Generic Name and Formulations:
Acarbose 25mg, 50mg, 100mg; tabs.
Adjunct to diet in type 2 diabetes, alone or with insulin, metformin, or a sulfonylurea.
Take with first bite of each main meal. Initially 25mg three times daily; increase at 4–8 wk intervals if needed. Or, (to minimize GI effects): initially 25mg once daily, increase gradually to 25mg three times daily. Range: 50–100mg three times daily. ≤60kg: max 50mg three times daily; >60kg: max 100mg three times daily.
Ketoacidosis. Cirrhosis. Inflammatory bowel disease. Colonic ulceration. Partial or predisposition to intestinal obstruction. Chronic intestinal disease with marked disorders of digestion or absorption. Conditions that may deteriorate from increased intestinal gas formation.
Significant renal dysfunction (serum creatinine >2mg/dL): not recommended. Use glucose, not sucrose, to treat hypoglycemia. Stress. Monitor 1-hour postprandial glucose initially and during titration, then glycosylated hemoglobin. Monitor serum transaminases every 3 months during 1st year and periodically thereafter. Pregnancy (Cat.B): consider insulin instead. Nursing mothers: not recommended.
Caution with drugs that cause hyperglycemia (eg, diuretics, steroids, estrogens, phenothiazines, thyroid products, phenytoin, niacin, sympathomimetics, calcium channel blockers, isoniazid). Antagonized by intestinal adsorbents (eg, charcoal), pancreatin, amylase, other carbohydrate-splitting enzymes. Monitor digoxin; and for hypoglycemia if used with insulin or a sulfonylurea. May result in unreliable measurements of 1,5-AG assay; use alternative methods to monitor glycemic control.
Transient flatulence, diarrhea, abdominal pain.
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