The dosage must be adjusted by the doctor to suit each patient, because efficacy and tolerability vary from one individual to another.
Unless otherwise prescribed, the recommended dosage is as follows: Initially: 3 x 1 tablet of 50 mg acarbose/day or 3 x ½ tablet of 100 mg acarbose/day.
Subsequently: 3 x 2 tablets of 50 mg acarbose/day or 3 x 1 tablet of 100 mg acarbose/day up to 3 x 2 tablets of 100 mg acarbose/day.
The dose may be increased after 4-8 weeks, and if patients show an inadequate clinical response in the later course of the treatment. If distressing complaints develop in spite of strict adherence to the diet the dose should not be increased further, and if necessary should be somewhat reduced. The average dose is 300 mg acarbose/day (corresponding to 3 x 2 tablets of Acarbose 50 mg/day, or 3 x 1 tablet Acarbose 100 mg/day).
Elderly (above 65 years): No alteration of dosage or dosing frequency is recommended with regard to the age of the patients.
Children: See Contraindications and Precautions.
Hepatic impairment: No dose adjustment is required in patients with pre-existing hepatic function.
Renal impairment: See Contraindications.
Nature and duration of use: Acarbose tablets are effective only if swallowed whole with a little liquid directly before the meal or be chewed with the first few mouthfuls of the meal. No limit to the length of time for which Acarbose can be used is envisaged. The limitation on dosage is due to the secondary effects of carbohydrate mal-absorption, in particular distention, flatulence and loose stools. Some adaptation to these effects occurs in the first few weeks of use. The optimal therapeutic dose is established by minimizing whilst reducing postprandial glycaemic rises. Diabetic diet should be adhered during acarbose administration.