[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Other glucose-lowering drugs](https://durgical.com/en/pharmacology/classes/other-glucose-lowering-drugs/) › Miglitol

# Miglitol

## Other glucose-lowering drugs?

Other glucose-lowering drugs

An alpha-glucosidase inhibitor taken with meals: it slows starch and sugar digestion in the gut and blunts the rise of glucose after eating.

Updated Nov 1, 2026

## Quick facts

**Group**
[Other glucose-lowering drugs](https://durgical.com/en/pharmacology/classes/other-glucose-lowering-drugs/)

**Target**
Intestinal alpha-glucosidases (maltase-glucoamylase, sucrase)

**Used for**
Type 2 diabetes

**Key effects**
Flatulence · Diarrhoea · Abdominal pain

**Monitor**
Post-meal and fasting glucose · Kidney function

**ATC**
A10BF02

No doses: the clinician sets them by the current guideline.

On this page

- The basics Mechanism of action
- Indications
- Adverse effects
- Pharmacokinetics
- Memory aid

- Safety Contraindications
- Key interactions
- What is monitored
- Administration and safety
- Pregnancy and breastfeeding
- Nursing care

- Study Test yourself

- Connections Connections

## Mechanism of action

✂**Intestinal alpha-glucosidases (maltase-glucoamylase, sucrase)**Miglitol

ⓘ The figure shows miglitol in the active site of the N-terminal domain of human intestinal maltase-glucoamylase.

**Target in 3D:** Intestinal alpha-glucosidases (maltase-glucoamylase, sucrase). PDB structure 3L4W (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/3L4W) · Drag to rotate · pinch to zoom

Miglitol is a glucose-like (deoxynojirimycin) molecule that competitively inhibits the alpha-glucosidases of the small-intestinal brush border. Starch and disaccharides such as sucrose are broken down and absorbed more slowly, so the post-meal glucose peak is lower. Undigested carbohydrate reaches the colon, where bacteria ferment it, causing gas and diarrhoea.

- Competitively blocks brush-border alpha-glucosidases
- Starch and sucrose are split into glucose more slowly
- Glucose enters the blood gradually after meals
- Post-meal glucose peak falls; fermentation causes gas

## Indications

- Type 2 diabetes, with diet and exercise, to lower post-meal glucose [Type 2 diabetes mellitus →](https://durgical.com/en/conditions/type-2-diabetes-mellitus/)

## Adverse effects

### Common

- Flatulence
- Diarrhoea
- Abdominal pain
- Skin rash

### Serious (rare, important)

- Hypoglycaemia when combined with insulin or a sulfonylurea (treated with glucose, not sucrose)

## Contraindications

- Diabetic ketoacidosis
- Inflammatory bowel disease, colonic ulceration or partial intestinal obstruction, or predisposition to obstruction
- Chronic intestinal disease with marked malabsorption, or conditions worsened by more intestinal gas
- Hypersensitivity to the drug

## Key interactions

**Intestinal adsorbents (charcoal) and carbohydrate-splitting digestive enzyme preparations (amylase, pancreatin)**
Reduce miglitol's effect; not taken together.

**Propranolol and ranitidine**
Their bioavailability can fall.

**Digoxin**
Plasma digoxin was lower in healthy volunteers (but not in a study of diabetic patients).

**Insulin or sulfonylureas**
Higher risk of hypoglycaemia.

## What is monitored

- Post-meal and fasting glucose, HbA1c
- Kidney function
- Gastrointestinal tolerance

## Administration and safety

- Oral tablet, taken with the first bite of each main meal.
- Started low and increased gradually to limit gas and diarrhoea.
- Hypoglycaemia (with other drugs) is treated with glucose (dextrose), not sucrose.

## Pregnancy and breastfeeding

Safety in pregnancy is not established; insulin is the usual treatment for diabetes in pregnancy.

## Nursing care

- Before: bowel disease, kidney function.
- During: gas, bloating, diarrhoea; glucose before and after meals.
- Teach to keep glucose tablets or gel, not sugar or candy, for hypoglycaemia.
- Teach that the tablet is skipped if the meal is skipped.

## Pharmacokinetics

**Absorption**
Unlike acarbose it is absorbed, saturably (less at higher amounts).

**Metabolism**
Not metabolized.

**Elimination**
Excreted unchanged by the kidneys; it accumulates in kidney impairment.

## Memory aid

MIGlitol = 'Make Intestine Go slow': carbohydrate digestion slows, gas rises. Low glucose? Give GLUCOSE, not table sugar, because sucrose cannot be split.

## Test yourself

Think of the answer, then tap the question to see it.

## How should hypoglycaemia be treated in a patient on miglitol plus a sulfonylurea?

With oral glucose (dextrose), because miglitol blocks the splitting of sucrose.

## How does miglitol differ from acarbose pharmacokinetically?

Miglitol is absorbed and excreted unchanged by the kidneys; acarbose is barely absorbed.

## Why does miglitol cause flatulence?

Undigested carbohydrate reaches the colon, where bacteria ferment it.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/miglitol/)

[More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology)

## Connections

## Related drugs 1

- [Acarbose](https://durgical.com/en/pharmacology/acarbose/)

## Related conditions 1

- [Type 2 diabetes mellitus](https://durgical.com/en/conditions/type-2-diabetes-mellitus/)

[← Back to the class: Other glucose-lowering drugs](https://durgical.com/en/pharmacology/classes/other-glucose-lowering-drugs/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Miglitol: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a601079.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [DailyMed - MIGLITOL tablet, coated](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f16ecb50-e54e-43e1-8789-eaf5bc94f332) (DailyMed (U.S. National Library of Medicine), 2022); [Crystal complex of N-terminal Human Maltase-Glucoamylase with miglitol](https://www.rcsb.org/structure/3L4W) (RCSB Protein Data Bank, 2010).

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Representative model, for educational purposes only.

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/miglitol/