How does this medication work? What will it do for me?

Acarbose is an antidiabetic medication known as an α-glucosidase inhibitor. Acarbose is used to control blood glucose for people with type 2 diabetes when it is not controlled well enough with diet, exercise, and weight reduction alone.

This medication is often added to other diabetes medications when additional blood glucose control is needed. Acarbose works by preventing the breakdown of starch into sugar (by blocking the α-glucosidase enzyme) and helps to lower blood sugar levels after meals.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

50 mg
Each white-to-off-white, circular biconvex tablet, with "P211" engraved on one side and "50" on the other side, contains 50 mg of acarbose. Nonmedicinal ingredients: colloidal silicon dioxide, corn starch, magnesium stearate, microcrystalline cellulose. Preservative- and dye-free.

100 mg
Each white-to-off-white, circular biconvex tablet, with "P212" engraved on one side and "100" on the other side with a break line, contains 100 mg of acarbose. Nonmedicinal ingredients: colloidal silicon dioxide, corn starch, magnesium stearate, microcrystalline cellulose. Preservative- and dye-free.

How should I use this medication?

The recommended adult dose of acarbose varies. The starting dose is 50 mg once daily, with a gradual increase in dose as needed to control blood glucose. The maximum daily dose is 100 mg three times daily, taken with the first bite of a meal.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

Take this medication regularly in order to keep blood glucose under control. If you forget a dose, start your regular dosing schedule again with your next meal. Do not take a double dose to make up for a missed one. Do not stop taking this medication without first consulting your doctor.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take this medication if you:

  • are allergic to acarbose or any ingredients of the medication
  • have a condition that may worsen as a result of increased gas formation in the intestine (e.g., larger hernias)
  • have a predisposition to intestinal blockage
  • have chronic intestinal conditions associated with severe problems with digestion or absorption
  • have colonic ulceration
  • have diabetic ketoacidosis
  • have inflammatory bowel disease
  • have partial intestinal blockage

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • abdominal or stomach pain
  • bloating or gas
  • diarrhea
  • vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • swelling or fluid retention
  • yellow eyes or skin

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin taking a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Decreased response: Over a period of time, blood glucose may be less easily controlled with acarbose or other diabetes medications because of worsening of diabetes. If acarbose fails to lower your blood glucose to target levels, talk to your doctor. Your doctor may stop and replace acarbose or have another blood glucose-lowering medication added to it.

Diabetes complications: Acarbose (or any other antidiabetic agent) has not been shown to prevent the development of complications related to diabetes, although good blood glucose control can delay these kinds of complications.

Diet: Acarbose must be taken along with a proper dietary regimen. It is not a substitute for following a proper diet.

Illness or stress: It is possible to lose control of blood sugar during illness or stressful situations such as infection, trauma, or surgery. Under these conditions, your doctor may consider stopping the medication and prescribe insulin until the situation improves.

Kidney function: If you have kidney problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver disease: People taking acarbose may have changes in liver function that cause abnormal liver test results. Your doctor may recommend liver tests while you are taking this medication. If you have severe changes in liver function, your doctor may recommend that you take a lower dose of this medication or stop taking it altogether.

Low blood sugar: Because of the way it works, acarbose will not cause low blood sugar when taken on its own. However, acarbose may increase the risk of low blood sugar caused by sulfonylurea medications such as glyburide if taken at the same time. See information on glyburide for further details about signs and management of low blood sugar.

If you experience low blood sugar, use glucose tablets to increase your blood glucose instead of regular sugar (sucrose).

Sucrose usage: Increased use of sucrose (cane sugar) and foods that contain sugar or starch can lead to stomach problems (e.g., flatulence and bloating) as well as loose stools and, occasionally, diarrhea.

Pregnancy: There are no adequate and well-controlled studies on the use acarbose by pregnant women. This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if acarbose passes into breast milk. If you are breast-feeding and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of acarbose for children and adolescents less than 18 years old have not been established.

What other drugs could interact with this medication?

There may be an interaction between acarbose and any of the following:

  • acetylsalicylic acid (ASA)
  • amphetamines (e.g., dextroamphetamine, lisdexamfetamine)
  • antipsychotics (e.g., clozapine, olanzapine, quetiapine, risperidone)
  • beta-2 agonists (e.g., formoterol, salbutamol, indacaterol, salmeterol, terbutaline)
  • basiliximab
  • buserelin
  • chloroquine
  • corticosteroids (e.g., beclomethasone, cortisone, dexamethasone, hydrocortisone, prednisone)
  • decongestant cold medications (e.g., phenylephrine, pseudoephedrine)
  • decongestant eye drops and nose sprays (e.g., naphazoline, oxymetazoline, xylometazoline)
  • dexmethylphenidate
  • diabetes medications (e.g., canagliflozin, glyburide, insulin, liraglutide, lixisenatide, metformin, rosiglitazone, sitagliptin)
  • digoxin
  • disopyramide
  • diuretics (e.g., hydrochlorothiazide, furosemide)
  • divalproex
  • estrogens (e.g., oral contraceptives, hormone replacement therapy)
  • everolimus
  • glucagon
  • goserelin
  • hepatitis C antivirals (e.g., elbasvir, grazoprevir, ledipasvir, sofosbuvir, velpatasvir)
  • HIV protease inhibitors (e.g., lopinavir, ritonavir, saquinavir, tipranavir)
  • hydroxychloroquine
  • lanreotide
  • methylphenidate
  • mifepristone
  • monoamine oxidase inhibitors (MAOIs; e.g., moclobemide, phenelzine, rasagiline, selegiline, tranylcypromine)
  • niacin
  • nilotinib
  • octreotide
  • pasireotide
  • pegvisomant
  • progestins (e.g., cyproterone, levonorgestrel, medroxyprogesterone, norethindrone, progesterone)
  • quinidine
  • selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, fluoxetine, paroxetine, sertraline)
  • sirolimus
  • somatropin
  • sulfonamide antibiotics ("sulfas"; e.g., sulfisoxazole, sulfamethoxazole)
  • sunitinib
  • tacrolimus
  • tramadol
  • valproic acid
  • venetoclax
  • vorinostat

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

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