Acarbose(a kar’ boz)
Prandase (CAN), Precose
PREGNANCY CATEGORY B
Drug Classes
Alpha-glucosidase inhibitor
Antidiabetic
Therapeutic Actions
Alpha-glucosidase inhibitor obtained from the fermentation process of a microorganism; delays the digestion of ingested carbohydrates, leading to a smaller increase in blood glucose following meals and a decrease in glycosylated Hgb; does not enhance insulin secretion, so its effects are additive to those of the sulfonylureas in controlling blood glucose.
Indications
Monotherapy or adjunct to diet to lower blood glucose in those patients with type 2 diabetes mellitus whose hyperglycemia cannot be managed by diet alone
Combination therapy with a sulfonylurea, metformin, or insulin to enhance glycemic control in patients who do not receive adequate control with diet and either drug alone
Contraindications and Cautions
Contraindicated with hypersensitivity to drug; diabetic ketoacidosis; cirrhosis; inflammatory bowel disease; conditions that deteriorate with increased gas in the bowel; type 1 diabetes; existence of or predisposition to intestinal obstruction; colonic ulceration.
Use cautiously with renal impairment, pregnancy, lactation.
Available Forms
Tablets—25, 50, 100 mg
Dosages
Adults
Monotherapy: Initially, 25 mg PO tid with first bite of each meal. May start with 25 mg/day and gradually increase to tid if GI side effects are a problem. Increase as needed every 4–8 wk as indicated by 1-hr postprandial glucose levels or glycosylated Hgb level and tolerance. For patient 60 kg or less, maximum dosage 50 mg tid; for patient more than 60 kg, maximum dosage 100 mg tid.
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