Pharmacy Diabetes

A-1.3 Alpha-glucosidase Inhibitors Acarbose-overview-counselling intervention

Gastrointestinal Symptoms

Side effects include bloating, flatulence, diarrhoea, and abdominal pain. These are common due to the nature of how the medication works and are dose dependent.


A diet lower in complex carbohydrates and cane sugar (sucrose) may reduce the side effect prolife.

Interventions:
  • Dose should be taken immediately before meals or with the first mouthful, up to three times a day.
  • If gastrointestinal side effects are common, referral to a dietitian trained in diabetes management should be considered.
  • Diabetes MedsCheck with counselling on side effect profile.
Hypoglycaemia
Acarbose does not cause hypoglycaemia, however, if used in conjunction with insulin or sulfonylureas can result in hypoglycaemia.
Interventions:
  • Use glucose to treat low blood glucose levels (under 4mmol/L). NOT sucrose since treatment will be delayed if sucrose is chosen.
  • Diabetes MedsCheck with counselling on managing hypoglycaemia.
  • Referral pathway for glucose monitoring.
Renal Impairment
Acarbose is contraindicated in individuals with severe renal impairment (creatinine clearance < 25 mL/min).
Interventions:
  • Annual cycle of care-renal check.
  • Diabetes MedsCheck with referral for annual cycle of care – renal check.
Digoxin

Acarbose may affect digoxin availability

Interventions:
  • Diabetes MedsCheck with counselling on potential interactions.