Can increase to 50 or 100 mg PO q8hr at 4- to 8-wk intervals based on 1 hour postprandial glucose or glycosylated hemoglobin levels, and on tolerance
Maximum Dose
<60 kg: 50 mg q8hr
>60 kg: 100 mg q8hr
Other Indications & Uses
Type 2 DM, mono treatment or with sulfonylurea
Safety & efficacy not established
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Interactions
Interaction Checker
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Serious - Use Alternative (2)
- ethanol
ethanol, acarbose. Other (see comment). Contraindicated. Comment: Excessive EtOH consumption may alter glycemic control. Some sulfonylureas may produce a disulfiram like rxn.
- pramlintide
pramlintide, acarbose. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI nutrient absorption.
Monitor Closely (59)
- albiglutide
albiglutide, acarbose. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Concurrent use may increase risk of hypoglycemia; monitor glucose levels.
- aripiprazole
aripiprazole, acarbose. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- asenapine
asenapine, acarbose. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- atazanavir
atazanavir decreases effects of acarbose by pharmacodynamic antagonism. Use Caution/Monitor. New onset or exacerbation of diabetes mellitus and hyperglycemia have been reported with protease inhibitors.
- bitter melon
bitter melon increases effects of acarbose by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypoglycemia.
- cinnamon
cinnamon increases effects of acarbose by pharmacodynamic synergism. Use Caution/Monitor. Potential for hypoglycemia.
- ciprofloxacin
ciprofloxacin increases effects of acarbose by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. .
- clozapine
acarbose, clozapine. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- darunavir
darunavir decreases effects of acarbose by pharmacodynamic antagonism. Use Caution/Monitor. New onset or exacerbation of diabetes mellitus and hyperglycemia have been reported with protease inhibitors.
- digoxin
acarbose will decrease the level or effect of digoxin by unspecified interaction mechanism. Use Caution/Monitor. Measure serum digoxin concentrations before initiating concomitant drugs; continue monitoring and increase digoxin dose by approximately 20% to 40% as necessary
- dulaglutide
dulaglutide, acarbose. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- exenatide injectable solution
exenatide injectable solution, acarbose. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Concurrent use may increase risk of hypoglycemia; monitor glucose levels.
- exenatide injectable suspension
exenatide injectable suspension, acarbose. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Concurrent use may increase risk of hypoglycemia; monitor glucose levels.
- fleroxacin
fleroxacin increases effects of acarbose by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.
- fosamprenavir
fosamprenavir decreases effects of acarbose by pharmacodynamic antagonism. Use Caution/Monitor. New onset or exacerbation of diabetes mellitus and hyperglycemia have been reported with protease inhibitors.
- gemifloxacin
gemifloxacin increases effects of acarbose by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.
- iloperidone
iloperidone, acarbose. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- indinavir
indinavir decreases effects of acarbose by pharmacodynamic antagonism. Use Caution/Monitor. New onset or exacerbation of diabetes mellitus and hyperglycemia have been reported with protease inhibitors.
- insulin aspart
acarbose, insulin aspart. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- insulin aspart protamine/insulin aspart
acarbose, insulin aspart protamine/insulin aspart. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- insulin degludec
acarbose, insulin degludec. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- insulin degludec/insulin aspart
acarbose, insulin degludec/insulin aspart. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- insulin detemir
acarbose, insulin detemir. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- insulin glargine
acarbose, insulin glargine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- insulin glulisine
acarbose, insulin glulisine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- insulin inhaled
acarbose, insulin inhaled. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- insulin isophane human/insulin regular human
acarbose, insulin isophane human/insulin regular human. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- insulin lispro
acarbose, insulin lispro. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- insulin lispro protamine/insulin lispro
acarbose, insulin lispro protamine/insulin lispro. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- insulin NPH
acarbose, insulin NPH. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- insulin regular human
acarbose, insulin regular human. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- ketotifen, ophthalmic
ketotifen, ophthalmic, acarbose. Other (see comment). Use Caution/Monitor. Comment: Combination may result in thrombocytopenia (rare). Monitor CBC.
- letermovir
letermovir will increase the level or effect of acarbose by unspecified interaction mechanism. Use Caution/Monitor. Monitor glucose concentrations
- levofloxacin
levofloxacin increases effects of acarbose by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.
- liraglutide
liraglutide, acarbose. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Concurrent use may increase risk of hypoglycemia; monitor glucose levels.
- lonapegsomatropin
lonapegsomatropin decreases effects of acarbose by Other (see comment). Modify Therapy/Monitor Closely. Comment: Closely monitor blood glucose when treated with antidiabetic agents. Lonapegsomatropin may decrease insulin sensitivity, particularly at higher doses. Patients with diabetes mellitus may require adjustment of their doses of insulin and/or other antihyperglycemic agents.
- lopinavir
lopinavir decreases effects of acarbose by pharmacodynamic antagonism. Use Caution/Monitor. New onset or exacerbation of diabetes mellitus and hyperglycemia have been reported with protease inhibitors.
- lurasidone
lurasidone, acarbose. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- marijuana
marijuana decreases effects of acarbose by pharmacodynamic antagonism. Use Caution/Monitor.
- mecasermin
mecasermin increases effects of acarbose by pharmacodynamic synergism. Use Caution/Monitor. Additive hypoglycemic effects.
- mipomersen
mipomersen, acarbose. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Both drugs have potential to increase hepatic enzymes; monitor LFTs.
- moxifloxacin
moxifloxacin increases effects of acarbose by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.
- nelfinavir
nelfinavir decreases effects of acarbose by pharmacodynamic antagonism. Use Caution/Monitor. New onset or exacerbation of diabetes mellitus and hyperglycemia have been reported with protease inhibitors.
- ofloxacin
ofloxacin increases effects of acarbose by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.
- olanzapine
olanzapine, acarbose. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- opuntia ficus indica
opuntia ficus indica increases effects of acarbose by pharmacodynamic synergism. Use Caution/Monitor.
- paliperidone
paliperidone, acarbose. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- pancrelipase
pancrelipase decreases effects of acarbose by pharmacodynamic antagonism. Use Caution/Monitor. Antihyperglycemic action of acarbose results from a competitive, reversible inhibition of pancreatic alpha-amylase and membrane-bound intestinal alpha-glucoside hydrolase enzymes.
- quetiapine
quetiapine, acarbose. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- risperidone
risperidone, acarbose. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- ritonavir
ritonavir decreases effects of acarbose by pharmacodynamic antagonism. Use Caution/Monitor. New onset or exacerbation of diabetes mellitus and hyperglycemia have been reported with protease inhibitors.
- saquinavir
saquinavir decreases effects of acarbose by pharmacodynamic antagonism. Use Caution/Monitor. New onset or exacerbation of diabetes mellitus and hyperglycemia have been reported with protease inhibitors.
- shark cartilage
shark cartilage increases effects of acarbose by pharmacodynamic synergism. Use Caution/Monitor. Theoretical interaction.
- somapacitan
somapacitan decreases effects of acarbose by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Growth hormone products may decrease insulin sensitivity, particularly at higher doses. Antidiabetic agents may require dose adjustment after initiating somapacitan. .
- sulfamethoxypyridazine
sulfamethoxypyridazine increases effects of acarbose by unspecified interaction mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- tipranavir
tipranavir decreases effects of acarbose by pharmacodynamic antagonism. Use Caution/Monitor. New onset or exacerbation of diabetes mellitus and hyperglycemia have been reported with protease inhibitors.
- triamcinolone acetonide injectable suspension
triamcinolone acetonide injectable suspension decreases effects of acarbose by pharmacodynamic antagonism. Use Caution/Monitor. Corticosteroids may diminish hypoglycemic effect of antidiabetic agents. Monitor blood glucose levels carefully.
- xipamide
xipamide decreases levels of acarbose by increasing renal clearance. Use Caution/Monitor.
- ziprasidone
ziprasidone, acarbose. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
Minor (69)
- activated charcoal
activated charcoal decreases levels of acarbose by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- agrimony
agrimony increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- American ginseng
American ginseng increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- amitriptyline
amitriptyline increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- amoxapine
amoxapine increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- anamu
anamu increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. Theoretical interaction.
- bendroflumethiazide
bendroflumethiazide decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- budesonide
budesonide decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown.
- chlorothiazide
chlorothiazide decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- chlorthalidone
chlorthalidone decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- chromium
chromium increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- clomipramine
clomipramine increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- clonidine
clonidine decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown. Diminished symptoms of hypoglycemia.
clonidine, acarbose. Other (see comment). Minor/Significance Unknown. Comment: Decreased symptoms of hypoglycemia. Mechanism: decreased hypoglycemia induced catecholamine production. - cornsilk
cornsilk increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (theoretical interaction).
- cortisone
cortisone decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown.
- cyclopenthiazide
cyclopenthiazide decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- damiana
damiana decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown. Theoretical interaction.
- danazol
danazol increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- deflazacort
deflazacort decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown.
- desipramine
desipramine increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- devil's claw
devil's claw increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- dexamethasone
dexamethasone decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown.
- doxepin
doxepin increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- elderberry
elderberry increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (in vitro research).
- eucalyptus
eucalyptus increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. Theoretical interaction.
- fludrocortisone
fludrocortisone decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown.
- fluoxymesterone
fluoxymesterone increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- fo-ti
fo-ti increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- forskolin
forskolin increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. Colenol, a compound found in Coleus root, may stimulate insulin release.
- gotu kola
gotu kola increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. (Theoretical interaction).
- guanfacine
guanfacine decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown. Diminished symptoms of hypoglycemia.
guanfacine, acarbose. Other (see comment). Minor/Significance Unknown. Comment: Decreased symptoms of hypoglycemia. Mechanism: decreased hypoglycemia induced catecholamine production. - gymnema
gymnema increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- horse chestnut seed
horse chestnut seed increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- hydrochlorothiazide
hydrochlorothiazide decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- hydrocortisone
hydrocortisone decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown.
- imipramine
imipramine increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- indapamide
indapamide decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- isoniazid
isoniazid decreases effects of acarbose by unspecified interaction mechanism. Minor/Significance Unknown.
- juniper
juniper increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (theoretical interaction).
- lofepramine
lofepramine increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- lycopus
lycopus increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (theoretical interaction).
- maitake
maitake increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (animal research).
- maprotiline
maprotiline increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- mesterolone
mesterolone increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- methyclothiazide
methyclothiazide decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- methylprednisolone
methylprednisolone decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown.
- methyltestosterone
methyltestosterone increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- metolazone
metolazone decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- nettle
nettle increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. (Theoretical interaction).
- nortriptyline
nortriptyline increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- ofloxacin
ofloxacin, acarbose. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential dysglycemia.
- oxandrolone
oxandrolone increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- oxymetholone
oxymetholone increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- pegvisomant
pegvisomant increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- potassium acid phosphate
potassium acid phosphate increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.
- potassium chloride
potassium chloride increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.
- potassium citrate
potassium citrate increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.
- prednisolone
prednisolone decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown.
- prednisone
prednisone decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown.
- protriptyline
protriptyline increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- sage
sage increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- stevia
stevia increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- testosterone
testosterone increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- testosterone buccal system
testosterone buccal system increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- testosterone topical
testosterone topical increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- tongkat ali
tongkat ali increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypoglycemia.
- trazodone
trazodone increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- trimipramine
trimipramine increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- vanadium
vanadium increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- activated charcoal
Minor (1)activated charcoal decreases levels of acarbose by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- agrimony
Minor (1)agrimony increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- albiglutide
Monitor Closely (1)albiglutide, acarbose. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Concurrent use may increase risk of hypoglycemia; monitor glucose levels.
- American ginseng
Minor (1)American ginseng increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- amitriptyline
Minor (1)amitriptyline increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- amoxapine
Minor (1)amoxapine increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- anamu
Minor (1)anamu increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. Theoretical interaction.
- aripiprazole
Monitor Closely (1)aripiprazole, acarbose. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- asenapine
Monitor Closely (1)asenapine, acarbose. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- atazanavir
Monitor Closely (1)atazanavir decreases effects of acarbose by pharmacodynamic antagonism. Use Caution/Monitor. New onset or exacerbation of diabetes mellitus and hyperglycemia have been reported with protease inhibitors.
- bendroflumethiazide
Minor (1)bendroflumethiazide decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- bitter melon
Monitor Closely (1)bitter melon increases effects of acarbose by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypoglycemia.
- budesonide
Minor (1)budesonide decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown.
- chlorothiazide
Minor (1)chlorothiazide decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- chlorthalidone
Minor (1)chlorthalidone decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- chromium
Minor (1)chromium increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- cinnamon
Monitor Closely (1)cinnamon increases effects of acarbose by pharmacodynamic synergism. Use Caution/Monitor. Potential for hypoglycemia.
- ciprofloxacin
Monitor Closely (1)ciprofloxacin increases effects of acarbose by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. .
- clomipramine
Minor (1)clomipramine increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- clonidine
Minor (2)clonidine decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown. Diminished symptoms of hypoglycemia.
clonidine, acarbose. Other (see comment). Minor/Significance Unknown. Comment: Decreased symptoms of hypoglycemia. Mechanism: decreased hypoglycemia induced catecholamine production. - clozapine
Monitor Closely (1)acarbose, clozapine. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- cornsilk
Minor (1)cornsilk increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (theoretical interaction).
- cortisone
Minor (1)cortisone decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown.
- cyclopenthiazide
Minor (1)cyclopenthiazide decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- damiana
Minor (1)damiana decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown. Theoretical interaction.
- danazol
Minor (1)danazol increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- darunavir
Monitor Closely (1)darunavir decreases effects of acarbose by pharmacodynamic antagonism. Use Caution/Monitor. New onset or exacerbation of diabetes mellitus and hyperglycemia have been reported with protease inhibitors.
- deflazacort
Minor (1)deflazacort decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown.
- desipramine
Minor (1)desipramine increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- devil's claw
Minor (1)devil's claw increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- dexamethasone
Minor (1)dexamethasone decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown.
- digoxin
Monitor Closely (1)acarbose will decrease the level or effect of digoxin by unspecified interaction mechanism. Use Caution/Monitor. Measure serum digoxin concentrations before initiating concomitant drugs; continue monitoring and increase digoxin dose by approximately 20% to 40% as necessary
- doxepin
Minor (1)doxepin increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- dulaglutide
Monitor Closely (1)dulaglutide, acarbose. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- elderberry
Minor (1)elderberry increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (in vitro research).
- ethanol
Serious - Use Alternative (1)ethanol, acarbose. Other (see comment). Contraindicated. Comment: Excessive EtOH consumption may alter glycemic control. Some sulfonylureas may produce a disulfiram like rxn.
- eucalyptus
Minor (1)eucalyptus increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. Theoretical interaction.
- exenatide injectable solution
Monitor Closely (1)exenatide injectable solution, acarbose. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Concurrent use may increase risk of hypoglycemia; monitor glucose levels.
- exenatide injectable suspension
Monitor Closely (1)exenatide injectable suspension, acarbose. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Concurrent use may increase risk of hypoglycemia; monitor glucose levels.
- fleroxacin
Monitor Closely (1)fleroxacin increases effects of acarbose by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.
- fludrocortisone
Minor (1)fludrocortisone decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown.
- fluoxymesterone
Minor (1)fluoxymesterone increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- fo-ti
Minor (1)fo-ti increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- forskolin
Minor (1)forskolin increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. Colenol, a compound found in Coleus root, may stimulate insulin release.
- fosamprenavir
Monitor Closely (1)fosamprenavir decreases effects of acarbose by pharmacodynamic antagonism. Use Caution/Monitor. New onset or exacerbation of diabetes mellitus and hyperglycemia have been reported with protease inhibitors.
- gemifloxacin
Monitor Closely (1)gemifloxacin increases effects of acarbose by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.
- gotu kola
Minor (1)gotu kola increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. (Theoretical interaction).
- guanfacine
Minor (2)guanfacine decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown. Diminished symptoms of hypoglycemia.
guanfacine, acarbose. Other (see comment). Minor/Significance Unknown. Comment: Decreased symptoms of hypoglycemia. Mechanism: decreased hypoglycemia induced catecholamine production. - gymnema
Minor (1)gymnema increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- horse chestnut seed
Minor (1)horse chestnut seed increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- hydrochlorothiazide
Minor (1)hydrochlorothiazide decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- hydrocortisone
Minor (1)hydrocortisone decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown.
- iloperidone
Monitor Closely (1)iloperidone, acarbose. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- imipramine
Minor (1)imipramine increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- indapamide
Minor (1)indapamide decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- indinavir
Monitor Closely (1)indinavir decreases effects of acarbose by pharmacodynamic antagonism. Use Caution/Monitor. New onset or exacerbation of diabetes mellitus and hyperglycemia have been reported with protease inhibitors.
- insulin aspart
Monitor Closely (1)acarbose, insulin aspart. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- insulin aspart protamine/insulin aspart
Monitor Closely (1)acarbose, insulin aspart protamine/insulin aspart. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- insulin degludec
Monitor Closely (1)acarbose, insulin degludec. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- insulin degludec/insulin aspart
Monitor Closely (1)acarbose, insulin degludec/insulin aspart. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- insulin detemir
Monitor Closely (1)acarbose, insulin detemir. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- insulin glargine
Monitor Closely (1)acarbose, insulin glargine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- insulin glulisine
Monitor Closely (1)acarbose, insulin glulisine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- insulin inhaled
Monitor Closely (1)acarbose, insulin inhaled. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- insulin isophane human/insulin regular human
Monitor Closely (1)acarbose, insulin isophane human/insulin regular human. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- insulin lispro
Monitor Closely (1)acarbose, insulin lispro. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- insulin lispro protamine/insulin lispro
Monitor Closely (1)acarbose, insulin lispro protamine/insulin lispro. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- insulin NPH
Monitor Closely (1)acarbose, insulin NPH. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- insulin regular human
Monitor Closely (1)acarbose, insulin regular human. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- isoniazid
Minor (1)isoniazid decreases effects of acarbose by unspecified interaction mechanism. Minor/Significance Unknown.
- juniper
Minor (1)juniper increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (theoretical interaction).
- ketotifen, ophthalmic
Monitor Closely (1)ketotifen, ophthalmic, acarbose. Other (see comment). Use Caution/Monitor. Comment: Combination may result in thrombocytopenia (rare). Monitor CBC.
- letermovir
Monitor Closely (1)letermovir will increase the level or effect of acarbose by unspecified interaction mechanism. Use Caution/Monitor. Monitor glucose concentrations
- levofloxacin
Monitor Closely (1)levofloxacin increases effects of acarbose by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.
- liraglutide
Monitor Closely (1)liraglutide, acarbose. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Concurrent use may increase risk of hypoglycemia; monitor glucose levels.
- lofepramine
Minor (1)lofepramine increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- lonapegsomatropin
Monitor Closely (1)lonapegsomatropin decreases effects of acarbose by Other (see comment). Modify Therapy/Monitor Closely. Comment: Closely monitor blood glucose when treated with antidiabetic agents. Lonapegsomatropin may decrease insulin sensitivity, particularly at higher doses. Patients with diabetes mellitus may require adjustment of their doses of insulin and/or other antihyperglycemic agents.
- lopinavir
Monitor Closely (1)lopinavir decreases effects of acarbose by pharmacodynamic antagonism. Use Caution/Monitor. New onset or exacerbation of diabetes mellitus and hyperglycemia have been reported with protease inhibitors.
- lurasidone
Monitor Closely (1)lurasidone, acarbose. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- lycopus
Minor (1)lycopus increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (theoretical interaction).
- maitake
Minor (1)maitake increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (animal research).
- maprotiline
Minor (1)maprotiline increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- marijuana
Monitor Closely (1)marijuana decreases effects of acarbose by pharmacodynamic antagonism. Use Caution/Monitor.
- mecasermin
Monitor Closely (1)mecasermin increases effects of acarbose by pharmacodynamic synergism. Use Caution/Monitor. Additive hypoglycemic effects.
- mesterolone
Minor (1)mesterolone increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- methyclothiazide
Minor (1)methyclothiazide decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- methylprednisolone
Minor (1)methylprednisolone decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown.
- methyltestosterone
Minor (1)methyltestosterone increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- metolazone
Minor (1)metolazone decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- mipomersen
Monitor Closely (1)mipomersen, acarbose. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Both drugs have potential to increase hepatic enzymes; monitor LFTs.
- moxifloxacin
Monitor Closely (1)moxifloxacin increases effects of acarbose by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.
- nelfinavir
Monitor Closely (1)nelfinavir decreases effects of acarbose by pharmacodynamic antagonism. Use Caution/Monitor. New onset or exacerbation of diabetes mellitus and hyperglycemia have been reported with protease inhibitors.
- nettle
Minor (1)nettle increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. (Theoretical interaction).
- nortriptyline
Minor (1)nortriptyline increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- ofloxacin
Monitor Closely (1)ofloxacin increases effects of acarbose by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.Minor (1)ofloxacin, acarbose. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential dysglycemia.
- olanzapine
Monitor Closely (1)olanzapine, acarbose. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- opuntia ficus indica
Monitor Closely (1)opuntia ficus indica increases effects of acarbose by pharmacodynamic synergism. Use Caution/Monitor.
- oxandrolone
Minor (1)oxandrolone increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- oxymetholone
Minor (1)oxymetholone increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- paliperidone
Monitor Closely (1)paliperidone, acarbose. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- pancrelipase
Monitor Closely (1)pancrelipase decreases effects of acarbose by pharmacodynamic antagonism. Use Caution/Monitor. Antihyperglycemic action of acarbose results from a competitive, reversible inhibition of pancreatic alpha-amylase and membrane-bound intestinal alpha-glucoside hydrolase enzymes.
- pegvisomant
Minor (1)pegvisomant increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- potassium acid phosphate
Minor (1)potassium acid phosphate increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.
- potassium chloride
Minor (1)potassium chloride increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.
- potassium citrate
Minor (1)potassium citrate increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.
- pramlintide
Serious - Use Alternative (1)pramlintide, acarbose. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI nutrient absorption.
- prednisolone
Minor (1)prednisolone decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown.
- prednisone
Minor (1)prednisone decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown.
- protriptyline
Minor (1)protriptyline increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- quetiapine
Monitor Closely (1)quetiapine, acarbose. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- risperidone
Monitor Closely (1)risperidone, acarbose. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- ritonavir
Monitor Closely (1)ritonavir decreases effects of acarbose by pharmacodynamic antagonism. Use Caution/Monitor. New onset or exacerbation of diabetes mellitus and hyperglycemia have been reported with protease inhibitors.
- sage
Minor (1)sage increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- saquinavir
Monitor Closely (1)saquinavir decreases effects of acarbose by pharmacodynamic antagonism. Use Caution/Monitor. New onset or exacerbation of diabetes mellitus and hyperglycemia have been reported with protease inhibitors.
- shark cartilage
Monitor Closely (1)shark cartilage increases effects of acarbose by pharmacodynamic synergism. Use Caution/Monitor. Theoretical interaction.
- somapacitan
Monitor Closely (1)somapacitan decreases effects of acarbose by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Growth hormone products may decrease insulin sensitivity, particularly at higher doses. Antidiabetic agents may require dose adjustment after initiating somapacitan. .
- stevia
Minor (1)stevia increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- sulfamethoxypyridazine
Monitor Closely (1)sulfamethoxypyridazine increases effects of acarbose by unspecified interaction mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- testosterone
Minor (1)testosterone increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- testosterone buccal system
Minor (1)testosterone buccal system increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- testosterone topical
Minor (1)testosterone topical increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- tipranavir
Monitor Closely (1)tipranavir decreases effects of acarbose by pharmacodynamic antagonism. Use Caution/Monitor. New onset or exacerbation of diabetes mellitus and hyperglycemia have been reported with protease inhibitors.
- tongkat ali
Minor (1)tongkat ali increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypoglycemia.
- trazodone
Minor (1)trazodone increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- triamcinolone acetonide injectable suspension
Monitor Closely (1)triamcinolone acetonide injectable suspension decreases effects of acarbose by pharmacodynamic antagonism. Use Caution/Monitor. Corticosteroids may diminish hypoglycemic effect of antidiabetic agents. Monitor blood glucose levels carefully.
- trimipramine
Minor (1)trimipramine increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- vanadium
Minor (1)vanadium increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- xipamide
Monitor Closely (1)xipamide decreases levels of acarbose by increasing renal clearance. Use Caution/Monitor.
- ziprasidone
Monitor Closely (1)ziprasidone, acarbose. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
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Adverse Effects
>10%
abdominal pain (19%)
diarrhea (31%)
elevated serum transaminases
flatulence (74%)
Postmarketing Reports
Gastrointestinal: Fulminant hepatitis with fatal outcome, ileus/subileus, jaundice and/or hepatitis and associated liver damage
Hypersensitive skin reactions: rash, erythema, exanthema and urticaria
Edema
Thrombocytopenia
Pneumatosis cystoides intestinalis
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Warnings
Contraindications
Documented hypersensitivity to acarbose
Diabetic ketoacidosis, cirrhosis, inflammatory bowel disease, colonic ulceration, partial intestinal obstruction or predisposed to intestinal obstruction, known marked absorptive impairment of GI
Conditions that may deteriorate as result of increased gas formation in GI tract
Cautions
No clinical studies exist establishing conclusive evidence of macrovascular risk reduction with acarbose or any other anti-diabetic drug
When diabetic patients are exposed to stress such as fever, trauma, infection, or surgery, a temporary loss of control of blood glucose may occur; at such times, temporary insulin therapy may be necessary
Monitoring glycemic control with 1,5-AG assay is not recommended; measurements of 1,5-AG are unreliable in assessing glycemic control in patients taking acarbose; use alternate methods to monitor for glycemic control
Hypoglycemia
- As per its mechanism of action, drug should not cause hypoglycemia, when administered alone, in the fasted or postprandial state
- Sulfonylurea agents or insulin may cause hypoglycemia; because when given in combination with a sulfonylurea or insulin combination treatment will cause further lowering of blood glucose, it may increase the potential for hypoglycemia
- Hypoglycemia does not occur in patients receiving metformin alone under usual circumstances of use; increased incidence of hypoglycemia not observed when acarbose added to metformin therapy
- Oral glucose (dextrose), whose absorption is not inhibited by acarbose, should be used instead of sucrose (cane sugar) in treatment of mild to moderate hypoglycemia
- Sucrose, whose hydrolysis to glucose and fructose is inhibited by acarbose, is unsuitable for rapid correction of hypoglycemia; severe hypoglycemia may require use of either intravenous glucose infusion or glucagon injection
Elevated serum transaminase
- Treatment-emergent elevations of serum transaminases (AST and/or ALT) above the upper limit of normal (ULN) reported; although differences between treatments were statistically significant, elevations were asymptomatic, reversible, more common in females, and, in general, were not associated with other evidence of liver dysfunction;
- Sixty-two cases of serum transaminase elevations > 500 IU/L (29 of which were associated with jaundice) reported; hepatic abnormalities improved or resolved upon discontinuation of therapy in majority of cases; cases of fulminant hepatitis with fatal outcome reported; relationship to acarbose unclear
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Pregnancy & Lactation
Pregnancy Category: B
Lactation: not known if crosses into breast milk, avoid using in nursing women
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.NA: Information not available.Previous
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Pharmacology
Half-Life: 2 hr
Onset: 1 hr
Peak Plasma Time: 1 hr
Bioavailability: <2 %
Metabolism: extensively degraded in the intestine by bacterial and digestive enzymes, glucose units are removed from acarbose molecule
Metabolites: 4-methylpyrogallol derivatives (major inactive mets) and other inactive mets
Excretion
Urine: 34 % as inactive metabolites
Feces: 51% as unabsorbed drug
Mechanism of Action
Oral pancreatic alpha-amylase and intestinal brush border alph-glucosidases. This results in delayed hydrolysis of ingested complex carbohydrates and disaccharides and absorption of glucose. Inhibits metabolism of sucrose to glucose and fructose.
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Images
BRANDFORM.UNIT PRICEPILL IMAGEPrecose oral
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100 mg tablet-
25 mg tablet-
50 mg tablet-
100 mg tablet-
50 mg tablet-
25 mg tablet-
25 mg tablet-
100 mg tablet-
50 mg tablet-
25 mg tablet-
50 mg tablet-
100 mg tablet-
100 mg tablet-
50 mg tablet-
25 mg tabletCopyright © 2010 First DataBank, Inc.
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Formulary
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Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.