Acarbose

Generic Details

Generic Name

Acarbose

Other Names

  • Precose
  • Glucobay

Drug Class

  • Alpha-glucosidase inhibitor

Chemical Formula

C25H43NO18

Molecular Weight

645.6 g/mol

Mechanism of Action

  • Inhibits alpha-glucosidase enzymes in the intestines, delaying carbohydrate digestion and absorption.

Indications

  • Type 2 Diabetes Mellitus

Common Dosage Forms

  • Tablet

Typical Dosage

  • The usual starting dose is 25 mg taken orally three times daily with the first bite of each main meal.

Pediatric Dosage

  • Safety and effectiveness in pediatric patients have not been established.

Geriatric Dosage

  • Dose selection should be cautious due to the greater frequency of decreased hepatic, renal, or cardiac function, and concomitant diseases or other drug therapy.

Side Effects

  • Flatulence
  • Diarrhea
  • Abdominal discomfort
  • Hypoglycemia (when used with insulin or sulfonylureas)

Contraindications

  • Hypersensitivity to acarbose
  • Diabetic ketoacidosis
  • Inflammatory bowel disease
  • Partial intestinal obstruction or predisposition to intestinal obstruction

Pregnancy Category

  • B - Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women.

Lactation Safety

  • Acarbose is excreted in breast milk. Consider the benefits of breastfeeding along with the mother's clinical need for acarbose and any potential adverse effects on the breastfed child.

Drug Interactions

  • Insulin
  • Sulfonylureas
  • Metformin
  • Digoxin
  • Warfarin

Overdose Symptoms

  • Severe flatulence
  • Diarrhea
  • Abdominal distention
  • Gas
  • Hypoglycemia

Antidote for Overdose

  • No specific antidote is known. However, supportive care should be provided.

Storage Conditions

  • Store at room temperature between 20-25°C (68-77°F)

Pharmacokinetics

  • Absorption: Poorly absorbed from the gut.
  • Distribution: Not extensively bound to plasma proteins.
  • Metabolism: Not extensively metabolized in the liver.
  • Excretion: Mainly excreted unchanged in the urine.

Precautions

  • Monitor liver function tests regularly during treatment.

Warnings

  • Monitor blood glucose regularly.

Others

  • Acarbose should be taken with the first bite of each main meal to maximize effectiveness.