Home Drug Guide Miglitol

Drug Guide

Generic Name

Miglitol

Brand Names Glyset

Classification

Therapeutic: Antidiabetic agent

Pharmacological: Alpha-glucosidase inhibitor

FDA Approved Indications

  • Management of type 2 diabetes mellitus as an adjunct to diet and exercise

Mechanism of Action

Miglitol inhibits intestinal alpha-glucosidases, enzymes responsible for breaking down complex carbohydrates into monosaccharides, thereby delaying carbohydrate digestion and absorption to reduce postprandial blood glucose levels.

Dosage and Administration

Adult: Initially 25 mg once daily at the first bite of the main meal. Dosage can be titrated up to 50 mg three times daily based on glycemic response.

Pediatric: Not approved for use in pediatric patients.

Geriatric: Use with caution; dose adjustments may be necessary based on renal function.

Renal Impairment: Renal function should be assessed prior to initiation and periodically; dose adjustment may be necessary for renal impairment.

Hepatic Impairment: Data limited; use with caution in hepatic impairment.

Pharmacokinetics

Absorption: Poorly absorbed from gastrointestinal tract; systemic absorption is minimal.

Distribution: Minimal systemic distribution due to poor absorption.

Metabolism: Not significantly metabolized.

Excretion: Excreted unchanged primarily via the urine.

Half Life: Approximately 2 hours in plasma, but not relevant as systemic absorption is minimal.

Contraindications

  • Impaired renal function (eGFR < 25 mL/min/1.73 m²)
  • Inflammatory bowel disease
  • Chronic intestinal disease associated with defect in carbohydrate absorption

Precautions

  • Use cautiously in patients with hepatic impairment, intestinal disorders, or colon ulceration; monitor blood glucose levels closely to avoid hypoglycemia, especially when used with other antidiabetics.

Adverse Reactions - Common

  • Flatulence (Common)
  • Diarrhea (Common)
  • Abdominal pain (Uncommon)

Adverse Reactions - Serious

  • Hepatic dysfunction (Rare)

Drug-Drug Interactions

  • Other antidiabetic agents (additive hypoglycemia risk)
  • Potassium chloride (can cause GI upset)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood glucose levels regularly; assess renal function periodically.

Diagnoses:

  • Risk for hypoglycemia
  • Risk for impaired gastrointestinal function

Implementation: Administer with first bite of meal; titrate dose based on response; educate patient on signs of hypoglycemia.

Evaluation: Evaluate glycemic control through blood glucose monitoring; assess for gastrointestinal side effects.

Patient/Family Teaching

  • Take medication with the first bite of each main meal.
  • Watch for signs of hypoglycemia and hyperglycemia.
  • Maintain regular blood glucose testing.
  • Report any unusual side effects, such as severe abdominal pain or hepatic symptoms.

Special Considerations

Black Box Warnings:

  • None

Genetic Factors: None known.

Lab Test Interference: May cause elevated liver enzymes; monitor as indicated.

Overdose Management

Signs/Symptoms: Severe hypoglycemia, gastrointestinal discomfort.

Treatment: Discontinue drug, provide supportive care, and administer glucose orally or IV as needed.

Storage and Handling

Storage: Store at room temperature away from moisture and heat.

Stability: Stable for at least 2 years if stored properly.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.