acarbose: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
acarbose: clinical details
Prescribing considerations
- Acarbose alone does not usually cause hypoglycaemia; assess risk from accompanying glucose-lowering treatments.
- Sucrose-containing foods and poor adherence to the recommended diabetes diet may intensify gastrointestinal effects.
- Safety and efficacy have not been established in people under 18 years.
Contraindications and cautions
- Hypersensitivity to acarbose or an excipient
- Inflammatory bowel disease or colonic ulceration
- Partial intestinal obstruction or predisposition to obstruction
- Severe renal failure
- Severe hepatic impairment, including cirrhosis
Monitoring
- Assess glycaemic response and gastrointestinal tolerability.
- Consider liver-enzyme monitoring after initiation and investigate persistent elevations or symptoms of liver injury.
- Review accompanying glucose-lowering treatment if hypoglycaemia occurs.
Clinical pharmacology
Acarbose competitively inhibits intestinal alpha-glucosidases, delaying carbohydrate digestion and absorption and reducing postprandial glucose excursions. Systemic absorption of active inhibitor is minimal.
Formulation and product differences
- The selected product is an immediate-release tablet.
- Its score line facilitates swallowing and is not intended to divide the tablet into equal amounts.
acarbose preparations and strengths
Tablet
Route: Oral
Strengths: 50 mg, 100 mg
acarbose interactions
Tell the prescriber or pharmacist about all medicines and supplements. Relevant interactions include:
Insulin and sulfonylureas
The combination can cause hypoglycaemia. Use glucose or dextrose rather than ordinary table sugar for rapid treatment.
Metformin and other glucose-lowering medicines
Blood glucose may fall too low when treatments are combined, so clinical review may be required.
Digoxin
Acarbose may alter digoxin availability, potentially requiring assessment and adjustment.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.