors such as fever, trauma, surgery or infection as there may be loss of blood glucose.

There have been no known differences with the use of miglitol in pediatric and geriatric patients as compared to the adult patient population. However, caution is still needed, as there may be special instances that patients have loss of control of their blood glucose levels, or may be complicated with existing renal or gastrointestinal concerns.

It is not known whether miglitol has adverse effects to the fetus. However, the use of the drug in pregnant women should always be consulted with the doctor. Miglitol was found excreted in breast milk, albeit at a very little amount. However, nursing mothers, or women planning to breastfeed must first consult their doctor prior to the usage of the drug. The potential benefits of the drug must always be weighed against its risks to the nursing mother and infant.

Miglitol has the following structural formula:

Chemical structure of miglitol

• Molecular formula of miglitol is C8H17NO5
• Chemical IUPAC Name is 1-(2-hydroxyethyl)-2-(hydroxymethyl)piperidine-3,4,5-triol
• Molecular weight is 207.224 g/mol
Miglitol available : 25mg tablets, 50mg tablets and 100mg tablets

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