Acarbose

Oral
Type 2 diabetes mellitus

CrCl	Dosage
<25	Contraindicated.

Severe: Contraindicated.

Should be taken with food. Take w/ 1st bite of each main meal.

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).

Patient exposed to stress (e.g. fever, trauma, infection, surgery). Mild to moderate hepatic and renal impairment. Pregnancy and lactation.

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.

PO: B

Adhere strictly to the prescribed diabetic diet.

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.

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.

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).

Source: National Center for Biotechnology Information. PubChem Database. Acarbose, CID=41774, https://pubchem.ncbi.nlm.nih.gov/compound/Acarbose (accessed on Jan. 20, 2020)

Store below 25°C. Protect from moisture.

Antidiabetic Agents

A10BF01 - acarbose ; Belongs to the class of alpha glucosidase inhibitors. Used in the treatment of diabetes.

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.