miglitol (Rx)

Type 2 DM (Monotherapy or with Sulfonylurea)

Initial: 25 mg PO q8hr at meals (with first bite)

Maintanance: Usually 50 mg PO q8hr, increase after 4-8 weeks

Not more than 100 mg PO q8hr

Hepatic Impairment

No admustment necessary

Renal Impairment

Mild-moderate impairment: No dosage adjustment

Severe impairment: Not recommended

Safety & efficacy not established

Initial: 25 mg PO q8hr at meals (with first bite)

Maintanance: Usually 50 mg PO q8hr, increase after 4-8 weeks

Not more than 100 mg PO q8hr

Contraindicated (0)

Serious - Use Alternative (2)

• ethanol

  ethanol, miglitol. Other (see comment). Contraindicated. Comment: Excessive EtOH consumption may alter glycemic control. Some sulfonylureas may produce a disulfiram like rxn.

• pramlintide

  pramlintide, miglitol. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI nutrient absorption.

Monitor Closely (57)

• albiglutide

  albiglutide, miglitol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Concurrent use may increase risk of hypoglycemia; monitor glucose levels.

• aripiprazole

  aripiprazole, miglitol. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

• asenapine

  asenapine, miglitol. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

• atazanavir

  atazanavir decreases effects of miglitol by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

• bitter melon

  bitter melon increases effects of miglitol by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypoglycemia.

• cinnamon

  cinnamon increases effects of miglitol by pharmacodynamic synergism. Use Caution/Monitor. Potential for hypoglycemia.

• ciprofloxacin

  ciprofloxacin increases effects of miglitol by pharmacodynamic synergism. Use Caution/Monitor. Hyper and hypoglycemia have been reported in patients treated concomitantly with quinolones and antidiabetic agents. Careful monitoring of blood glucose is recommended.

• clozapine

  clozapine, miglitol. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

• darunavir

  darunavir decreases effects of miglitol by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

• dulaglutide

  dulaglutide, miglitol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

• exenatide injectable solution

  exenatide injectable solution, miglitol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Concurrent use may increase risk of hypoglycemia; monitor glucose levels.

• exenatide injectable suspension

  exenatide injectable suspension, miglitol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Concurrent use may increase risk of hypoglycemia; monitor glucose levels.

• fleroxacin

  fleroxacin increases effects of miglitol by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

• fosamprenavir

  fosamprenavir decreases effects of miglitol by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

• gemifloxacin

  gemifloxacin increases effects of miglitol by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

• iloperidone

  iloperidone, miglitol. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

• indinavir

  indinavir decreases effects of miglitol by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

• insulin aspart

  miglitol, insulin aspart. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

• insulin aspart protamine/insulin aspart

  miglitol, insulin aspart protamine/insulin aspart. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

• insulin degludec

  miglitol, insulin degludec. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

• insulin degludec/insulin aspart

  miglitol, insulin degludec/insulin aspart. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

• insulin detemir

  miglitol, insulin detemir. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

• insulin glargine

  miglitol, insulin glargine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

• insulin glulisine

  miglitol, insulin glulisine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

• insulin inhaled

  miglitol, insulin inhaled. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

• insulin isophane human/insulin regular human

  miglitol, insulin isophane human/insulin regular human. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

• insulin lispro

  miglitol, insulin lispro. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

• insulin lispro protamine/insulin lispro

  miglitol, insulin lispro protamine/insulin lispro. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

• insulin NPH

  miglitol, insulin NPH. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

• insulin regular human

  miglitol, insulin regular human. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

• ketotifen, ophthalmic

  ketotifen, ophthalmic, miglitol. Other (see comment). Use Caution/Monitor. Comment: Combination may result in thrombocytopenia (rare). Monitor CBC.

• letermovir

  letermovir will increase the level or effect of miglitol by unspecified interaction mechanism. Use Caution/Monitor. Monitor glucose concentrations

• levofloxacin

  levofloxacin increases effects of miglitol by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

• liraglutide

  liraglutide, miglitol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Concurrent use may increase risk of hypoglycemia; monitor glucose levels.

• lonapegsomatropin

  lonapegsomatropin decreases effects of miglitol by Other (see comment). Modify Therapy/Monitor Closely. Comment: Closely monitor blood glucose when treated with antidiabetic agents. Lonapegsomatropin may decrease insulin sensitivity, particularly at higher doses. Patients with diabetes mellitus may require adjustment of their doses of insulin and/or other antihyperglycemic agents.

• lopinavir

  lopinavir decreases effects of miglitol by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

• lurasidone

  lurasidone, miglitol. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

• marijuana

  marijuana decreases effects of miglitol by pharmacodynamic antagonism. Use Caution/Monitor.

• mecasermin

  mecasermin increases effects of miglitol by pharmacodynamic synergism. Use Caution/Monitor. Additive hypoglycemic effects.

• moxifloxacin

  moxifloxacin increases effects of miglitol by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

• nelfinavir

  nelfinavir decreases effects of miglitol by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

• ofloxacin

  ofloxacin increases effects of miglitol by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

• olanzapine

  olanzapine, miglitol. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

• opuntia ficus indica

  opuntia ficus indica increases effects of miglitol by pharmacodynamic synergism. Use Caution/Monitor.

• paliperidone

  paliperidone, miglitol. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

• pancrelipase

  pancrelipase decreases levels of miglitol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Digestive enzymes may reduce levels of miglitol when administered concomitantly.

• quetiapine

  quetiapine, miglitol. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

• risperidone

  risperidone, miglitol. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

• ritonavir

  ritonavir decreases effects of miglitol by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

• saquinavir

  saquinavir decreases effects of miglitol by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

• shark cartilage

  shark cartilage increases effects of miglitol by pharmacodynamic synergism. Use Caution/Monitor. Theoretical interaction.

• somapacitan

  somapacitan decreases effects of miglitol by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Growth hormone products may decrease insulin sensitivity, particularly at higher doses. Antidiabetic agents may require dose adjustment after initiating somapacitan. .

• sulfamethoxypyridazine

  sulfamethoxypyridazine increases effects of miglitol by unspecified interaction mechanism. Use Caution/Monitor. Risk of hypoglycemia.

• tipranavir

  tipranavir decreases effects of miglitol by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

• triamcinolone acetonide injectable suspension

  triamcinolone acetonide injectable suspension decreases effects of miglitol by pharmacodynamic antagonism. Use Caution/Monitor. Corticosteroids may diminish hypoglycemic effect of antidiabetic agents. Monitor blood glucose levels carefully.

• xipamide

  xipamide decreases levels of miglitol by increasing renal clearance. Use Caution/Monitor.

• ziprasidone

  ziprasidone, miglitol. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

Minor (72)

• activated charcoal

  activated charcoal decreases levels of miglitol by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

• agrimony

  agrimony increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• American ginseng

  American ginseng increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• amitriptyline

  amitriptyline increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• amoxapine

  amoxapine increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• anamu

  anamu increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown. Theoretical interaction.

• bendroflumethiazide

  bendroflumethiazide decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

• budesonide

  budesonide decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown.

• chlorothiazide

  chlorothiazide decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

• chlorthalidone

  chlorthalidone decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

• chromium

  chromium increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• clomipramine

  clomipramine increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• clonidine

  clonidine decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown. Diminished symptoms of hypoglycemia.
  
  clonidine, miglitol. Other (see comment). Minor/Significance Unknown. Comment: Decreased symptoms of hypoglycemia. Mechanism: decreased hypoglycemia induced catecholamine production.

• cornsilk

  cornsilk increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (theoretical interaction).

• cortisone

  cortisone decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown.

• cyclopenthiazide

  cyclopenthiazide decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

• damiana

  damiana decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown. Theoretical interaction.

• danazol

  danazol increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• deflazacort

  deflazacort decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown.

• desipramine

  desipramine increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• devil's claw

  devil's claw increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• dexamethasone

  dexamethasone decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown.

• digoxin

  miglitol decreases levels of digoxin by unspecified interaction mechanism. Minor/Significance Unknown.

• doxepin

  doxepin increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• elderberry

  elderberry increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (in vitro research).

• eucalyptus

  eucalyptus increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown. Theoretical interaction.

• fludrocortisone

  fludrocortisone decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown.

• fluoxymesterone

  fluoxymesterone increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• fo-ti

  fo-ti increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• forskolin

  forskolin increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown. Colenol, a compound found in Coleus root, may stimulate insulin release.

• glyburide

  miglitol decreases levels of glyburide by unspecified interaction mechanism. Minor/Significance Unknown.

• gotu kola

  gotu kola increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown. (Theoretical interaction).

• guanfacine

  guanfacine decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown. Diminished symptoms of hypoglycemia.
  
  guanfacine, miglitol. Other (see comment). Minor/Significance Unknown. Comment: Decreased symptoms of hypoglycemia. Mechanism: decreased hypoglycemia induced catecholamine production.

• gymnema

  gymnema increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• horse chestnut seed

  horse chestnut seed increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• hydrochlorothiazide

  hydrochlorothiazide decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

• hydrocortisone

  hydrocortisone decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown.

• imipramine

  imipramine increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• indapamide

  indapamide decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

• isoniazid

  isoniazid decreases effects of miglitol by unspecified interaction mechanism. Minor/Significance Unknown.

• juniper

  juniper increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (theoretical interaction).

• lofepramine

  lofepramine increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• lycopus

  lycopus increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (theoretical interaction).

• maitake

  maitake increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (animal research).

• maprotiline

  maprotiline increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• mesterolone

  mesterolone increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• methyclothiazide

  methyclothiazide decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

• methylprednisolone

  methylprednisolone decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown.

• methyltestosterone

  methyltestosterone increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• metolazone

  metolazone decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

• nettle

  nettle increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown. (Theoretical interaction).

• nortriptyline

  nortriptyline increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• ofloxacin

  ofloxacin, miglitol. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential dysglycemia.

• oxandrolone

  oxandrolone increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• oxymetholone

  oxymetholone increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• pegvisomant

  pegvisomant increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• potassium acid phosphate

  potassium acid phosphate increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.

• potassium chloride

  potassium chloride increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.

• potassium citrate

  potassium citrate increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.

• prednisolone

  prednisolone decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown.

• prednisone

  prednisone decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown.

• propranolol

  miglitol decreases levels of propranolol by unspecified interaction mechanism. Minor/Significance Unknown.

• protriptyline

  protriptyline increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• sage

  sage increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• stevia

  stevia increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• testosterone

  testosterone increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• testosterone buccal system

  testosterone buccal system increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• testosterone topical

  testosterone topical increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• tongkat ali

  tongkat ali increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypoglycemia.

• trazodone

  trazodone increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• trimipramine

  trimipramine increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• vanadium

  vanadium increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• activated charcoal

  Minor (1)activated charcoal decreases levels of miglitol by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

• agrimony

  Minor (1)agrimony increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• albiglutide

  Monitor Closely (1)albiglutide, miglitol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Concurrent use may increase risk of hypoglycemia; monitor glucose levels.

• American ginseng

  Minor (1)American ginseng increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• amitriptyline

  Minor (1)amitriptyline increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• amoxapine

  Minor (1)amoxapine increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• anamu

  Minor (1)anamu increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown. Theoretical interaction.

• aripiprazole

  Monitor Closely (1)aripiprazole, miglitol. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

• asenapine

  Monitor Closely (1)asenapine, miglitol. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

• atazanavir

  Monitor Closely (1)atazanavir decreases effects of miglitol by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

• bendroflumethiazide

  Minor (1)bendroflumethiazide decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

• bitter melon

  Monitor Closely (1)bitter melon increases effects of miglitol by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypoglycemia.

• budesonide

  Minor (1)budesonide decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown.

• chlorothiazide

  Minor (1)chlorothiazide decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

• chlorthalidone

  Minor (1)chlorthalidone decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

• chromium

  Minor (1)chromium increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• cinnamon

  Monitor Closely (1)cinnamon increases effects of miglitol by pharmacodynamic synergism. Use Caution/Monitor. Potential for hypoglycemia.

• ciprofloxacin

  Monitor Closely (1)ciprofloxacin increases effects of miglitol by pharmacodynamic synergism. Use Caution/Monitor. Hyper and hypoglycemia have been reported in patients treated concomitantly with quinolones and antidiabetic agents. Careful monitoring of blood glucose is recommended.

• clomipramine

  Minor (1)clomipramine increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• clonidine

  Minor (2)clonidine decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown. Diminished symptoms of hypoglycemia.
  
  clonidine, miglitol. Other (see comment). Minor/Significance Unknown. Comment: Decreased symptoms of hypoglycemia. Mechanism: decreased hypoglycemia induced catecholamine production.

• clozapine

  Monitor Closely (1)clozapine, miglitol. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

• cornsilk

  Minor (1)cornsilk increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (theoretical interaction).

• cortisone

  Minor (1)cortisone decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown.

• cyclopenthiazide

  Minor (1)cyclopenthiazide decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

• damiana

  Minor (1)damiana decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown. Theoretical interaction.

• danazol

  Minor (1)danazol increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• darunavir

  Monitor Closely (1)darunavir decreases effects of miglitol by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

• deflazacort

  Minor (1)deflazacort decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown.

• desipramine

  Minor (1)desipramine increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• devil's claw

  Minor (1)devil's claw increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• dexamethasone

  Minor (1)dexamethasone decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown.

• digoxin

  Minor (1)miglitol decreases levels of digoxin by unspecified interaction mechanism. Minor/Significance Unknown.

• doxepin

  Minor (1)doxepin increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• dulaglutide

  Monitor Closely (1)dulaglutide, miglitol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

• elderberry

  Minor (1)elderberry increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (in vitro research).

• ethanol

  Serious - Use Alternative (1)ethanol, miglitol. Other (see comment). Contraindicated. Comment: Excessive EtOH consumption may alter glycemic control. Some sulfonylureas may produce a disulfiram like rxn.

• eucalyptus

  Minor (1)eucalyptus increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown. Theoretical interaction.

• exenatide injectable solution

  Monitor Closely (1)exenatide injectable solution, miglitol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Concurrent use may increase risk of hypoglycemia; monitor glucose levels.

• exenatide injectable suspension

  Monitor Closely (1)exenatide injectable suspension, miglitol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Concurrent use may increase risk of hypoglycemia; monitor glucose levels.

• fleroxacin

  Monitor Closely (1)fleroxacin increases effects of miglitol by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

• fludrocortisone

  Minor (1)fludrocortisone decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown.

• fluoxymesterone

  Minor (1)fluoxymesterone increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• fo-ti

  Minor (1)fo-ti increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• forskolin

  Minor (1)forskolin increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown. Colenol, a compound found in Coleus root, may stimulate insulin release.

• fosamprenavir

  Monitor Closely (1)fosamprenavir decreases effects of miglitol by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

• gemifloxacin

  Monitor Closely (1)gemifloxacin increases effects of miglitol by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

• glyburide

  Minor (1)miglitol decreases levels of glyburide by unspecified interaction mechanism. Minor/Significance Unknown.

• gotu kola

  Minor (1)gotu kola increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown. (Theoretical interaction).

• guanfacine

  Minor (2)guanfacine decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown. Diminished symptoms of hypoglycemia.
  
  guanfacine, miglitol. Other (see comment). Minor/Significance Unknown. Comment: Decreased symptoms of hypoglycemia. Mechanism: decreased hypoglycemia induced catecholamine production.

• gymnema

  Minor (1)gymnema increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• horse chestnut seed

  Minor (1)horse chestnut seed increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• hydrochlorothiazide

  Minor (1)hydrochlorothiazide decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

• hydrocortisone

  Minor (1)hydrocortisone decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown.

• iloperidone

  Monitor Closely (1)iloperidone, miglitol. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

• imipramine

  Minor (1)imipramine increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• indapamide

  Minor (1)indapamide decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

• indinavir

  Monitor Closely (1)indinavir decreases effects of miglitol by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

• insulin aspart

  Monitor Closely (1)miglitol, insulin aspart. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

• insulin aspart protamine/insulin aspart

  Monitor Closely (1)miglitol, insulin aspart protamine/insulin aspart. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

• insulin degludec

  Monitor Closely (1)miglitol, insulin degludec. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

• insulin degludec/insulin aspart

  Monitor Closely (1)miglitol, insulin degludec/insulin aspart. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

• insulin detemir

  Monitor Closely (1)miglitol, insulin detemir. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

• insulin glargine

  Monitor Closely (1)miglitol, insulin glargine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

• insulin glulisine

  Monitor Closely (1)miglitol, insulin glulisine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

• insulin inhaled

  Monitor Closely (1)miglitol, insulin inhaled. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

• insulin isophane human/insulin regular human

  Monitor Closely (1)miglitol, insulin isophane human/insulin regular human. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

• insulin lispro

  Monitor Closely (1)miglitol, insulin lispro. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

• insulin lispro protamine/insulin lispro

  Monitor Closely (1)miglitol, insulin lispro protamine/insulin lispro. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

• insulin NPH

  Monitor Closely (1)miglitol, insulin NPH. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

• insulin regular human

  Monitor Closely (1)miglitol, insulin regular human. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

• isoniazid

  Minor (1)isoniazid decreases effects of miglitol by unspecified interaction mechanism. Minor/Significance Unknown.

• juniper

  Minor (1)juniper increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (theoretical interaction).

• ketotifen, ophthalmic

  Monitor Closely (1)ketotifen, ophthalmic, miglitol. Other (see comment). Use Caution/Monitor. Comment: Combination may result in thrombocytopenia (rare). Monitor CBC.

• letermovir

  Monitor Closely (1)letermovir will increase the level or effect of miglitol by unspecified interaction mechanism. Use Caution/Monitor. Monitor glucose concentrations

• levofloxacin

  Monitor Closely (1)levofloxacin increases effects of miglitol by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

• liraglutide

  Monitor Closely (1)liraglutide, miglitol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Concurrent use may increase risk of hypoglycemia; monitor glucose levels.

• lofepramine

  Minor (1)lofepramine increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• lonapegsomatropin

  Monitor Closely (1)lonapegsomatropin decreases effects of miglitol by Other (see comment). Modify Therapy/Monitor Closely. Comment: Closely monitor blood glucose when treated with antidiabetic agents. Lonapegsomatropin may decrease insulin sensitivity, particularly at higher doses. Patients with diabetes mellitus may require adjustment of their doses of insulin and/or other antihyperglycemic agents.

• lopinavir

  Monitor Closely (1)lopinavir decreases effects of miglitol by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

• lurasidone

  Monitor Closely (1)lurasidone, miglitol. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

• lycopus

  Minor (1)lycopus increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (theoretical interaction).

• maitake

  Minor (1)maitake increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (animal research).

• maprotiline

  Minor (1)maprotiline increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• marijuana

  Monitor Closely (1)marijuana decreases effects of miglitol by pharmacodynamic antagonism. Use Caution/Monitor.

• mecasermin

  Monitor Closely (1)mecasermin increases effects of miglitol by pharmacodynamic synergism. Use Caution/Monitor. Additive hypoglycemic effects.

• mesterolone

  Minor (1)mesterolone increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• methyclothiazide

  Minor (1)methyclothiazide decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

• methylprednisolone

  Minor (1)methylprednisolone decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown.

• methyltestosterone

  Minor (1)methyltestosterone increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• metolazone

  Minor (1)metolazone decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

• moxifloxacin

  Monitor Closely (1)moxifloxacin increases effects of miglitol by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

• nelfinavir

  Monitor Closely (1)nelfinavir decreases effects of miglitol by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

• nettle

  Minor (1)nettle increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown. (Theoretical interaction).

• nortriptyline

  Minor (1)nortriptyline increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• ofloxacin

  Monitor Closely (1)ofloxacin increases effects of miglitol by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.Minor (1)ofloxacin, miglitol. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential dysglycemia.

• olanzapine

  Monitor Closely (1)olanzapine, miglitol. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

• opuntia ficus indica

  Monitor Closely (1)opuntia ficus indica increases effects of miglitol by pharmacodynamic synergism. Use Caution/Monitor.

• oxandrolone

  Minor (1)oxandrolone increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• oxymetholone

  Minor (1)oxymetholone increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• paliperidone

  Monitor Closely (1)paliperidone, miglitol. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

• pancrelipase

  Monitor Closely (1)pancrelipase decreases levels of miglitol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Digestive enzymes may reduce levels of miglitol when administered concomitantly.

• pegvisomant

  Minor (1)pegvisomant increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• potassium acid phosphate

  Minor (1)potassium acid phosphate increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.

• potassium chloride

  Minor (1)potassium chloride increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.

• potassium citrate

  Minor (1)potassium citrate increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.

• pramlintide

  Serious - Use Alternative (1)pramlintide, miglitol. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI nutrient absorption.

• prednisolone

  Minor (1)prednisolone decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown.

• prednisone

  Minor (1)prednisone decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown.

• propranolol

  Minor (1)miglitol decreases levels of propranolol by unspecified interaction mechanism. Minor/Significance Unknown.

• protriptyline

  Minor (1)protriptyline increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• quetiapine

  Monitor Closely (1)quetiapine, miglitol. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

• risperidone

  Monitor Closely (1)risperidone, miglitol. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

• ritonavir

  Monitor Closely (1)ritonavir decreases effects of miglitol by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

• sage

  Minor (1)sage increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• saquinavir

  Monitor Closely (1)saquinavir decreases effects of miglitol by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

• shark cartilage

  Monitor Closely (1)shark cartilage increases effects of miglitol by pharmacodynamic synergism. Use Caution/Monitor. Theoretical interaction.

• somapacitan

  Monitor Closely (1)somapacitan decreases effects of miglitol by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Growth hormone products may decrease insulin sensitivity, particularly at higher doses. Antidiabetic agents may require dose adjustment after initiating somapacitan. .

• stevia

  Minor (1)stevia increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• sulfamethoxypyridazine

  Monitor Closely (1)sulfamethoxypyridazine increases effects of miglitol by unspecified interaction mechanism. Use Caution/Monitor. Risk of hypoglycemia.

• testosterone

  Minor (1)testosterone increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• testosterone buccal system

  Minor (1)testosterone buccal system increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• testosterone topical

  Minor (1)testosterone topical increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• tipranavir

  Monitor Closely (1)tipranavir decreases effects of miglitol by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

• tongkat ali

  Minor (1)tongkat ali increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypoglycemia.

• trazodone

  Minor (1)trazodone increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• triamcinolone acetonide injectable suspension

  Monitor Closely (1)triamcinolone acetonide injectable suspension decreases effects of miglitol by pharmacodynamic antagonism. Use Caution/Monitor. Corticosteroids may diminish hypoglycemic effect of antidiabetic agents. Monitor blood glucose levels carefully.

• trimipramine

  Minor (1)trimipramine increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• vanadium

  Minor (1)vanadium increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• xipamide

  Monitor Closely (1)xipamide decreases levels of miglitol by increasing renal clearance. Use Caution/Monitor.

• ziprasidone

  Monitor Closely (1)ziprasidone, miglitol. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.