I learned many lessons from that, but the strongest one was the clear and strong feeling of rightness in dealing honestly with the patient's family. Dr. Rehfeldt, may he rest in peace, was absolutely right. It is unfortunate that malpractice litigation is often viewed as the only way to compensate a patient for medical mistakes. Facing our mistakes. Promoting patient safety by preventing medical error.
Transaminase elevations are reversible with discontinuation of the drug and are often asymptomatic.
Serum transaminase levels should be checked every three months for the first year patients take the medication and periodically thereafter. These statements are misleading with respect to miglitol because one of the pivotal U.S. clinical trials revealed a similar and very low incidence of elevated liver enzymes when the drug was compared with placebo. According to the product label, acarbose is contraindicated in patients with cirrhosis. A synopsis of clinical trial safety data for acarbose concluded that sustained treatment-emergent increases in serum transaminase levels of at least 1.8 times the ULN were evident in 3.8 percent of patients receiving acarbose versus 0.9 percent on placebo in U.S. clinical trials. In conclusion, I want to emphasize that physicians should be aware that the alpha-glucosidase inhibitor, miglitol, has not been linked to hepatotoxicity.