糖尿病 Type 2 diabetes mellitus (noninsulin-dependent)
Adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus

Antidiabetic Agent, Alpha-Glucosidase Inhibitor

Renal function impairment: Because miglitol is excreted primarily by the kidneys, accumulation is expected. However, dosage adjustment to correct the increased plasma concentrations is not feasible because miglitol acts locally.

Hypersensitivity to miglitol or any of component of the formulation; diabetic ketoacidosis; inflammatory bowel disease; colonic ulceration; partial intestinal obstruction or predisposition to intestinal obstruction; chronic intestinal diseases associated with marked disorders of digestion or absorption or with conditions that may deteriorate as a result of increased gas formation in the intestine

Agents other than miglitol are currently recommended to treat diabetes mellitus in pregnancy (ADA 2020).
To prevent adverse outcomes, prior to conception and throughout pregnancy, maternal blood glucose and HbA1c should be kept as close to target goals as possible but without causing significant hypoglycemia (ADA 2020; Blumer 2013).

Miglitol is present in breast milk( ~0.4% of a 100 mg maternal dose). Breastfeeding is not recommended by the manufacturer.

>10%: Gastrointestinal: Flatulence (42%), diarrhea (29%), abdominal pain (12%)

Initial: 25 mg 3 times daily at the start of each meal or may consider 25 mg once daily with gradual titration to 25 mg 3 times daily to minimize GI intolerance.
After 4 to 8 weeks: Dose should be titrated to maintenance dose of 50 mg 3 times daily and continue for ~3 months; if glycosylated hemoglobin is not satisfactory, may further increase to maximum recommended dose: 100 mg 3 times daily.
As tolerated, the lowest effective dose should be maintained.

1. CrCl ?25 mL/minute: No dosage adjustment necessary. Although miglitol is primarily excreted unchanged, the increased plasma levels in renal impairment are not expected to affect efficacy (clinical response is localized to the GI tract); however, the effects on adverse effects are unknown.
2. CrCl <25 mL/minute or SCr >2 mg/dL: Use not recommended (not adequately studied).

No dosage adjustment necessary.