acarbose (Rx)

Brand and Other Names:Precose
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablet

  • 25mg
  • 50mg
  • 100mg

Type 2 Diabetes Mellitus

Initially 25 mg PO q8hr, at meals (with first bite)

Can increase to 50 or 100 mg PO q8hr at 4- to 8-wk intervals based on 1 hour postprandial glucose or glycosylated hemoglobin levels, and on tolerance

Maximum Dose

<60 kg: 50 mg q8hr

>60 kg: 100 mg q8hr

Other Indications & Uses

Type 2 DM, mono treatment or with sulfonylurea

Safety & efficacy not established

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Interactions

Interaction Checker

and acarbose

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    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

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            Contraindicated (0)

              Serious - Use Alternative (2)

              • ethanol

                ethanol, acarbose. Other (see comment). Contraindicated. Comment: Excessive EtOH consumption may alter glycemic control. Some sulfonylureas may produce a disulfiram like rxn.

              • pramlintide

                pramlintide, acarbose. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI nutrient absorption.

              Monitor Closely (59)

              • albiglutide

                albiglutide, acarbose. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Concurrent use may increase risk of hypoglycemia; monitor glucose levels.

              • aripiprazole

                aripiprazole, acarbose. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

              • asenapine

                asenapine, acarbose. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

              • atazanavir

                atazanavir decreases effects of acarbose by pharmacodynamic antagonism. Use Caution/Monitor. New onset or exacerbation of diabetes mellitus and hyperglycemia have been reported with protease inhibitors.

              • bitter melon

                bitter melon increases effects of acarbose by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypoglycemia.

              • cinnamon

                cinnamon increases effects of acarbose by pharmacodynamic synergism. Use Caution/Monitor. Potential for hypoglycemia.

              • ciprofloxacin

                ciprofloxacin increases effects of acarbose by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. .

              • clozapine

                acarbose, clozapine. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

              • darunavir

                darunavir decreases effects of acarbose by pharmacodynamic antagonism. Use Caution/Monitor. New onset or exacerbation of diabetes mellitus and hyperglycemia have been reported with protease inhibitors.

              • digoxin

                acarbose will decrease the level or effect of digoxin by unspecified interaction mechanism. Use Caution/Monitor. Measure serum digoxin concentrations before initiating concomitant drugs; continue monitoring and increase digoxin dose by approximately 20% to 40% as necessary

              • dulaglutide

                dulaglutide, acarbose. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

              • exenatide injectable solution

                exenatide injectable solution, acarbose. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Concurrent use may increase risk of hypoglycemia; monitor glucose levels.

              • exenatide injectable suspension

                exenatide injectable suspension, acarbose. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Concurrent use may increase risk of hypoglycemia; monitor glucose levels.

              • fleroxacin

                fleroxacin increases effects of acarbose by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

              • fosamprenavir

                fosamprenavir decreases effects of acarbose by pharmacodynamic antagonism. Use Caution/Monitor. New onset or exacerbation of diabetes mellitus and hyperglycemia have been reported with protease inhibitors.

              • gemifloxacin

                gemifloxacin increases effects of acarbose by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

              • iloperidone

                iloperidone, acarbose. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

              • indinavir

                indinavir decreases effects of acarbose by pharmacodynamic antagonism. Use Caution/Monitor. New onset or exacerbation of diabetes mellitus and hyperglycemia have been reported with protease inhibitors.

              • insulin aspart

                acarbose, insulin aspart. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

              • insulin aspart protamine/insulin aspart

                acarbose, insulin aspart protamine/insulin aspart. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

              • insulin degludec

                acarbose, insulin degludec. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

              • insulin degludec/insulin aspart

                acarbose, insulin degludec/insulin aspart. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

              • insulin detemir

                acarbose, insulin detemir. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

              • insulin glargine

                acarbose, insulin glargine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

              • insulin glulisine

                acarbose, insulin glulisine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

              • insulin inhaled

                acarbose, insulin inhaled. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

              • insulin isophane human/insulin regular human

                acarbose, insulin isophane human/insulin regular human. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

              • insulin lispro

                acarbose, insulin lispro. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

              • insulin lispro protamine/insulin lispro

                acarbose, insulin lispro protamine/insulin lispro. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

              • insulin NPH

                acarbose, insulin NPH. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

              • insulin regular human

                acarbose, insulin regular human. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

              • ketotifen, ophthalmic

                ketotifen, ophthalmic, acarbose. Other (see comment). Use Caution/Monitor. Comment: Combination may result in thrombocytopenia (rare). Monitor CBC.

              • letermovir

                letermovir will increase the level or effect of acarbose by unspecified interaction mechanism. Use Caution/Monitor. Monitor glucose concentrations

              • levofloxacin

                levofloxacin increases effects of acarbose by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

              • liraglutide

                liraglutide, acarbose. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Concurrent use may increase risk of hypoglycemia; monitor glucose levels.

              • lonapegsomatropin

                lonapegsomatropin decreases effects of acarbose by Other (see comment). Modify Therapy/Monitor Closely. Comment: Closely monitor blood glucose when treated with antidiabetic agents. Lonapegsomatropin may decrease insulin sensitivity, particularly at higher doses. Patients with diabetes mellitus may require adjustment of their doses of insulin and/or other antihyperglycemic agents.

              • lopinavir

                lopinavir decreases effects of acarbose by pharmacodynamic antagonism. Use Caution/Monitor. New onset or exacerbation of diabetes mellitus and hyperglycemia have been reported with protease inhibitors.

              • lurasidone

                lurasidone, acarbose. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

              • marijuana

                marijuana decreases effects of acarbose by pharmacodynamic antagonism. Use Caution/Monitor.

              • mecasermin

                mecasermin increases effects of acarbose by pharmacodynamic synergism. Use Caution/Monitor. Additive hypoglycemic effects.

              • mipomersen

                mipomersen, acarbose. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Both drugs have potential to increase hepatic enzymes; monitor LFTs.

              • moxifloxacin

                moxifloxacin increases effects of acarbose by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

              • nelfinavir

                nelfinavir decreases effects of acarbose by pharmacodynamic antagonism. Use Caution/Monitor. New onset or exacerbation of diabetes mellitus and hyperglycemia have been reported with protease inhibitors.

              • ofloxacin

                ofloxacin increases effects of acarbose by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

              • olanzapine

                olanzapine, acarbose. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

              • opuntia ficus indica

                opuntia ficus indica increases effects of acarbose by pharmacodynamic synergism. Use Caution/Monitor.

              • paliperidone

                paliperidone, acarbose. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

              • pancrelipase

                pancrelipase decreases effects of acarbose by pharmacodynamic antagonism. Use Caution/Monitor. Antihyperglycemic action of acarbose results from a competitive, reversible inhibition of pancreatic alpha-amylase and membrane-bound intestinal alpha-glucoside hydrolase enzymes.

              • quetiapine

                quetiapine, acarbose. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

              • risperidone

                risperidone, acarbose. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

              • ritonavir

                ritonavir decreases effects of acarbose by pharmacodynamic antagonism. Use Caution/Monitor. New onset or exacerbation of diabetes mellitus and hyperglycemia have been reported with protease inhibitors.

              • saquinavir

                saquinavir decreases effects of acarbose by pharmacodynamic antagonism. Use Caution/Monitor. New onset or exacerbation of diabetes mellitus and hyperglycemia have been reported with protease inhibitors.

              • shark cartilage

                shark cartilage increases effects of acarbose by pharmacodynamic synergism. Use Caution/Monitor. Theoretical interaction.

              • somapacitan

                somapacitan decreases effects of acarbose by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Growth hormone products may decrease insulin sensitivity, particularly at higher doses. Antidiabetic agents may require dose adjustment after initiating somapacitan. .

              • sulfamethoxypyridazine

                sulfamethoxypyridazine increases effects of acarbose by unspecified interaction mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • tipranavir

                tipranavir decreases effects of acarbose by pharmacodynamic antagonism. Use Caution/Monitor. New onset or exacerbation of diabetes mellitus and hyperglycemia have been reported with protease inhibitors.

              • triamcinolone acetonide injectable suspension

                triamcinolone acetonide injectable suspension decreases effects of acarbose by pharmacodynamic antagonism. Use Caution/Monitor. Corticosteroids may diminish hypoglycemic effect of antidiabetic agents. Monitor blood glucose levels carefully.

              • xipamide

                xipamide decreases levels of acarbose by increasing renal clearance. Use Caution/Monitor.

              • ziprasidone

                ziprasidone, acarbose. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

              Minor (69)

              • activated charcoal

                activated charcoal decreases levels of acarbose by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • agrimony

                agrimony increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.

              • American ginseng

                American ginseng increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.

              • amitriptyline

                amitriptyline increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.

              • amoxapine

                amoxapine increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.

              • anamu

                anamu increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. Theoretical interaction.

              • bendroflumethiazide

                bendroflumethiazide decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

              • budesonide

                budesonide decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown.

              • chlorothiazide

                chlorothiazide decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

              • chlorthalidone

                chlorthalidone decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

              • chromium

                chromium increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.

              • clomipramine

                clomipramine increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.

              • clonidine

                clonidine decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown. Diminished symptoms of hypoglycemia.

                clonidine, acarbose. Other (see comment). Minor/Significance Unknown. Comment: Decreased symptoms of hypoglycemia. Mechanism: decreased hypoglycemia induced catecholamine production.

              • cornsilk

                cornsilk increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (theoretical interaction).

              • cortisone

                cortisone decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown.

              • cyclopenthiazide

                cyclopenthiazide decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

              • damiana

                damiana decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown. Theoretical interaction.

              • danazol

                danazol increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.

              • deflazacort

                deflazacort decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown.

              • desipramine

                desipramine increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.

              • devil's claw

                devil's claw increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.

              • dexamethasone

                dexamethasone decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown.

              • doxepin

                doxepin increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.

              • elderberry

                elderberry increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (in vitro research).

              • eucalyptus

                eucalyptus increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. Theoretical interaction.

              • fludrocortisone

                fludrocortisone decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown.

              • fluoxymesterone

                fluoxymesterone increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.

              • fo-ti

                fo-ti increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.

              • forskolin

                forskolin increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. Colenol, a compound found in Coleus root, may stimulate insulin release.

              • gotu kola

                gotu kola increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. (Theoretical interaction).

              • guanfacine

                guanfacine decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown. Diminished symptoms of hypoglycemia.

                guanfacine, acarbose. Other (see comment). Minor/Significance Unknown. Comment: Decreased symptoms of hypoglycemia. Mechanism: decreased hypoglycemia induced catecholamine production.

              • gymnema

                gymnema increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.

              • horse chestnut seed

                horse chestnut seed increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.

              • hydrochlorothiazide

                hydrochlorothiazide decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

              • hydrocortisone

                hydrocortisone decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown.

              • imipramine

                imipramine increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.

              • indapamide

                indapamide decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

              • isoniazid

                isoniazid decreases effects of acarbose by unspecified interaction mechanism. Minor/Significance Unknown.

              • juniper

                juniper increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (theoretical interaction).

              • lofepramine

                lofepramine increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.

              • lycopus

                lycopus increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (theoretical interaction).

              • maitake

                maitake increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (animal research).

              • maprotiline

                maprotiline increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.

              • mesterolone

                mesterolone increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.

              • methyclothiazide

                methyclothiazide decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

              • methylprednisolone

                methylprednisolone decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown.

              • methyltestosterone

                methyltestosterone increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.

              • metolazone

                metolazone decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

              • nettle

                nettle increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. (Theoretical interaction).

              • nortriptyline

                nortriptyline increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.

              • ofloxacin

                ofloxacin, acarbose. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential dysglycemia.

              • oxandrolone

                oxandrolone increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.

              • oxymetholone

                oxymetholone increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.

              • pegvisomant

                pegvisomant increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.

              • potassium acid phosphate

                potassium acid phosphate increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.

              • potassium chloride

                potassium chloride increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.

              • potassium citrate

                potassium citrate increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.

              • prednisolone

                prednisolone decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown.

              • prednisone

                prednisone decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown.

              • protriptyline

                protriptyline increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.

              • sage

                sage increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.

              • stevia

                stevia increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.

              • testosterone

                testosterone increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.

              • testosterone buccal system

                testosterone buccal system increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.

              • testosterone topical

                testosterone topical increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.

              • tongkat ali

                tongkat ali increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypoglycemia.

              • trazodone

                trazodone increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.

              • trimipramine

                trimipramine increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.

              • vanadium

                vanadium increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.

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              Adverse Effects

              >10%

              abdominal pain (19%)

              diarrhea (31%)

              elevated serum transaminases

              flatulence (74%)

              Postmarketing Reports

              Gastrointestinal: Fulminant hepatitis with fatal outcome, ileus/subileus, jaundice and/or hepatitis and associated liver damage

              Hypersensitive skin reactions: rash, erythema, exanthema and urticaria

              Edema

              Thrombocytopenia

              Pneumatosis cystoides intestinalis

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              Warnings

              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 result of increased gas formation in GI tract

              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, 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 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 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 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) 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 > 500 IU/L (29 of which were associated with jaundice) reported; hepatic abnormalities improved or resolved upon discontinuation of therapy in majority of cases; cases of fulminant hepatitis with fatal outcome reported; relationship to acarbose unclear
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              Pregnancy & Lactation

              Pregnancy Category: B

              Lactation: not known if crosses into breast milk, avoid using in nursing women

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

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              Pharmacology

              Half-Life: 2 hr

              Onset: 1 hr

              Peak Plasma Time: 1 hr

              Bioavailability: <2 %

              Metabolism: extensively degraded in the intestine by bacterial and digestive enzymes, glucose units are removed from acarbose molecule

              Metabolites: 4-methylpyrogallol derivatives (major inactive mets) and other inactive mets

              Excretion

              Urine: 34 % as inactive metabolites

              Feces: 51% as unabsorbed drug

              Mechanism of Action

              Oral pancreatic alpha-amylase and intestinal brush border alph-glucosidases. This results in delayed hydrolysis of ingested complex carbohydrates and disaccharides and absorption of glucose. Inhibits metabolism of sucrose to glucose and fructose.

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              Precose oral
              -
              100 mg tablet
              Precose oral
              -
              25 mg tablet
              Precose oral
              -
              50 mg tablet
              acarbose oral
              -
              100 mg tablet
              acarbose oral
              -
              50 mg tablet
              acarbose oral
              -
              25 mg tablet
              acarbose oral
              -
              25 mg tablet
              acarbose oral
              -
              100 mg tablet
              acarbose oral
              -
              50 mg tablet
              acarbose oral
              -
              25 mg tablet
              acarbose oral
              -
              50 mg tablet
              acarbose oral
              -
              100 mg tablet
              acarbose oral
              -
              100 mg tablet
              acarbose oral
              -
              50 mg tablet
              acarbose oral
              -
              25 mg tablet

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

              A Patient Handout is not currently available for this monograph.
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              Formulary

              FormularyPatient Discounts

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              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
              2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
              3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
              4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              NC NOT COVERED – Drugs that are not covered by the plan.
              Code Definition
              PA Prior Authorization
              Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
              QL Quantity Limits
              Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
              ST Step Therapy
              Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
              OR Other Restrictions
              Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.