A-1.2 Alpha-glucosidase Inhibitors Acarbose-overview-formulations

Treatment of type 2 diabetes where physical activity and dietary management has not resulted in adequate glycaemic targets.

For the most up to date PBS therapeutic indications for acarbose, please see

https://www.pbs.gov.au/medicine/item/8188Y

• The average adult dose of acarbose is 100mg three times a day just before each meal. However occasionally there is a need to increase this to 200mg three times a day.
• To prevent gastrointestinal side effects (boating, flatulence, nausea)
  • Start at 50mg once a day for one week.
  • Increase to 50mg twice a day for the second week.
  • Then increase to 50mg three times a day after the third week.
  • Further increases in the dose may occur depending on glucose levels 6-8 weeks later.

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

No modification in the dose is necessary in the elderly.

Acarbose may affect digoxin availability.

Gastrointestinal side effects including diarrhoea, flatulence, nausea, and loose stools. A dose reduction or a change in the diet often helps reduce these side effects.

• Hypersensitivity to acarbose or any active ingredient
• Individuals under the age of 18 years
• Severe renal impairment: Acarbose is contraindicated in individuals with severe renal impairment (creatinine clearance < 25 mL/min). (annual cycle of care-renal check, Diabetes Medscheck referral back to GP for screening)
• Any form of malabsorption syndrome including Crohn’s disease, ulcerative colitis, intestinal obstruction or ileus, and intestinal ulcers.