ALPHA GLUCOSIDASE INHIBITORS


Alpha-glucosidase inhibitors help control glycemia by slowing down the digestion of complex carbohydrates in the intestine. Because these drugs only work in the intestine and enter the bloodstream in negligible amounts, they are considered very safe.

Drugs in this class include acarbose, miglitol and voglibose.

  • ACARBOSE

    Tradename(s) Precose® (in the US), Glucobay®, Glucor® and Prandase®
    Company(ies) Bayer
    Available doses 25 mg, 50 mg and 100 mg
    Dose per day with each meal
    Side-effects gastrointestinal effects
    Elimination half-life 2 hours
    Metabolism metabolized in the gastrointestinal track principally by instestinal bacteria, but also by digestive enzymes
    US patent status 
    US FDA status approved September 1995
    EMEA status first approved in Germany in 1990
    Indication

    Precose®, as monotherapy, is indicated as an adjunct to diet to lower blood glucose in patients with type 2 diabetes mellitus whose hyperglycemia cannot be managed on diet alone.

    Precose® may also be used in combination with a sulfonylurea when diet plus either Precose® or a sulfonylurea do not result in adequate glycemic control. Also, Precose® may be used in combination with insulin or metformin. The effect of Precose® to enhance glycemic control is additive to that of sulfonylureas, insulin, or metformin when used in combination, presumably because its mechanism of action is different.

  • MIGLITOL

    Tradename(s) Glyset® (in the US), Diastabol®, Diastobol®, Miglitol Bayer®, Plumarol®
    Company(ies) Bayer, Pfizer
    Available doses 25 mg, 50 mg and 100 mg
    Dose per day with each meal
    Side-effects gastrointestinal effects
    Elimination half-life 2 hours
    Metabolism not metabolized
    US patent status generic
    US FDA status approved December 1996
    EMEA status approved December 1996
    Indication

    Miglitol, as monotherapy, is indicated as adjunct to diet to improve glycemic control in patients with non-insulin dependent diabetes mellitus (NIDDM) whose hyperglycemia cannot be managed with diet alone.

    Miglitol may also be used in combination with a sulfonylurea when diet plus either miglitol or a sulfonylurea alon do not result in adequate glycemic control. The effect of miglitol to enhance glycemic control is additive to that of sulfonylureas when used in combination, presumatly because its mechanism of action is different.

  • VOGLIBOSE

    Tradename(s) Basen® and Vogseal in Japan
    Volix in India
    Company(ies) Takeda and Nihon Pharmaceutical Industry Ltd. in Japan
    Ranbaxy Laboratories in India
    Available doses 0.2 mg and 0.3 mg
    Dose per daywith each meal
    Side-effects gastrointestinal effects
    Elimination half-life  
    Metabolism  
    US patent status generic
    US FDA status not approved
    EMEA status not approved
    Indication
    Voglibose is indicated for improvement of postprandial hyperglymia in diabetes mellitus only when diet and/or exercise or oral hyperglycemic drug or insulin preparation in addition to diet and/or exercise does not result in adequate glycemic control.
    Comments
    • Voglibose is not available in the US.
    • Initially marketed in Japan by Takeda in 1994
    • Marketed in India by Ranbaxy since 2005