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Miglitol is referred to the class of hypoglycemic agents. It has high chemical affinity (more than 1000-fold) to intestine disaccharides. Being a reversible inhibitor of alpha-glucosidase (sucrase, glucoamylase, maltase, pancreatic amylase), it is located on the brush border epithelium of the small intestine and in the final stage involved in digestion of carbohydrates.
The preparation slows splitting of di, oligo-and polysaccharides to glucose and inhibits its absorption. The intensity of the effect depends on the dosage. The preparation helps to reduce postprandial hyperglycemia, smooth surges of glucose concentration in blood, acting positively on lipid metabolism. A vital property of Migitol is that it neither affects the digestibility of glucose, nor stimulates secretion of insulin by the pancreas. The treatment is considered to be most effective when the preparation is taken on an empty stomach or in combination with other hypoglycemic drugs.
Miglitol is almost completely absorbed after oral administration of low doses (12.5-25 mg). Increasing the dose from 25 mg to 200 mg results in a non-linear change of the absorption profile. At a dose of 50 mg of absorption is equal to 90%, 100 mg – 60%. Absorption characteristics correspond to the kinetics of the Michaelis - Menten equation, and the absorption takes place from the 6th to the 10th hour after administration. Plasma protein binding is < 4%. Not biotransformation. Excreted by the kidneys in unchanged form.
The interaction of preparation is characterized by the following effects:
• Hypoglycemic effect of the sulfonylureas, insulin enhancement.
• Propranolol and ranitidine absorption reduction.
• Intestinal absorbents, antacids, cholestyramine and drugs containing enzymes that break down carbohydrates, weaken the therapeutic effect of the drug.
• In combination with laxative drugs gastrointestinal tract disorders may develop.
Miglitol indications for use
The medication is prescribed to those suffering from Type 2 diabetes mellitus. Migitol can be prescribed both as monotherapy (not amenable to treatment by diet) and in combinative therapy (in addition to diet, or as an additive to sulfonylureas or metformin).
The medication is prescribed for perioral administration, chew the pill and take it with the first meal or before a meal. The medication is recommended to be washed down with a sip of the liquid. The initial dose of Miglitol equals 25 mg 1-3 times per day. After 4-8 weeks of treatment the dosage of 50 mg 3 times a day can be used. In case of good individual tolerability, the daily dose regimen may be increased to 300-600 mg / day (3 doses).
The medication should be administered carefully or avoided in case of hypersensitivity to Miglitol components, diabetic ketoacidosis, malabsorption syndrome in chronic intestinal diseases, remhelda syndrome, inflammatory diseases of the gastrointestinal tract, ulcerative lesions of the colon (ulcerative colitis), partial intestinal obstruction (a predisposition to it), the threat of an increase in hernia result of increased gas formation, chronic renal failure (creatinine clearance less than 25 ml/ min). Women during pregnancy and lactation periods as well as individuals under 18 years old are not recommended to take the medication. Not recommended for use in patients with severe renal impairment (serum creatinine more than 2 mg dL).
Consult your doctor prior to treatment course to avoid side effects such as flatulence, abdominal pain, diarrhea, feeling of heaviness in the stomach, nausea, constipation, increased activity of liver enzymes, allergic reactions (skin rash).
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