Adult Dosing
Non-insulin-dependent diabetes mellitus (NIDDM)
- Initial dose: 25 mg PO qd or tid, at the start of each main meal
- Maintenance dose
- Usual dose: 50 mg PO tid
- After 4-8 weeks of the initial 25 mg tid regimen, titrate the dose to 50 mg tid x3 months; obtain glycosylated hemoglobin (HbA1c) levels to assess therapeutic response
- Gradually increase the dose to 100 mg tid if the HbA1c level is not satisfactory
- After obtaining an effective and tolerable dose, it should be maintained
- Max: 300 mg/day
Notes:- Use the lowest effective dose, either alone or in combination with a sulfonylurea
- Gradually increase the frequency of administration from qd to tid to reduce gastrointestinal adverse effects and to determine the minimum dose required for adequate glycemic control
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
Renal Dose Adjustment (Based on serum creatinine)
- Severe renal impairment (serum creatinine >2.0 mg/dL): Use not recommended
Hepatic Dose Adjustment
- Hepatic impairment: Dose adjustment not defined
See Supplemental Patient Information
- There is no evidence of macrovascular risk reduction with miglitol or other anti-diabetic drugs
- Miglitol does not cause hypoglycemia in the fasted or postprandial state; however, hypoglycemia may develop if used together with a sulfonylurea. Use oral dextrose instead of sucrose in the treatment of mild-to-moderate hypoglycemia
- Use temporary insulin therapy in patients exposed to stress such as fever, trauma, infection, or surgery because a temporary loss of control of blood glucose may occur
- Not recommended in diabetic patients with significant renal dysfunction
- Regularly monitor creatinine at baseline, postprandial blood glucose concentrations, and HbA1c levels
Supplemental Patient Information
- Advise patients to take the drug at the start of each main meal and adhere to dietary instructions, a regular exercise program, and regular testing of urine and/or blood glucose
- Emphasize the importance of proper dietary management, caloric restriction, weight loss, and regular physical activity
Pregnancy Category:B
Breastfeeding: Limited information indicates poor excretion of miglitol into breastmilk, unlikely to adversely affect the breastfed infant. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 14 January 2011). As per the manufacturer's data, although low levels of the drug are excreted into human milk; it is recommended not to be administered in nursing women.
Pricing data from www.DrugStore.com in U.S.A.
- Glyset 25 MG TABS [Bottle] (PFIZER U.S.)
90 mg = $111.99
270 mg = $316.96 - Glyset 100 MG TABS [Bottle] (PFIZER U.S.)
90 mg = $125.99
270 mg = $352.76 - Glyset 50 MG TABS [Bottle] (PFIZER U.S.)
90 mg = $120
270 mg = $337.95
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
