ACARBOSE
50mg
Tablet
100mg
Tablet
BRAND NAMES:
Glucobay; Precose
DRUG
CATEGORY:
Antidiabetic (Type II)
Antidiabetic (Type II)
PHARMACODYNAMICS:
Acarbose
works against diabetes in a way different from all other antidiabetes
medicines. It interferes with enzymes in the intestine responsible
for breaking the complex carbohydrates found in starchy foods down
into simple sugars, including glucose, and lowers blood sugar by
delaying the absorption of glucose into the blood. Because it works
by a different method than the sulfonylurea-type oral antidiabetes
drugs and Metformin, the blood-sugar-lowering effect of Acarbose is
additive to that of other antidiabetes drugs. Acarbose may also be
used by people who are unable to control their blood sugar by diet
alone. Half of each dose of Acarbose remains unchanged in the
intestines and passes out of the body in the stool, and about 2% is
absorbed into the blood, and the rest is broken down in the
intestines. Most of Acarbose's side effects are directly related to
the fact that it leaves undigested carbohydrate in the lower
intestines. In studies of Acarbose, both black and white patients
responded similarly, but a better response was seen in Hispanic
patients.
DOSAGE
AND ADMINISTRATION
Adult
Additional Therapy in patients with Diabetes Mellitus:
Initially
3 times 1 tab 500mg/day or 3 times ½ tab 100mg/day up to 3 times 1
tab 100mg/day. Further increase to 3 times 200mg acarbose/day may
occasionally necessary.
Impaired
glucose tolerance: 100mg 3 times a day.
It
is not recommended for children.
SPECIAL
PRECAUTION:
It
is essential to take each dose of Acarbose at the beginning of each
meal. Since the drug works in the intestines, it has to be there at
the same time as the food you are digesting.
As
with all antidiabetes medicines, people taking Acarbose must follow
their physician's instructions for diet and exercise. Read product
labels carefully or check with your pharmacist before buying any
nonprescription medicine to be sure it is safe for diabetics to take
with Acarbose.
If
you forget a dose of Acarbose, skip it and continue with your regular
schedule. Taking a missed dose later on will not provide any benefit.
SIDE
EFFECTS:
Gastrointestinal:
Stomach gas (which 75% of the people who take it experience it),
abdominal pains, and diarrhea. But these side effects tend to improve
or go away after a few weeks.
Liver
and other organs: Liver irritation and some minor abnormalities
in blood tests.
CONTRAINDICATION:
Acarbose
should not be used if you are hypersensitive to it. People should not
use Acarbose if they have diabetic ketoacidosis, cirrhosis, severe
kidney disease, inflammatory bowel disease, ulcers of the colon,
intestinal obstruction, severe digestive disease, or absorption
disease, or if intestinal gas will be a severe problem. It is also
contraindicated to patient with hepatic impairment such as CrCl <25
ml/min/1.73ml and liver inflammation.
DRUG
INTERACTIONS:
- Augments blood-sugar-lowering effect of sulfonylurea and other antidiabetes drugs.
- Drugs such as diuretics, thyroid hormones, corticosteroids, phenothiazines, estorgens, oral contraceptives, phenytoin, nicotinic acid stimulants and decongestants, calcium channel blockers, and isoniazid which can raise blood sugar can decrease effects of Acarbose.
- Activated charcoal, antacids, and other drugs intended to absorb stomach contents, and digestive enzyme preparations may reduce the effectiveness of Acarbose. Separate these drugs from Acarbose by at least 2 hours.
- Cholestyramine, intestinal absorbents and digestive enzymes may attenuate its effect.
- Acarbose must be taken at the beginning (with the first bite) of each meal.
USE
IN ELDERLY:
Blood
levels of Acarbose are higher in older adults, but this is not
considered important. Older adults with severe kidney disease should
avoid this medicine.
USE
IN PREGNANCY AND LACTATING:
Animal
studies of Acarbose showed no effects on the developing fetus. There
is no information available on the effects of Acarbose in pregnant
women. As with all medicines, Acarbose should be taken during
pregnancy only if absolutely necessary and only if the potential
risks have been completely discussed with your doctor.
It
is not known if Acarbose passes into breast milk. Nursing mothers who
must take this medicine should consider bottle-feeding their babies.
OVERDOSAGE:
There
has no reported with Acarbose overdosage, but diarrhea, abdominal
pains, and intestinal gas can expected. Excess blood-sugar-lowering
should not occur. Call your local poison center for more information.
STORAGE
CONDITION:
Store
at temperatures not exceeding 30o C.
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