Formulary
Acarbose: Indications, Dosing, Side Effects and Interactions
Acarbose, an inhibitor of intestinal alpha glucosidases, delays the digestion and absorption of starch and sucrose; it has a small but significant effect in...
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Acarbose: Indications, Dosing, Side Effects and Interactions
Acarbose, an inhibitor of intestinal alpha glucosidases, delays the digestion and absorption of starch and sucrose; it has a small but significant effect in...
Drug action
Acarbose, an inhibitor of intestinal alpha glucosidases, delays the digestion and absorption of starch and sucrose; it has a small but significant effect in lowering blood glucose.
Indications and dose
**Diabetes mellitus inadequately controlled by diet or by diet with oral antidiabetic drugs**
- **Adult** (By Mouth): Initially 50 mg 1-2 times a day, then increased to 50 mg 3 times a day for 6-8 weeks, then increased if necessary to 100 mg 3 times a day; increased if necessary to 200 mg 3 times a day.
Cautions
May enhance hypoglycaemic effects of insulin and sulfonylureas (hypoglycaemic episodes may be treated with oral glucose but not with sucrose)
Contraindications
Disorders of digestion or absorption; hernia (condition may deteriorate); inflammatory bowel disease; predisposition to intestinal obstruction
Side effects
Common or very common Diarrhoea (may need to reduce dose); gastrointestinal discomfort; gastrointestinal disorders Uncommon Nausea; vomiting Rare or very rare Hepatic disorders; oedema Frequency not known Acute generalised exanthematous pustulosis (AGEP); thrombocytopenia Side-effects, further information Antacids containing magnesium and aluminium salts unlikely to be beneficial for treating side effects.
Interactions
**Severe interactions:**
- If the symptoms are severe, a temporary dose reduction of acarbose may be warranted.
- In a pilot study to investigate a possible interaction between Acarbose and nifedipine, no significant or reproducible changes were observed in the plasma nifedipine profiles.
**Other interactions (13):**
- When administered alone, acarbose does not cause hypoglycaemia.
- It may, however, act to potentiate the hypoglycaemic effects of insulin, metformin and sulphonylurea drugs, and the dosages of these agents may need to be modified accordingly.
- In individual cases hypoglycaemic shock may occur (i.e.
- Episodes of hypoglycaemia occurring during therapy must, where appropriate, be treated by the administration of glucose, not sucrose.
- This is because acarbose will delay the digestion and absorption of disaccharides, but not monosaccharides.
- Sucrose (cane sugar) and foods containing sucrose, often cause abdominal discomfort or even diarrhoea during treatment with Acarbose as a result of increased fermentation of carbohydrates in the...
Pregnancy
Avoid.
Breast feeding
Avoid.
Hepatic impairment
Manufacturer advises avoid in severe impairment.
Renal impairment
Avoid if creatinine clearance less than 25 mL/minute. M See Prescribing in renal impairment .
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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