Precose (acarbose)

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

WWhat is the treatment dosage for acarbose?

  • The recommended initial dose for type 2 diabetes is 25 mg three times daily.
  • The dose is then increased every four to eight weeks based on response and tolerance.
  • The maximum dose is 50 mg three times daily for patients weighing 60 kg or less and 100 mg three times daily for those weighing more than 60 kg.
  • This medication should be taken at the first bite of each meal.
  • Smaller doses may be adequate for patients with severe kidney dysfunction or liver disease.
  • This medication is not recommended if a patient has cirrhosis.
  • Precose therapy is not advised in the presence of certain medical conditions such as inflammatory bowel disease (IBD) or intestinal obstruction and chronic intestinal diseases that interfere with digestion or absorption such as Crohn's disease.
  • The doses of this type 2 diabetes medication should be adjusted based upon blood glucose levels taken one hour after a meal and blood HbA1c levels taken about three months after starting or changing the dose. (HbA1c is a chemical in the blood that is a good indicator of blood glucose control.)

WWhich drugs or supplements interact with acarbose?

  • Acarbose may interfere with digoxin (Lanoxin) absorption thereby decreasing digoxin blood levels and its effect. Therefore, the digoxin dose may need to be increased if acarbose is begun.
  • Since adding insulin or a sulfonylurea to acarbose therapy may lower blood glucose more than acarbose alone, the risk for developing hypoglycemia is greater when these drugs are combined. Caution should be used when combining these drugs. If mild to moderate hypoglycemia occurs while taking acarbose in combination with another anti-diabetic drug, the treatment for hypoglycemia is with with oral glucose (dextrose) instead of sucrose (table sugar) because acarbose blocks the digestion of sucrose to glucose, and hypoglycemia will not be corrected rapidly with sucrose. Acarbose alone does not produce hypoglycemia.
  • Charcoal may absorb acarbose and digestive enzyme preparations such as amylase or pancreatin may breakdown acarbose and should not be administered with this diabetes drug.

Is acarbose safe to use during pregnancy or while breastfeeding?

  • There are no studies of acarbose treatment during pregnancy in humans. Insulin therapy is recommended in pregnancy.
  • Acarbose is excreted in the milk of lactating animals, but no human studies have been conducted. Precose use is not recommended for women who are breastfeeding.

WWhat else should I know about acarbose?

What preparations are available?
  • Tablets: 25, 50 and 100 mg.
How should I keep this drug stored?
  • Precose should be stored at room temperature, 15 C - 30 C (59 F - 86 F) in a tight container.
WWhen was acarbose approved by the FDA?
  • The FDA approved acarbose in September 1995.

REFERENCE: FDA Prescribing Information

Medically Reviewed by a Doctor on 1/6/2017

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