Pharmacy Diabetes

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

Name of Medicine
Acarbose
Presentation

Acarbose is available in 50mg or 100mg tablets.

Key Practice Points
Therapeutic Indications:

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

 

Dose:
  • 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.

Elderly:

No modification in the dose is necessary in the elderly.

Precautions:

Acarbose may affect digoxin availability.

Adverse Effects:

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.

Contraindications:
  • 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.
Pharmacokinetic Properties - Summary
Absorption:
  • Only an exceedingly small amount of acarbose is absorbed (1-2%) by the gastrointestinal tract.
Excretion:
  • The small amount of acarbose that is absorbed is excreted unchanged by the kidneys.
More Information

For more detailed information on this product please consult the product information.

https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/PICMI?OpenForm&t=&q=acarbose