ACARBOSE (Systemic)
Some commonly used brand names are:
In the U.S.?
Category
Description
Acarbose (AY-car-bose) is used to treat a type of diabetesmellitus called type 2 diabetes. Normally, your pancreas releases insulininto the blood stream after you eat. Insulin is used by all the cells in yourbody to help turn the food you eat into energy. This is done by using glucose(sugar) in the blood as quick energy. When you have type 2 diabetes, insulinis still produced by your pancreas, but the amount of insulin produced maynot be enough or your body may not be using it properly and you may stillneed more. Because of this, the insulin is not able to lower your blood sugarproperly and you will have too much sugar in your blood. Acarbose lowers yourblood sugar by preventing the breakdown of starch into sugar. It may be usedalone or in combination with another type of oral diabetes medicine calleda sulfonylurea.
This medicine is available only with your doctor's prescription, in thefollowing dosage form:
Before Using This Medicine
In deciding to use a medicine,the risks of taking the medicine must be weighed against the good it willdo. This is a decision you and your doctor will make. For acarbose, the followingshould be considered:
Allergies?Tell your doctor if you have ever had any unusual orallergic reaction to acarbose. Also tell your health care professional ifyou are allergic to any other substances, such as foods, preservatives, ordyes.
Pregnancy?Acarbose has not been studied in pregnant women.However, it is easier during pregnancy to control your blood sugar by usinginjections of insulin rather than by taking acarbose. Close control of yourblood sugar can reduce the chance of your baby gaining too much weight, havingbirth defects, or having high blood sugar before birth. Be sure to tell yourdoctor if you plan to become pregnant or you think you are pregnant.
Breast-feeding?It is not known whether acarbose passes into breastmilk. However, acarbose is not recommended during breast-feeding.
Children?Studies on this medicine have been done only in adultpatients, and there is no specific information comparing use of acarbose inchildren with use in other age groups.
Older adults?This medicine has been tested in a limited numberof elderly people and has not been shown to cause different side effects orproblems in older people than it does in younger adults.
Other medicines?Although certain medicines should not be usedtogether at all, in other cases two different medicines may be used togethereven if an interaction might occur. In these cases, your doctor may want tochange the dose, or other precautions may be necessary. When you are takingacarbose, it is especially important that your health care professional knowif you are taking any of the following:
- Activated charcoal or
- Medicine for digestion that contains amylase or pancreatin (e.g.,Creon)?Use of these medicines with acarbose may prevent acarbose fromworking properly
Other medical problems?The presence of other medicalproblems may affect the use of acarbose. Make sure you tell your doctor ifyou have any other medical problems, especially:
- Diabetic ketoacidosis or
- Fever or
- Infection or
- Surgery or
- Trauma?Insulin is needed to control these conditions
- Digestion problems or
- Inflammatory bowel disease or
- Intestinal blockage or
- Other intestinal problems?Acarbose should not be used
- Kidney disease (severe)?Higher blood levels of acarbose mayoccur; acarbose should not be used
- Liver disease?Acarbose may make this condition worse
Proper Use of This Medicine
Follow carefully the special meal plan your doctor gave you. This isthe most important part of controlling your condition, and is necessary ifthe medicine is to work properly. Also, exercise regularly and test for sugarin your blood or urine as directed.
For this medicine to work properly it must be takenat the beginning of each main meal.
Dosing?The dose of acarbose will be different fordifferent patients. Follow your doctor's orders or thedirections on the label. The following information includes only theaverage doses of acarbose. If your dose is different,do not change it unless your doctor tells you to do so.
- For oral dosage form (tablets):
- For type 2 diabetes:
- Adults?At first the dose is 25 milligrams (mg) three timesa day, at the start of each main meal. Your dose may then be adjusted by yourdoctor.
- Children?Use and dose must be determined by your doctor.
Missed dose?It is important that you donot miss any doses. However, if you finish a meal and you have forgottento take the medicine, do not take the missed dose. Instead, take the nextdose at the beginning of your next meal, as scheduled. Do not double doses.
Storage?To store this medicine:
- Keep out of the reach of children.
- Store away from heat and direct light.
- Do not store in the bathroom, near the kitchen sink, or in otherdamp places. Heat or moisture may cause the medicine to break down.
- Do not keep outdated medicine or medicine no longer needed. Be surethat any discarded medicine is out of the reach of children.
Precautions While Using This Medicine
Your doctor will want to check your progress at regular visits, especially during the first few weeks you take this medicine.
It is very important to follow carefully any instructionsfrom your health care team about:
- Alcohol?Drinking alcohol may cause severe low blood sugar.Discuss this with your health care team.
- Other medicines?Do not take other medicines during the timeyou are taking acarbose unless they have been discussed with your doctor.This especially includes nonprescription medicines such as aspirin, and medicinesfor appetite control, asthma, colds, cough, hay fever, or sinus problems.
- Counseling?Other family members need to learn how to preventside effects or help with side effects if they occur. Also, patients withdiabetes may need special counseling about diabetes medicine dosing changesthat might occur because of lifestyle changes, such as changes in exerciseand diet. Furthermore, counseling on contraception and pregnancy may be neededbecause of the problems that can occur in patients with diabetes during pregnancy.
- Travel?Keep a recent prescription and your medical historywith you. Be prepared for an emergency as you would normally. Make allowancesfor changing time zones and keep your meal times as close as possible to yourusual meal times.
In case of emergency?There may be a timewhen you need emergency help for a problem caused by your diabetes. You needto be prepared for these emergencies. It is a good idea to wear a medicalidentification (ID) bracelet or neck chain at all times. Also, carry an IDcard in your wallet or purse that says that you have diabetes and a list ofall of your medicines.
Acarbose does not cause hypoglycemia (low blood sugar). However, low bloodsugar can occur if you take acarbose with another type of diabetes medicine,delay or miss a meal or snack, exercise more than usual, drink alcohol, orcannot eat because of nausea or vomiting. Symptoms oflow blood sugar must be treated before they lead to unconsciousness (passingout). Different people may feel different symptoms of low blood sugar. It is important that you learn which symptoms of lowblood sugar you usually have so that you can treat it quickly.
Symptoms of low blood sugar include anxiety;behavior change similar to being drunk; blurred vision; cold sweats; confusion;cool, pale skin; difficulty in thinking; drowsiness; excessive hunger; fastheartbeat; headache (continuing); nausea; nervousness; nightmares; restlesssleep; shakiness; slurred speech; or unusual tiredness or weakness.
If symptoms of low blood sugar occur, eat glucosetablets or gel or honey, or drink fruit juice to relieve the symptoms. Tablesugar (sucrose) or regular (nondiet) soft drinks will not work. Also,check your blood for low blood sugar. Glucagon is usedin emergency situations when severe symptoms such as seizures (convulsions)or unconsciousness occur. Have a glucagon kit available, along witha syringe and needle, and know how to use it. Members of your household alsoshould know how to use it.
Hyperglycemia (high blood sugar) may occur ifyou do not take enough or skip a dose of your antidiabetic medicine, overeator do not follow your meal plan, have a fever or infection, or do not exerciseas much as usual.
Symptoms of high blood sugar include blurredvision; drowsiness; dry mouth; flushed, dry skin; fruit-like breath odor;increased urination; ketones in urine; loss of appetite; stomachache, nausea,or vomiting; tiredness; troubled breathing (rapid and deep); unconsciousness;or unusual thirst.
If symptoms of high blood sugar occur, check yourblood sugar level and then call your doctor for instructions.
Side Effects of This Medicine
Along with its needed effects, a medicine maycause some unwanted effects. Although not all of these side effects may occur,if they do occur they may need medical attention.
Other side effects may occurthat usually do not need medical attention. These side effects may go awayduring treatment as your body adjusts to the medicine. However, check withyour doctor if any of the following side effects continue or are bothersome:
Other side effects not listed above may also occur insome patients. If you notice any other effects, check with your doctor.
Revised: 07/31/1998
