Acarbose

It is a pseudo-tetrasaccharide which inhibits alpha glucosidases. It has a direct effect on postprandial peaks without producing hyperinsulinemia. It delays carbohydrate digestion and glucose absorption thereby reducing postprandial peaks.

Indications

First-line therapy in NIDDM after diet has proved insufficient and as an adjunct to existing conventional oral therapy where glycaemic control is inadequate.

Dosage

Starting dose 50 mg three times a day and can be increased to 100 mg three times a day.

Contra-Indications

hypersensitivity to the drug, diabetic ketoacidosis or cirrhosis, inflammatory bowel disease, colonic ulceration, partial intestinal obstruction, chronic intestinal diseases associated with marked disorders of digestion or absorption and in those who have conditions that may deteriorate as a result of increased gas formation in the intestine.

Special Precautions

On combination with sulphonylurea, acarbose may increase the hypoglycaemia potential of the sulphonylurea. Paediatrics: Contraindicated. Pregnancy: Contraindicated. Lactation: Contraindicated.

Side Effects

Gasrointestinal tract symptoms, abdominal pain, diarrhoea tended to return to pretreatment levels, antacids (aluminium, magnesium salts) have not been shown to ameliorate acute gastrointestinal symptoms of acarbose.

Drug Interactions

Sucrose and food containing sucrose cause abdominal discomfort or diarrhoea. If prescribed in addition to drugs containing sulphonylureas or metformin in addition to insulin, it causes hypoglycaemia. Intestinal absorbents and digestive enzyme preparation containing carbohydrate may reduces the effect of acarbose.