Classifications: antidiabetic agent; alpha-glucosidase inhibitor; Therapeutic: antidiabetic
Pregnancy Category: B
50 mg, 100 mg tablets
Acarbose is an oral alpha-glucosidase inhibitor. It inhibits or delays the absorption of sugars from the intestinal tract.
The inhibitory effect of acarbose varies according to which enzymes are involved; from most to least inhibited are glucoamylase,
sucrase, maltase, and isomaltase. Lactase is not affected by acarbose.
Acarbose reduces blood sugar by interfering with carbohydrate absorption from the GI tract.
As monotherapy or in combination with a sulfonylurea in patients with type 2 diabetes mellitus.
In combination with insulin and metformin in patients with type 1 diabetes mellitus.
Inflammatory bowel disease, colon ulcers, partial bowel obstruction, predisposition for obstruction; patients <18 y; lactation.
GI distress or liver disorders, pregnancy (category B).
Route & Dosage
Adult: PO Start with 25 mg daily to t.i.d. with meals, may increase q48wk up to 50100 mg t.i.d. with meals (max: 150 mg/d
for ≤60 kg, 300 mg/d for >60 kg)
- Remove drug from foil wrapper immediately before administration.
- Give drug with first bite at each of the three main meals.
- Do not store above 25° C (77° F). Keep tightly closed and protect from moisture.
Adverse Effects (≥1%)CNS:
Sleepiness, weakness, dizziness, headache, vertigo (may be due to poor diabetic control
). Endocrine: Hypoglycemia
(especially in combination with sulfonylureas and insulin). GI: Diarrhea, flatulence, abdominal distention,
borborygmi, increased liver function tests. Hematologic: Anemia
(especially iron deficiency). Skin: Erythema
, exanthema, urticaria.
Interactions Drug: sulfonylureas
may increase hypoglycemic effects. Drugs that induce hyperglycemia (e.g., thiazides
, phenytoin, isoniazid
) may decrease effectiveness of acarbose. Herbal: Garlic, ginseng
may increase hypoglycemic effects.
0.52% is absorbed intact from GI tract. After degradation by intestinal bacteria, up to 35% of dose may be
Peak blood glucose reduction approximately 70 min after dose. Metabolism:
In GI tract by intestinal bacteria and digestive enzymes. Elimination:
35% in urine, 51% in feces, 5% in air as CO2
Assessment & Drug Effects
- Lab tests: Periodically monitor blood glucose, HbA1C liver, enzymes, Hct and Hgb.
- Treat hypoglycemia with dextrose; not with sucrose (table sugar).
Patient & Family Education
- Note: Acarbose prevents the breakdown of table sugar. Have a source of dextrose, such as dextrose paste, available to treat low
- Monitor closely blood glucose especially following dosage changes.
- Report abdominal distress; dietary adjustment or dosage reduction may be warranted.
- Monitor weight and report significant changes.