Acarbose

Acarbose Brand Name – Precose

What is Acarbose

Acarbose is an alpha-glucosidase inhibitor used for the treatment of type 2 diabetes mellitus (DM); in contrast to miglitol, acarbose has minimal systemic absorption.

Acarbose has been shown to effectively lower postprandial blood glucose when administered alone or in combination with insulin, metformin, or an oral sulfonylurea.

At recommended doses, agents in this class have only modest effects on A1C levels (i.e., mean reduction, 0.3% to 0.7%). Although not FDA-approved, acarbose reduces the risk of future diabetes by 25% to 30% and may confer cardiovascular (CV) benefit.

Metformin is first-line in the treatment of type 2 DM. In patients with established cardiovascular (CV) disease, heart failure (HF), or chronic kidney disease (CKD), a sodium-glucose co-transporter 2 (SGLT2) inhibitor or glucagon-like peptide-1 receptor agonist (GLP-1 RA) with proven CV benefit and reduction of CKD progression is recommended for add-on therapy, independent of baseline A1C or individualized A1C target.

In patients without indicators of high-risk or established CVD, HF, or CKD, acarbose may be considered as a therapeutic option

Indications

  • type 2 diabetes mellitus

For the treatment of type 2 diabetes mellitus in patients not controlled by diet alone

Side Effects

  1. abdominal pain
  2. anemia
  3. borborygmi
  4. diarrhea
  5. edema
  6. elevated hepatic enzymes
  7. eosinophilia
  8. erythema
  9. erythema multiforme
  10. flatulence
  11. hepatitis
  12. ileus
  13. jaundice
  14. pneumatosis cystoides intestinalis
  15. rash
  16. thrombocytopenia
  17. urticaria
  18. weight loss

Monitoring Parameters

  • blood glucose
  • LFTs

Contraindications

  • breast-feeding
  • children
  • diabetic ketoacidosis
  • diarrhea
  • females
  • geriatric
  • GI disease
  • GI obstruction
  • hepatic disease
  • hepatitis
  • hiatal hernia
  • hypoglycemia
  • ileus
  • inflammatory bowel disease
  • jaundice
  • pregnancy
  • renal failure
  • renal impairment
  • vomiting

Interactions

  • Acebutolol
  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Propoxyphene
  • Acetazolamide
  • Aminosalicylate sodium, Aminosalicylic acid
  • Amlodipine; Benazepril
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
  • Androgens
  • Angiotensin II receptor antagonists
  • Angiotensin-converting enzyme inhibitors
  • Aspirin, ASA
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Caffeine; Orphenadrine
  • Aspirin, ASA; Carisoprodol
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Citric Acid; Sodium Bicarbonate
  • Aspirin, ASA; Dipyridamole
  • Aspirin, ASA; Omeprazole
  • Aspirin, ASA; Oxycodone
  • Aspirin, ASA; Pravastatin
  • Atenolol
  • Atenolol; Chlorthalidone
  • Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • atypical antipsychotic
  • Azelastine; Fluticasone
  • Beclomethasone
  • Benazepril
  • Benazepril; Hydrochlorothiazide, HCTZ
  • Bendroflumethiazide; Nadolol
  • Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Beta-blockers
  • Betamethasone
  • Betaxolol
  • Bismuth Subsalicylate
  • Bismuth Subsalicylate; Metronidazole; Tetracycline
  • Bisoprolol
  • Bisoprolol; Hydrochlorothiazide, HCTZ
  • Bortezomib
  • Brimonidine; Timolol
  • Budesonide
  • Budesonide; Formoterol
  • Captopril
  • Captopril; Hydrochlorothiazide, HCTZ
  • Cardiac glycosides
  • Carteolol
  • Carvedilol
  • Charcoal
  • Chloroquine
  • Chlorthalidone; Clonidine
  • Cholestyramine
  • Choline Salicylate; Magnesium Salicylate
  • Chromium
  • Ciclesonide
  • Cisapride
  • Clarithromycin
  • Clonidine
  • Colestipol
  • Conjugated Estrogens; Medroxyprogesterone
  • Corticosteroids
  • Corticotropin, ACTH
  • Cortisone
  • Cyclosporine
  • Daclatasvir
  • Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
  • Deflazacort
  • Dexamethasone
  • Diazoxide
  • Dienogest; Estradiol valerate
  • Disopyramide
  • Dorzolamide; Timolol
  • Drospirenone
  • Drospirenone; Estradiol
  • Drospirenone; Ethinyl Estradiol
  • Drospirenone; Ethinyl Estradiol; Levomefolate
  • Elagolix; Estradiol; Norethindrone acetate
  • Elbasvir; Grazoprevir
  • Enalapril, Enalaprilat
  • Enalapril; Felodipine
  • Enalapril; Hydrochlorothiazide, HCTZ
  • Esmolol
  • Estradiol Cypionate; Medroxyprogesterone
  • Estradiol; Levonorgestrel
  • Estradiol; Norethindrone
  • Estradiol; Norgestimate
  • Estradiol; Progesterone
  • Estramustine
  • Estrogens
  • Ethanol
  • Ethinyl Estradiol; Desogestrel
  • Ethinyl Estradiol; Ethynodiol Diacetate
  • Ethinyl Estradiol; Etonogestrel
  • Ethinyl Estradiol; Levonorgestrel
  • Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
  • Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
  • Ethinyl Estradiol; Norelgestromin
  • Ethinyl Estradiol; Norethindrone
  • Ethinyl Estradiol; Norethindrone Acetate
  • Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
  • Ethinyl Estradiol; Norethindrone; Ferrous fumarate
  • Ethinyl Estradiol; Norgestimate
  • Ethinyl Estradiol; Norgestrel
  • Ethotoin
  • Etonogestrel
  • Fibric acid derivatives
  • Fludrocortisone
  • Flunisolide
  • Fluoxetine
  • Fluoxetine; Olanzapine
  • Fluticasone
  • Fluticasone; Salmeterol
  • Fluticasone; Umeclidinium; Vilanterol
  • Fluticasone; Vilanterol
  • Formoterol; Mometasone
  • Fosinopril
  • Fosinopril; Hydrochlorothiazide, HCTZ
  • Fosphenytoin
  • Garlic, Allium sativum
  • Gastrointestinal Enzymes
  • Glecaprevir; Pibrentasvir
  • Green Tea
  • Hydantoins
  • Hydrochlorothiazide, HCTZ; Lisinopril
  • Hydrochlorothiazide, HCTZ; Metoprolol
  • Hydrochlorothiazide, HCTZ; Moexipril
  • Hydrochlorothiazide, HCTZ; Propranolol
  • Hydrochlorothiazide, HCTZ; Quinapril
  • Hydrochlorothiazide, HCTZ; Triamterene
  • Hydrocortisone
  • Hydroxychloroquine
  • Hydroxyprogesterone
  • Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
  • Indapamide
  • Isocarboxazid
  • Labetalol
  • Lanreotide
  • Ledipasvir; Sofosbuvir
  • Leuprolide; Norethindrone
  • Levobetaxolol
  • Levobunolol
  • Levonorgestrel
  • Lisinopril
  • Lithium
  • Lomefloxacin
  • Loop diuretics
  • Lorcaserin
  • Lovastatin; Niacin
  • Magnesium Salicylate
  • Mecasermin rinfabate
  • Mecasermin, Recombinant, rh-IGF-1
  • Medroxyprogesterone
  • Mestranol; Norethindrone
  • Methazolamide
  • Methylprednisolone
  • Metoprolol
  • Metyrapone
  • Moexipril
  • Mometasone
  • Monoamine oxidase inhibitors
  • Nadolol
  • Nebivolol
  • Nebivolol; Valsartan
  • Neomycin
  • Niacin, Niacinamide
  • Niacin; Simvastatin
  • Nicotine
  • Norethindrone
  • Norgestrel
  • Octreotide
  • Orlistat
  • Pancrelipase
  • Pasireotide
  • Pegvisomant
  • Penbutolol
  • Pentamidine
  • Pentoxifylline
  • Perindopril
  • Perindopril; Amlodipine
  • Phenelzine
  • Phenothiazines
  • Phenytoin
  • Pindolol
  • Pramlintide
  • Prednisolone
  • Prednisone
  • Progesterone
  • Progestins
  • Propoxyphene
  • Propranolol
  • Protease inhibitors
  • Quinapril
  • Quinolones
  • Ramipril
  • Reserpine
  • Salicylates
  • Salsalate
  • Segesterone Acetate; Ethinyl Estradiol
  • Selegiline
  • Sofosbuvir
  • Sofosbuvir; Velpatasvir
  • Sofosbuvir; Velpatasvir; Voxilaprevir
  • Somatropin, rh-GH
  • Sotalol
  • Sparfloxacin
  • Sulfonamides
  • Sympathomimetics
  • Tacrolimus
  • Tegaserod
  • Thiazide diuretics
  • Thyroid hormones
  • Timolol
  • tobacco
  • Trandolapril
  • Trandolapril; Verapamil
  • Tranylcypromine
  • Triamcinolone
  • Triamterene
  • Trovafloxacin, Alatrofloxacin
  • Warfarin
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