Acarbose

Acarbose is a prescription medication used for the treatment of type 2 diabetes mellitus.

• Acarbose is available under the following different brand names: Precose

Adult dosage

Tablet

• 25mg
• 50mg
• 100mg

Type 2 Diabetes Mellitus

Adult dosage

• Initially 25 mg orally every 8 hours, at meals (with the first bite)
• Can increase to 50 or 100 mg orally every 8 hours at 4- to 8-weeks intervals based on 1-hour postprandial glucose or glycosylated hemoglobin levels, and tolerance

Maximum Dose

• Weighing below 60 kg: 50 mg every 8 hours
• Weighing above 60 kg: 100 mg every 8 hours

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

Common side effects of Acarbose include:

• stomach discomfort, 
• gas,
• bloating,
• mild diarrhea, or
• mild skin rash or itching.

Serious side effects of Acarbose include:

• severe constipation,
• severe stomach pain, 
• watery or bloody diarrhea,
• easy bruising,
• unusual bleeding (nose, mouth, vagina, or rectum), 
• purple or red pinpoint spots under your skin, or
• liver problems--nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Rare side effects of Acarbose include:

• none 

This is not a complete list of side effects and other serious side effects or health problems that may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Acarbose has severe interactions with no other drugs.
• Acarbose has serious interactions with the following drugs:
  • ethanol
  • pramlintide
• Acarbose has moderate interactions with at least 59 other drugs.
• Acarbose has minor interactions with at least 69 other drugs.

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns.

Contraindications

• Documented hypersensitivity to acarbose
• Diabetic ketoacidosis, cirrhosis, inflammatory bowel disease, colonic ulceration, partial intestinal obstruction or predisposed to intestinal obstruction, known marked absorptive impairment of GI
• Conditions that may deteriorate as a result of increased gas formation in the GI tract

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Acarbose?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Acarbose?”

Cautions

• No clinical studies exist establishing conclusive evidence of macrovascular risk reduction with acarbose or any other anti-diabetic drug
• When diabetic patients are exposed to stress such as fever, trauma, infection, or surgery, a temporary loss of control of blood glucose may occur; at such times, temporary insulin therapy may be necessary
• Monitoring glycemic control with 1,5-AG assay is not recommended; measurements of 1,5-AG are unreliable in assessing glycemic control in patients taking acarbose; use alternate methods to monitor for glycemic control
• Hypoglycemia
  • As per its mechanism of action, the drug should not cause hypoglycemia, when administered alone, in the fasted or postprandial state
  • Sulfonylurea agents or insulin may cause hypoglycemia; because when given in combination with a sulfonylurea or insulin combination treatment will cause further lowering of blood glucose, it may increase the potential for hypoglycemia
  • Hypoglycemia does not occur in patients receiving metformin alone under usual circumstances of use; increased incidence of hypoglycemia is not observed when acarbose added to metformin therapy
  • Oral glucose (dextrose), whose absorption is not inhibited by acarbose, should be used instead of sucrose (cane sugar) in the treatment of mild to moderate hypoglycemia
  • Sucrose, whose hydrolysis to glucose and fructose is inhibited by acarbose, is unsuitable for rapid correction of hypoglycemia; severe hypoglycemia may require the use of either intravenous glucose infusion or glucagon injection
• Elevated serum transaminase
  • Treatment-emergent elevations of serum transaminases (AST and/or ALT) above the upper limit of normal (ULN) were reported; although differences between treatments were statistically significant, elevations were asymptomatic, reversible, more common in females, and, in general, were not associated with other evidence of liver dysfunction;
  • Sixty-two cases of serum transaminase elevations above 500 IU/L (29 of which were associated with jaundice) were reported; hepatic abnormalities improved or resolved upon discontinuation of therapy in the majority of cases; cases of fulminant hepatitis with fatal outcome reported; relationship to acarbose unclear

Pregnancy and Lactation

• May be acceptable during pregnancy.
• Lactation
  • Not known if crosses into breast milk, avoid using in nursing women.