acarbose (Rx) - Precose

 Dosing & Uses

 Interactions
 Adverse Effects
 Warnings
 Pregnancy
 Pharmacology
 Images
 Patient Handout

Dosing & Uses

Adult

Dosing Forms & Strengths

tablet

 25mg
 50mg
 100mg

Type 2 Diabetes Mellitus

Initially 25 mg PO q8hr, at meals (with first bite)

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

PEDIATRIC Safety & efficacy not established

Drug Interactions
Interaction Checker
acarbose and

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Contraindicated (0)

Serious - Use Alternative (2)

 ethanol
 pramlintide

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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

Contraindications & Cautions

Contraindications

Documented hypersensitivity to acarbose

DKA, 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

Concurrent use with sulfonylureas may result in hypoglycemia; treat hypoglycemia with oral
glucose (dextrose), not sucrose (cane sugar)

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.

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.

Patient Handout
Print w/ Office Info
Print w/out Office Info
62
Patient Education
acarbose oral
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT
have all possible information about this product. This information does not assure that this
product is safe, effective, or appropriate for you. This information is not individual medical
advice and does not substitute for the advice of your health care professional. Always ask
your health care professional for complete information about this product and your specific
health needs.

ACARBOSE - ORAL

(AY-kar-bose)

COMMON BRAND NAME(S): Precose

USES:
Acarbose is used along with a proper diet and exercise program to control high blood sugar in
people with type 2 diabetes. Controlling high blood sugar helps prevent kidney damage,
blindness, nerve problems, loss of limbs, and sexual function problems. Proper control of
diabetes may also lessen your risk of a heart attack or stroke. Acarbose works by slowing the
breakdown of starch (carbohydrates) from the food you eat into sugar, so that your blood
sugar level does not rise as much after a meal.

Acarbose may be used with other medications (e.g., insulin, metformin, sulfonylureas such as
glipizide) to control diabetes because they work in different ways.

HOW TO USE:
Take this medication by mouth, usually 3 times a day at the start (with the first bites) of each
main meal or as directed by your doctor.

The dosage is based on your medical condition, weight, and response to therapy. Your dose
may be gradually increased to determine the most effective dose for you. The manufacturer
recommends that you do not take more than 300 milligrams per day.

Use this medication regularly to get the most benefit from it. To help you remember, take it at
the same times each day.

For best results, continue to eat a proper diet, exercise regularly, and check your urine/blood
sugar levels as directed by your doctor.

SIDE EFFECTS:
Diarrhea, gas, upset stomach, constipation, or stomach pain may occur in the first few weeks
of treatment as your body adjusts to this medication but usually improve with time. Follow
your prescribed diet to help lessen these side effects. If any of these effects persist or worsen,
tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that
the benefit to you is greater than the risk of side effects. Many people using this medication
do not have serious side effects.
Tell your doctor immediately if any of these rare but very serious side effects occur: unusual
tiredness, persistent nausea/vomiting, severe stomach/abdominal pain, rectal bleeding,
yellowing eyes/skin, dark urine.

Acarbose does not cause low blood sugar (hypoglycemia). However, this effect can occur if
you also take other anti-diabetic drugs (e.g., sulfonylureas, insulin) and if you do not
consume enough calories from food or if you do unusually heavy exercise. Symptoms of low
blood sugar include cold sweat, blurred vision, dizziness, drowsiness, shaking, fast heartbeat,
headache, fainting, tingling of the hands/feet, and hunger. Do not use table sugar (also called
cane sugar or sucrose) to relieve these symptoms because acarbose delays its breakdown.
Carry glucose tablets or gel with you to treat low blood sugar. If you are in a situation where
you don't have these reliable forms of glucose, eat some honey or drink a glass of orange
juice (sources of another sugar, fructose) to quickly raise your blood sugar level. Tell your
doctor about the reaction immediately. To help prevent low blood sugar, eat meals on a
regular schedule, and do not skip meals. Check with your doctor or pharmacist to find out
what you should do if you miss a meal.

Symptoms of high blood sugar (hyperglycemia) include thirst, increased urination, confusion,
drowsiness, flushing, rapid breathing, and fruity breath odor. If these symptoms occur, tell
your doctor immediately. Your dosage may need to be increased or you may need other
drugs.

A very serious allergic reaction to this drug is rare. However, seek immediate medical
attention if you notice any of the following symptoms of a serious allergic reaction: rash,
itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above,
contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at
1-800-FDA-1088.

In Canada - Call your doctor for medical advice about side effects. You may report side
effects to Health Canada at 1-866-234-2345.

PRECAUTIONS:
Before taking acarbose, tell your doctor or pharmacist if you are allergic to it; or if you have
any other allergies. This product may contain inactive ingredients, which can cause allergic
reactions or other problems. Talk to your pharmacist for more details.

This medication should not be used if you have certain medical conditions. Before using this
medicine, consult your doctor or pharmacist if you have: severe liver disease (cirrhosis),
intestine/bowel problems (e.g., inflammatory bowel disease, intestinal blockage/ulcers,
digestion/absorption disorders).

Before using this medication, tell your doctor or pharmacist your medical history, especially
of: kidney disease.
You may experience blurred vision, dizziness, or drowsiness due to extremely low or high
blood sugar levels. Do not drive, use machinery, or do any activity that requires alertness or
clear vision until you are sure you can perform such activities safely. Limit alcoholic
beverages because they can increase the risk of developing low blood sugar.

It may be harder to control your blood sugar when your body is stressed (e.g., due to fever,
infection, injury, or surgery). Consult your doctor because this may require a change in your
treatment plan, medications, or blood sugar testing.

During pregnancy, this medication should be used only when clearly needed. Discuss the
risks and benefits with your doctor. Your doctor may substitute insulin for this drug during
your pregnancy. Follow all instructions carefully.

It is unknown if this medication passes into breast milk. Consult your doctor before breast-
feeding.

DRUG INTERACTIONS:
Your doctor or pharmacist may already be aware of any possible drug interactions and may
be monitoring you for them. Do not start, stop, or change the dosage of any medicine before
checking with them first.

This drug should not be used with the following medications because very serious
interactions may occur: activated charcoal, digestive enzyme products (e.g., amylase,
pancreatin).

If you are currently using any of these medications listed above, tell your doctor or
pharmacist before starting acarbose.

Before using this medication, tell your doctor or pharmacist of all prescription and
nonprescription/herbal products you may use, especially of: pramlintide.

Beta-blocker medications (e.g., metoprolol, propranolol, glaucoma eye drops such as timolol)
may prevent the fast/pounding heartbeat you would usually feel when your blood sugar level
falls too low (hypoglycemia). Other symptoms of low blood sugar such as dizziness, hunger,
and sweating are unaffected by these drugs.

Many drugs can affect your blood sugar levels, making it more difficult to control your blood
sugar. Before you start, stop, or change any medication, talk with your doctor or pharmacist
about how the medication may affect your blood sugar. Check your blood sugar levels
regularly as directed by your doctor. Tell your doctor about the results and of any symptoms
of high or low blood sugar. (See also Side Effects section.) Your doctor may need to adjust
your anti-diabetic medication, exercise program, or diet.

This document does not contain all possible interactions. Therefore, before using this
product, tell your doctor or pharmacist of all the products you use. Keep a list of all your
medications with you, and share the list with your doctor and pharmacist.

OVERDOSE:
If overdose is suspected, contact a poison control center or emergency room immediately. US
residents can call their local poison control center at 1-800-222-1222. Canada residents can
call a provincial poison control center.

NOTES:
Do not share this medication with others.

You should attend a diabetes education program to learn more about diabetes and all the
important aspects of its treatment, including meals/diet, exercise, personal hygiene,
medications, and getting regular eye/foot/medical exams.

Keep all medical appointments. Laboratory and/or medical tests (e.g., liver and kidney
function tests, fasting and after-meal blood glucose levels, hemoglobin A1c, complete blood
counts) should be performed periodically to check for side effects and monitor your response
to therapy. Check your blood or urine sugar levels regularly as directed by your doctor or
pharmacist.

MISSED DOSE:
If you miss a dose, take it as soon as you remember. If it is near the time of the next dose,
skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch
up.

STORAGE:
Store at room temperature below 77 degrees F (25 degrees C) away from light and moisture.
Do not store in the bathroom. Keep all medicines away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so.
Properly discard this product when it is expired or no longer needed. Consult your pharmacist
or local waste disposal company for more details about how to safely discard your product.

MEDICAL ALERT: Your condition can cause complications in a medical emergency. For
information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507
(Canada).

Information last revised March 2014. Copyright(c) 2014 First Databank, Inc.