Pharm
Alpha-glucosidase Inhibitor
search
Alpha-glucosidase Inhibitor
, Acarbose, Precose, Miglitol, Glyset
See Also
Oral Hypoglycemic
Agents
Indications
Type II Diabetes Mellitus
Close to target (
Hemoglobin A1C
<8% as monotherapy)
Contraindications
Diabetic Ketoacidosis
(DKA)
Intestinal disorder
Inflammatory Bowel Disease
Colonic ulceration
Partial
Intestinal Obstruction
Mechanism
Structurally similar to
Glucose
Reversible inhibitor of alpha glucosidase
Present in brush border of
Small Intestine
Interferes with hydrolysis of
Carbohydrate
s
Complex
Carbohydrate
s
Dietary
Disaccharide
s
Delays absorption of
Glucose
and other
Monosaccharide
s
Pharmacokinetics
Acarbose is not absorbed from
Gastrointestinal Tract
Miglitol is absorbed from
Gastrointestinal Tract
Not metabolized
Excreted in urine
Elimination Half-Life
: 2 hours
Excreted in
Breast Milk
in small amounts
Adverse Effects
Poorly tolerated
Gastrointestinal side effects (unabsorbed
Carbohydrate
)
Abdominal Pain
Diarrhea
Flatulence
Hypoglycemia
If used with other
Oral Hypoglycemic
agent or
Insulin
Use oral
Glucose
(not sucrose) to treat
Hypoglycemia
Efficacy
Acarbose associated with cardiovascular benefits
Reduced cardiovascular events
Reduced
Hypertension
risk
Significant weight loss
Chiasson (2003) JAMA 290:486-94 [PubMed]
Dosages
Acarbose (Precose)
Start dose: 25 mg PO tid at start of meal
Maintenance: 50-100 mg PO tid ($45/month)
Miglitol (Glyset)
Start dose: 25 mg PO tid at start of meal
Maintenance: 50-100 mg PO tid ($52/month)
References
(1999) Med Lett Drugs Ther, 41(1053):49-50 [PubMed]
Chiasson (1994) Ann Intern Med 121:928-35 [PubMed]
Type your search phrase here