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Does Precose (acarbose) cause side effects?
Carbohydrates that are eaten are digested by enzymes in the intestine into smaller sugars, which are absorbed into the body and increase blood sugar levels.
The process of carbohydrate digestion requires the pancreas to release into the intestine alpha-amylase enzymes, which digest the large carbohydrates into smaller carbohydrates called oligosaccharides.
The cells lining the small intestine then release alpha-glucosidase enzymes that further digest the oligosaccharides into smaller sugars, like glucose, that can be absorbed.
Precose is a man-made oligosaccharide designed to slow down the actions of alpha-amylase and alpha-glucosidase enzymes, thereby slowing the appearance of sugar in the blood after a meal.
Common side effects of Precose include
Serious side effects of Precose include
- decreases in hematocrit, calcium or vitamin B6 levels;
- liver failure,
- yellowing skin and eyes (jaundice),
- low blood platelets (thrombocytopenia),
- severe skin reactions (rash, redness, and hives),
- pneumatosis cystoides intestinalis infection, and rarely,
- severe gastrointestinal side effects that may progress to intestinal obstruction caused by paralysis of the intestinal muscles (paralytic ileus).
- Since adding insulin or a sulfonylurea to Precose therapy may lower blood glucose more than acarbose alone, the risk for developing hypoglycemia is greater when these drugs are combined.
- Charcoal may absorb Precose and digestive enzyme preparations such as amylase or pancreatin may breakdown acarbose and should not be administered with this diabetes drug.
There are no studies of Precose treatment during pregnancy in humans. Insulin therapy is recommended in pregnancy.
Precose 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.
What are the important side effects of Precose (acarbose)?
The most common side effects of include:
There is a rare possibility that these gastrointestinal side effects may become severe and progress to intestinal obstruction caused by paralysis of the intestinal muscles (paralytic ileus).
Possible serious, but rare side effects of include:
Precose (acarbose) side effects list for healthcare professionals
Gastrointestinal symptoms are the most common reactions to Precose. In U.S. placebo-controlled trials, the incidences of abdominal pain, diarrhea, and flatulence were 19%, 31%, and 74% respectively in 1255 patients treated with Precose 50–300 mg t.i.d., whereas the corresponding incidences were 9%, 12%, and 29% in 999 placebo-treated patients.
In a one-year safety study, during which patients kept diaries of gastrointestinal symptoms, abdominal pain and diarrhea tended to return to pretreatment levels over time, and the frequency and intensity of flatulence tended to abate with time.
The increased gastrointestinal tract symptoms in patients treated with Precose are a manifestation of the mechanism of action of Precose and are related to the presence of undigested carbohydrate in the lower GI tract.
If the prescribed diet is not observed, the intestinal side effects may be intensified. If strongly distressing symptoms develop in spite of adherence to the diabetic diet prescribed, the doctor must be consulted and the dose temporarily or permanently reduced.
Elevated Serum Transaminase Levels
See prescribing information for further details on precautions.
Other Abnormal Laboratory Findings
Small reductions in hematocrit occurred more often in Precose-treated patients than in placebo-treated patients but were not associated with reductions in hemoglobin.
Low serum calcium and low plasma vitamin B6 levels were associated with Precose therapy but are thought to be either spurious or of no clinical significance.
Postmarketing Adverse Event Reports
Additional adverse events reported from worldwide postmarketing experience include
- fulminant hepatitis with fatal outcome,
- hypersensitive skin reactions (for example rash, erythema, exanthema and uticaria),
- jaundice and/or hepatitis and associated liver damage,
- thrombocytopenia, and
- pneumatosis cystoides intestinalis.
Pneumatosis Cystoides Intestinalis
There have been rare postmarketing reports of pneumatosis cystoides intestinalis associated with the use of alpha-glucosidase inhibitors, including Precose.
Pneumatosis cystoides intestinalis may present with symptoms of
Complications may include
- intestinal obstruction,
- intestinal hemorrhage, and
- intestinal perforation.
If pneumatosis cystoides intestinalis is suspected, discontinue Precose and perform the appropriate diagnostic imaging.
What drugs interact with Precose (acarbose)?
- thyroid products,
- oral contraceptives,
- nicotinic acid,
- calcium channel-blocking drugs, and
When such drugs are administered to a patient receiving Precose, the patient should be closely observed for loss of blood glucose control. When such drugs are withdrawn from patients receiving Precose in combination with sulfonylureas or insulin, patients should be observed closely for any evidence of hypoglycemia.
Patients Receiving Sulfonylureas or Insulin: Sulfonylurea agents or insulin may cause hypoglycemia. Precose given in combination with a sulfonylurea or insulin may cause a further lowering of blood glucose and may increase the potential for hypoglycemia.
If hypoglycemia occurs, appropriate adjustments in the dosage of these agents should be made.
Intestinal adsorbents (for example, charcoal) and digestive enzyme preparations containing carbohydrate-splitting enzymes (for example, amylase, pancreatin) may reduce the effect of Precose and should not be taken concomitantly.
Precose has been shown to change the bioavailability of digoxin when they are coadministered, which may require digoxin dose adjustment.
Precose (acarbose) is an oral alpha-glucosidase inhibitor used to control blood glucose (sugar) levels in people type 2 diabetes in conjunction with diet, exercise, and other diabetes drugs, for example, metformin (Glucophage) or insulin. Common side effects of Precose include abdominal pain, diarrhea, gas (flatulence), and increased liver enzymes. There are no studies of Precose treatment during pregnancy in humans. Precose use is not recommended for women who are breastfeeding.
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People with diabetes can manage and prevent low or high blood sugar levels (hyperglycemia or hypoglycemia) by keeping a log of your blood sugar levels when you are eating and fasting and eat foods that are high in carbohydrates and sugar, for example, buttered potatoes, candy, sugary desserts, and fatty foods. Blood tests, for example, the hemoglobin A1c test (A1c test) and urinalysis can diagnose the type of diabetes the person has. Diabetes during pregnancy, called gestational diabetes, should be managed by you and your OB/GYN or another healthcare professional. Extremely high levels of blood glucose in the blood can be dangerous and life threatening if you have type 1, type 2, or gestational diabetes. If you or someone that you are with has extremely high blood glucose levels, call 911 or go to your nearest Urgent Care or Emergency Department immediately. To prevent and manage high blood glucose levels in people with diabetes keep a log of your blood sugar levels, eat foods that are high in carbohydrates sugar, for example, buttered potatoes, candy, sugary deserts, and fatty foods that you can share with your doctor and other healthcare professionals.
Type 2 Diabetes Diet Plan
A type 2 diabetes diet or a type 2 diabetic diet is important for blood sugar (glucose) control in people with diabetes to prevent complications of diabetes. There are a variety of type 2 diabetes diet eating plans such as the Mediterranean diet, Paleo diet, ADA Diabetes Diet, and vegetarian diets.Learn about low and high glycemic index foods, what foods to eat, and what foods to avoid if you have type 2 diabetes.
Diabetes (Type 1 and Type 2)
Diabetes is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
Diabetes Symptoms in Men
Diabetes mellitus is a disease in which a person's blood sugar (blood glucose) is either too high (hyperglycemia) or too low (hypoglycemia) due to problems with insulin regulation in the body. There are two main types of diabetes mellitus, type 1 and type 2. Type 1 diabetes usually occurs during childhood, while type 2 diabetes usually occurs during adulthood, however, rates of both types of diabetes in children, adolescents, and teens is increasing. More men than women have diabetes in the US, and the disease can affect men differently than women.Warning symptoms of diabetes that men have and women do not include low testosterone (low-t), sexual problems, impotence (erectile dysfunction), decreased interest in sex, and retrograde ejaculation. Type 1 and type 2 diabetes symptoms and signs that are the same in men and women include skin infections, numbness or tingling in the feet or hands, nausea, excessive thirst or hunger, fatigue, irritability, blurred vision, weight gain, weight loss, urinary tract infections (URIs), and kidney problems. Treatment for type 1 diabetes is insulin, and treatment for type 2 diabetes are lifestyle changes like eating a healthy diet, getting exercise daily, and if necessary, diabetes medications.
Type 1 vs Type 2 Diabetes (Similarities and Differences)
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Learning how to avoid gestational diabetes is possible and maintaining a healthy weight and diet before and during pregnancy can help. Discover risk factors, tests and treatments for, and signs and symptoms of gestational diabetes.
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Pregnancy and Gestational Diabetes
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Type 2 Diabetes
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Eye Problems and Diabetes
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Tips for Managing Type 1 and 2 Diabetes at Home
Managing your diabetes is a full time commitment. The goal of diabetic therapy is to control blood glucose levels and prevent the complications of diabetes. Information about exercise, diet, and medication will help you manage your diabetes better. Blood glucose reagent strips, blood glucose meters, urine glucose tests, tests for urinary ketones, continuous glucose sensors, and Hemoglobin A1C testing information will enable you to mange your diabetes at home successfully.
Can Type 2 Diabetes be Cured?
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What Are the Early Signs of Type 2 Diabetes?
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Medications & Supplements
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
Professional side effects and drug interactions sections courtesy of the U.S. Food and Drug Administration.