Sucrose (cane sugar) and foods containing sucrose often cause abdominal discomfort or even diarrhoea during treatment with Acarbose as a result of increased carbohydrate fermentation in the colon.
Acarbose has an antihyperglycaemic effect, but does not itself induce hypoglycaemia. If Acarbose is prescribed in addition to drugs containing sulphonylureas or metformin, or in addition to insulin, a fall of the blood glucose values into the hypoglycaemic range may necessitate a suitable decrease in the sulphonylurea, metformin or insulin dose. In individual cases hypoglycaemic shock may occur.
If acute hypoglycaemia develops it should be borne in mind that sucrose (cane sugar) is broken down into fructose and glucose more slowly during treatment with Acarbose; for this reason sucrose is unsuitable for a rapid alleviation of hypoglycaemia and glucose should be used instead.
In individual cases Acarbose may affect digoxin bioavailability, which may require dose adjustment of digoxin. Because they may possibly influence the action of Acarbose, simultaneous administration of cholestyramine, intestinal adsorbents, and digestive enzyme products should be avoided. No interaction was observed with dimeticone/simeticone. Certain drugs tend to produce hyperglycaemia and may lead to loss of blood glucose control. These drugs included diuretics (thiazides, furosemide), corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptive, phenytoin, nicotinic acid, symphatomimetics and isoniazid. When such of drugs are administered to a patient receiving acarbose, the patients should be closely monitored for loss of blood glucose control.
Due to neomycin induced ma-absorption of carbohydrate, concomitant administration of neomycin may lead to an enhanced reduction of post prandial blood glucose and to an increased in the frequently and severity of gastrointestinal adverse reactions. If the symptoms are severe, a temporary dose reduction of acarbose may warranted.