Type 2 diabetes mellitus
Adult: Initially, 50 mg daily increased to 50 mg tid, then increased if necessary after 6-8 wk to 100 mg tid. Max: 200 mg tid.
Indications and Dosage
Oral
Type 2 diabetes mellitus Adult: Initially, 50 mg daily increased to 50 mg tid, then increased if necessary after 6-8 wk to 100 mg tid. Max: 200 mg tid.
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Renal Impairment
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Hepatic Impairment
Severe: Contraindicated.
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Administration
Should be taken with food. Take w/ 1st bite of each main meal.
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Contraindications
Patient w/ inflammatory bowel disease, diabetic ketoacidosis or cirrhosis, colonic ulceration, partial intestinal obstruction or predisposition to this condition, chronic intestinal diseases associated w/ marked disorders of digestion or absorption and state/s which may deteriorate as a result of increased gas formation in the intestine (e.g. larger hernias). Severe hepatic and renal impairment (CrCl <25 mL/min).
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Special Precautions
Patient exposed to stress (e.g. fever, trauma, infection, surgery). Mild to moderate hepatic and renal impairment. Pregnancy and lactation.
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Adverse Reactions
Flatulence, abdominal pain and distension, diarrhoea, nausea, vomiting, abnormal LFTs, thrombocytopenia, pneumatosis cystoidis intestinalis. Rarely, ileus, jaundice, hepatitis, skin reactions and oedema.
Potentially Fatal: Fulminant hepatitis. |
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Patient Counseling Information
Adhere strictly to the prescribed diabetic diet.
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MonitoringParameters
Monitor postprandial glucose, glycosylated Hb levels, renal function (serum creatinine) and BP. Monitor serum transaminase levels 3 mthly during the 1st yr of treatment and periodically thereafter.
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Drug Interactions
May enhance effects of other antidiabetics including insulin. Diminished effects w/ GI adsorbents (e.g. charcoal) and digestive enzyme preparations containing carbohydrate splitting enzymes (e.g. amylase, pancreatin). Neomycin and colestyramine may enhance effects of acarbose. May inhibit absorption of digoxin.
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Action
Description: Acarbose competitively and reversibly inhibits pancreatic α-amylase and intestinal brush border α-glucosidases, resulting in delayed hydrolysis of ingested complex carbohydrates and disaccharides, and glucose absorption; dose-dependent reduction in postprandial serum insulin and glucose peaks; inhibits metabolism of sucrose to glucose and fructose.
Pharmacokinetics: Absorption: <2% (as active drug) and approx 35% (as metabolites) are absorbed from the GI tract. Time to peak plasma concentration: Approx 1 hr. Metabolism: Metabolised exclusively via GI tract, principally by microbial flora and intestinal enzymes. Excretion: Via urine (approx 34% as inactive metabolites; <2% parent drug and active metabolite) and faeces (approx 51% as unabsorbed drug). |
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Chemical Structure
![]() Source: National Center for Biotechnology Information. PubChem Database. Acarbose, CID=41774, https://pubchem.ncbi.nlm.nih.gov/compound/Acarbose (accessed on Jan. 20, 2020) |
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Storage
Store below 25°C. Protect from moisture.
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MIMS Class
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ATC Classification
A10BF01 - acarbose ; Belongs to the class of alpha glucosidase inhibitors. Used in the treatment of diabetes.
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References
Anon. Acarbose. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 14/08/2014. Buckingham R (ed). Acarbose. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 14/08/2014. Joint Formulary Committee. Acarbose. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 14/08/2014. McEvoy GK, Snow EK, Miller J et al (eds). Acarbose. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 14/08/2014. Precose Tablets. U.S. FDA. https://www.fda.gov/. Accessed 14/08/2014.
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