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ALIMENTARY TRACT AND METABOLISM › DRUGS USED IN DIABETES › BLOOD GLUCOSE LOWERING DRUGS, EXCL. INSULINS › Alpha glucosidase inhibitors
acarbose
A10BF01
Forms & Strengths
- Oral tablets: 25 mg
- Oral tablets: 50 mg
- Oral tablets: 100 mg
Adult Dosing
- Initial: 25 mg orally once daily with the first bite of each main meal
- Titration: Increase by 25 mg increments at 4-to-8-week intervals based on efficacy and tolerance
- Maintenance: 50 mg to 100 mg orally three times daily with meals
- Maximum dose: 50 mg TID for patients <= 60 kg; 100 mg TID for patients > 60 kg
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
Indications
- Adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus
Mechanism of Action
- Competitive, reversible inhibition of membrane-bound intestinal alpha-glucosidase enzymes
- Delays the hydrolysis of ingested complex carbohydrates and disaccharides into absorbable monosaccharides
- Blunts postprandial glycemic and insulinemic excursions
Contraindications
- Known hypersensitivity to acarbose
- Diabetic ketoacidosis
- Cirrhosis
- Inflammatory bowel disease, colonic ulceration, or partial intestinal obstruction
- Chronic digestive or absorptive disorders associated with significant marked impairment of digestion/absorption
Adverse Reactions
- Flatulence (74%)
- Diarrhea (31%)
- Abdominal pain (19%)
- Elevated serum transaminases (asymptomatic, reversible)
Drug Interactions
- Intestinal adsorbents (e.g., charcoal, digestive enzyme preparations) may reduce acarbose efficacy
- Thiazides, corticosteroids, phenothiazines, thyroid products, estrogen, oral contraceptives, and calcium channel blockers may cause hyperglycemia and reduce efficacy
- Concomitant sulfonylureas or insulin may increase the risk of hypoglycemia; treat hypoglycemia with oral glucose (dextrose), not sucrose
Curated Content: Needs Vetting Before Put to Clinical Use