Acarbose

Description

Acarbose is a drug useful in the management of patients with type 2 diabetes. Acarbose acts inside the gut to prevent the breakdown of starch, and hence prevents the absorption of glucose contained in food. It may be considered a medical form of diet control, and is used when the patient fails to control his diet in spite of medical advice, and as an add on therapy to other anti diabetic drugs, especially sulphonylureas like gliclazide and repaglinide, etc..

Dosage

The dose of acarbose will be different for different patients. Follow your doctor’s orders. The following information includes only the average doses of these medicines. If your dose is different, do not change it unless your doctor tells you to do so.

  • For oral dosage form (tablets):
    • For type 2 diabetes:
      • Adults–At first the dose is 25 milligrams (mg) three times a day, at the start of each main meal. Your dose may then be adjusted by your doctor.
      • Children–Use and dose must be determined by your doctor.

For this medicine to work properly it must be taken at the beginning of each main meal .

 

Missed dose–It is important that you do not miss any doses . However, if you finish a meal and you have forgotten to take the medicine, do not take the missed dose. Instead, take the next dose at the beginning of your next meal, as scheduled. Do not double doses .

Before Using This Medicine

Your doctor needs to know some information about you before you are prescribed this drug. Tell him about the following:

  • Allergies–Any unusual or allergic reaction to such drugs?  Also tell your doctor if you are allergic to any other substances, such as foods, preservatives, or dyes.
  • Pregnancy–No oral antidiabetic drug is recommended during pregnancy. If you are pregnant or contemplating pregnancy, you need to be on insulin for the duration of pregnancy, in the best interests of your baby.
  • Breast-feeding–These drugs pass into breast milk. So far it has not been shown to cause problems in nursing babies.
  • Children–Due to ethical reasons, studies on this medicine have been done only in adult patients, and there is no scientific information comparing use of such drugs in children with use in other age groups.
  • Adolescents–Due to ethical reasons, studies on this medicine have been done only in adult patients, and there is no specific information comparing use of such drugs in teenagers with use in other age groups.
  • Older adults–Limited studies in older patients has not been shown this drug to cause different side effects or problems in older people than it does in younger adults.
  • Other medicines–Acarbose acts by interfering with the digestion process and food absorption in the gut. Hence, its concomitant use with the following is not advisable:
  • Activated charcoal.
  • Enzyme preparations and enzyme based tonics that contain amylase or pancreatin.

Other medical problems–The following medical problems make changes within the body environment, which may increase risk of side effects. They include:

  • Acidosis, Fever, Infection.
  • Severe burns, Surgery or injury leading to massive tissue destruction.
  • Diabetic coma or diabetic ketoacidosis.
  • Diarrhea, Vomiting or Slow stomach emptying.
  • Hormonal changes as seen in Puberty, pregnancy, or menstruation, Overactive adrenal gland.
  • Mental stress.

Precautions While Using This Medicine

Your doctor needs to know some background information about you before the use of such drugs. Be sure to tell him about:

  • Alcohol usage.
  • Other medicines which may interact with these drugs: your doctor knows best.
  • Counseling–Teach your family members to recognize side effects like low blood sugar, and what to do about it.
  • Seek a gynecologists opinion if planning for child. Women may need to be switched over to insulin during pregnancy and lactation.
  • Travel–Carry a copy of your recent prescription, brief disease history, and a small packet of glucose to use in case of sudden low blood sugar. Take you meal at usual meal times as far as possible.

Be prepared for an emergency:

  • Wear a locket or identification batch or keep a identification card in your wallet storing your disease details and drug history, including emergency medicines that should be given you in case you are unconscious or unable to communicate your needs.
  • Acarbose does not cause low blood sugar. However, low blood sugar can occur if you take acarbose with another type of diabetes medicine, delay or miss a meal or snack, exercise more than usual, drink alcohol, or cannot eat because of nausea or vomiting. Keep a small pouch / bottle of glucose handy to treat low blood sugar. Ordinary sugar is sucrose, which needs to be broken down to glucose and fructose, then absorbed and then work …… a needless waste of time.

Symptoms of low blood sugar

  • Anxious feeling, behaving as if drunk, blurred vision, cold sweats, confusion, cool pale skin, difficulty in concentrating, drowsiness, excessive hunger, fast heartbeat, headache, nausea, nervousness, nightmares, restless sleep, shakiness, slurred speech, and unusual tiredness or weakness.

Causes of developing low blood sugar

  • Missing or markedly delaying a meal, especially when another antidiabetic drug is being co prescribed also.
  • Excessive exercising.
  • Too much alcohol.
  • Drug interaction (see above).
  • Illnesses like vomiting or diarrhea.

Emergency measures for low blood sugar

  • Learn to recognize a  low blood sugar attack.
  • Eat a fistful of glucose if available. Otherwise eat two or three table spoons of sugar or a glass of fruit juice or a table spoon of honey.

Side Effects of This Medicine

Rare Yellow eyes or skin
More common Abdominal or stomach pain; bloated feeling or passing of gas; diarrhea