Acarbose

ACARBOSE

50mg Tablet

100mg Tablet

BRAND NAMES:
Glucobay; Precose
 

DRUG CATEGORY:  
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:

1. Augments blood-sugar-lowering effect of sulfonylurea and other antidiabetes drugs.
2. 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.
3. 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.
4. Cholestyramine, intestinal absorbents and digestive enzymes may attenuate its effect.
5. 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 30^o C.