Acarbose

💊 What is Acarbose used for?

• •The label says acarbose is used as an add-on to diet and exercise to improve blood sugar control (glycemic control) in adults with type 2 diabetes mellitus.

How it works

The label describes acarbose as an alpha-glucosidase inhibitor. It prevents the breakdown of table sugar (sucrose). The label also says that the undigested carbohydrate that reaches the lower digestive tract is related to the stomach and gut side effects.

How it is usually taken

• •The label says acarbose is taken by mouth three times a day, at the start of each main meal (with the first bite).
• •The label says the medicine should be started at a low dose and adjusted over time, based on how well it works and how well it is tolerated.
• •The label says people should keep following their diabetic diet, a regular exercise program, and regular blood or urine glucose testing.
• •The label says there is no fixed dosing schedule for diabetes, so the dose is set individually. Follow the instructions from your prescriber or pharmacist.

Comes as

• •25 mg tablets
• •50 mg tablets (white to yellow-tinged, round, debossed with "HP" and "148" on one side)
• •The label text is cut off in the description, so other strengths may be listed in the full label.

⚠️ Acarbose side effects

🛑 Who should not take Acarbose, and who should be careful

The label says not to take it if

• 🚨You have a known allergy (hypersensitivity) to acarbose.
• 🚨You have diabetic ketoacidosis or cirrhosis.
• 🚨You have inflammatory bowel disease, colonic ulceration, partial intestinal obstruction, or are predisposed to intestinal obstruction.
• 🚨You have a chronic intestinal disease with marked problems digesting or absorbing food.
• 🚨You have a condition that may get worse from increased gas in the intestine.

Tell your doctor before taking it if

• •The label says patients should understand the risk of low blood sugar, its symptoms, and how to treat it, along with family members who may help.
• •The label says that if you take acarbose with a sulfonylurea or insulin, you should have a readily available source of glucose (dextrose) to treat low blood sugar. Sucrose (cane sugar) is not suitable for rapidly correcting low blood sugar.
• •The label says liver test changes (transaminase elevations) were more common in females, and that cases occurred more often in patients who weighed less than 60 kg.
• •Tell your prescriber about all your medicines, including over-the-counter products, before starting acarbose.

🔀 Acarbose with other medicines, food and alcohol

The label says to discuss these with your doctor or pharmacist

• •Thiazide and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid can raise blood sugar. The label says blood sugar control should be watched closely when these are taken with acarbose, and watched for low blood sugar when they are stopped.
• •Sulfonylureas and insulin can cause low blood sugar. Acarbose added to these medicines may increase that risk, and their doses may need adjusting.
• •Intestinal adsorbents such as charcoal, and digestive enzyme products that contain carbohydrate-splitting enzymes such as amylase or pancreatin, may reduce acarbose's effect and should not be taken at the same time.
• •Acarbose can change how digoxin is absorbed, which may require a digoxin dose adjustment.

Alcohol and food

The label says acarbose should be taken with the first bite of each main meal, and that the diabetic diet should be followed. The label does not mention alcohol.

🤰 Acarbose in pregnancy and breastfeeding

Pregnancy

The label lists this medicine as Pregnancy Category B. It says the safety of acarbose in pregnant women has not been established, and that it should be used during pregnancy only if clearly needed. The label also notes that most experts recommend insulin during pregnancy to keep blood sugar as close to normal as possible.

Breastfeeding

The label says it is not known whether acarbose passes into human milk. Because many drugs do, the label says acarbose should not be given to a nursing woman.

🗓️ Storage, missed doses and taking too much

Storage

The label says to store at 20 to 25 degrees C (68 to 77 degrees F). Protect from moisture, and keep the bottle tightly closed.

If a dose is missed

The label does not say.

If too much is taken

The label says that unlike sulfonylureas or insulin, an overdose of acarbose will not cause low blood sugar. An overdose may cause temporary increases in gas, diarrhea, and belly discomfort that go away shortly. The label says that for the next 4 to 6 hours, the patient should not be given drinks or meals containing carbohydrates.

🗒️ Questions to ask about Acarbose

• When exactly should I take acarbose in relation to my meals?
• How will my doctor check whether acarbose is working for me?
• What should I do if the gas or diarrhea is strong or does not go away?
• What low blood sugar symptoms should I watch for if I also take insulin or a sulfonylurea?
• Should I keep a source of glucose (dextrose) on hand, and what should I use?
• Do any of my other medicines, such as diuretics, steroids, or digoxin, interact with acarbose?
• What liver or intestinal warning signs should prompt me to call my doctor right away?

❓ Acarbose: frequently asked questions