Pronunciation:

MIG-loo-stat

Brand Names:

• Zavesca

Dosage Forms:

• Capsule

Classifications:

Therapeutic—

Endocrine-Metabolic Agent

Pharmacologic—

Glucosylceramide Synthase Inhibitor

Uses of This Medicine:

Miglustat is used to treat adults with mild to moderate type 1 Gaucher disease. Miglustat is only used in people who cannot be treated with enzyme replacement therapy. Type 1 Gaucher disease is a disease you get from both your parents. People with type 1 Gaucher disease are missing an enzyme (naturally occurring substance in your body) that breaks down a chemical in your body called glucosylceramide. Too much glucosylceramide causes liver and spleen enlargement, changes in the blood, and bone disease. Miglustat works by stopping the body from making glucosylceramide.

This medicine is available only with your doctor's prescription.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

This medicine is not used in children under 18 years of age.

Older adults—

Many medicines have not been specifically studied in older people. Therefore, it may not be known whether they work the same way the do in younger adults. This medicine is not expected to cause different side effects or problems in older people than it does in younger adults.

Pregnancy—

	Pregnancy Category	Explanation
All Trimesters	X	Studies in animals or pregnant women have demonstrated positive evidence of fetal abnormalities. This drug should not be used in women who are or may become pregnant because the risk clearly outweighs any possible benefit.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Gaucher disease, Type 1, severe—this medicine is not currently being used in patients with severe Type 1 Gaucher disease

• Kidney disease—this condition may cause you to have more miglustat in your body; your doctor may want to change the amount of miglustat that you take

Proper Use of This Medicine:

It is important to take miglustat exactly as your doctor prescribed. You should take your medicine at the same time or at the same times each day.

The capsules should be swallowed whole with water and may be taken with or without food. Check with your doctor or pharmacist if you have any questions.

Your doctor may recommend changes to your diet to help with some side effects. It is important that you follow these changes.

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage form (capsules):
  • For Mild to Moderate Type 1 Gaucher disease
    • Adults—One 100 milligram (mg) capsule given three times a day; your doctor may change this dose as needed
    • Children—Use is not recommended in children under the age of 18

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using This Medicine:

Miglustat can cause problems affecting your nerves. If you have hand tremors (shaky movements) or if miglustat worsens a hand tremor you already have call your doctor. Your doctor might want to change your dose of miglustat.

If you experience numbness and tingling in your hands, arms, legs, or feet (peripheral neuropathy) call your doctor right away.

It is very important that your doctor check you at regular visits. Your doctor will also want to test your nerves (neurological exam) before you start taking miglustat and may repeat this test at a later time.

Diarrhea is the most common side effect for people taking miglustat. Your doctor may give you another medicine (anti-diarrheal) to help treat diarrhea if it is a problem for you. Your doctor may also recommend changes to your diet. You may also lose weight when you start treatment with miglustat.

It is very important to discuss with your doctor if you are pregnant or plan to become pregnant before starting miglustat. You should use effective birth control while taking miglustat. Miglustat may also harm a man's sperm. All men should use effective birth control during treatment and for three months after stopping treatment.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Black, tarry stools

bleeding gums

blood in urine or stools

burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings

pinpoint red spots on skin

unusual bleeding or bruising

Unknown

Painful sensations

shakiness in legs, arms, hands, feet

trembling or shaking of hands or feet

unsteadiness or awkwardness

weakness in arms, hands, legs, or feet

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More Common

Acid or sour stomach

back pain

belching

bloated, full feeling

change in vision

cramps

diarrhea

difficulty having a bowel movement (stool)

dizziness

dry mouth

excess air or gas in stomach or intestines

full or bloated feeling or pressure in the stomach

headache

heartburn

heaviness in limbs

indigestion

leg cramps

loss of appetite

memory loss

menstrual changes

nausea

pain or discomfort in chest, upper stomach, or throat

passing gas

stomach discomfort, upset or pain

swelling

swelling of abdominal or stomach area

unsteady walk

vomiting

weakness

weight loss

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.