Acarbose

Acarbose

Acarbose, a powerful anti-diabetic drug, can help manage blood sugar levels without directly affecting insulin. This medicine plays a crucial role in controlling glucose absorption in the digestive system, making it a valuable tool for many people struggling with type 2 diabetes or prediabetes.

What is Acarbose?

Acarbose is an anti-diabetic medication used to treat type 2 diabetes and, in some countries, prediabetes. It's a complex oligosaccharide that acts as a starch blocker by inhibiting alpha-glucosidase, an intestinal enzyme that breaks down carbohydrates. This drug slows the digestion of carbohydrates, reducing glucose absorption and postprandial blood sugar levels.

Acarbose tablet Uses

• Acarbose tablets are primarily used to treat type 2 diabetes. They help lower blood sugar levels when combined with diet and exercise. 
• This alpha-glucosidase inhibitor slows down the action of certain enzymes that break down food you have eaten into sugars. This process slows the digestion of carbohydrates, preventing blood sugar from rising sharply after meals.
• Acarbose drug acts in the small intestine to block the fermentation of complex carbohydrates into glucose, the sugar the body can absorb. By slowing the absorption of sugar from the small intestines, acarbose helps manage blood glucose levels effectively.

How to Use Acarbose Tablet

• Acarbose tablets should be taken orally three times daily with the first bite of each meal. 
• Patients must take acarbose drugs right at the start or during meals for maximum effectiveness. Taking it 15 minutes before eating reduces its efficacy by 50%. It's crucial to inform patients about proper usage and potential dietary adjustments. 
• Patients should avoid sugar-containing drinks and know that a gradual dose increase is common.

Side Effects of Acarbose Tablets

Acarbose can cause both common and serious side effects. 
Common acarbose side effects are stomach pain, diarrhoea, and gas. These typically occur during the first few weeks of treatment and decrease over time. Patients should connect with their doctors if these symptoms persist or become severe.
Serious side effects, though less common, require immediate medical attention. These include:

• Severe Allergic Reactions: Symptoms may include breathing problems,  face or throat swelling, skin rash, or hives.
• Low Blood Sugar (Hypoglycaemia): This can occur when acarbose is used with other diabetes medications. Symptoms include headache, dizziness, confusion, and sweating.
• Liver Problems: Watch for yellowing of the skin or eyes and stomach pain.
• Pneumatosis Cystoides Intestinalis: This rare condition causes gas-filled cysts in the intestines, leading to severe diarrhoea or constipation.

Precautions

• Certain Systemic Conditions: Patients with diabetic ketoacidosis, cirrhosis, or severe liver disease should not take this medication. 
• Gastrointestinal Ailments: It's also unsuitable for those with inflammatory bowel disease, colonic ulceration, or intestinal obstruction. People with chronic kidney problems need to consult their doctor before using acarbose.
• Precaution for Adverse Effects: Patients should be aware of potential side effects. These include pneumatosis cystoides intestinalis, allergic skin reactions, or liver problems.
• Precaution for Hypoglycaemia: Acarbose may increase the risk of hypoglycaemia when used with insulin or sulfonylureas. Patients should use glucose tablets or liquid glucose instead of cane sugar to manage low blood sugar.

How Acarbose Tablet Works

Acarbose, a complex oligosaccharide, acts as a competitive and reversible inhibitor of pancreatic alpha-amylase and intestinal alpha-glucosidases. It slows down the breakdown of complex carbohydrates into glucose in the small intestine. By delaying carbohydrate digestion, acarbose reduces glucose absorption, resulting in lower postprandial blood sugar and insulin levels.
For acarbose to be effective, patients must take it with the first bite of a meal. This timing ensures that the drug is present when carbohydrates enter the digestive system, allowing it to exert its therapeutic effect.

Can I take acarbose with other medicines?

Acarbose can interact with various medications, so informing doctors about all current medications is crucial. 

• It may decrease the bioavailability of digoxin and valproic acid. 
• The risk of hypoglycaemia increases when acarbose is combined with other anti-diabetic agents, especially insulin or sulfonylureas. 
• Digestive enzymes containing amylase or pancreatin can reduce acarbose's effectiveness. 
• Patients should be cautious when taking acarbose with medicines that affect blood glucose levels. Monitoring blood sugar levels more closely when starting or stopping other medications while on acarbose is essential. Always consult a doctor before combining acarbose with other medicines or supplements.

Dosing Information

The initial acarbose dose is 25 mg, taken orally thrice daily with the first bite of each main meal. Doctors adjust the dose every 4 to 8 weeks based on efficacy and tolerability. The maximum dose varies based on body weight:

• For individuals weighing 60 kg or less: 50 mg three times a day
• For those weighing over 60 kg: 100 mg three times a day

Conclusion

Acarbose stands out as a valuable tool in managing type 2 diabetes, offering a unique approach to blood sugar control. By slowing down carbohydrate digestion in the gut, acarbose affects post-meal glucose levels without directly affecting insulin. When used alongside a healthy diet and regular exercise, this medication can make a real difference in helping people keep their blood sugar in check.
While acarbose can be incredibly helpful, it's crucial to be aware of its potential side effects and to use it correctly. Taking it at the right time and being mindful of how it interacts with other medications is key to getting the most benefit.

FAQ's

1. What is acarbose mainly used for?

The primary use of acarbose is to treat type 2 diabetes mellitus. It helps lower blood sugar levels when combined with diet and exercise. This medication slows down carbohydrate digestion, preventing sharp rises in blood glucose after meals.

2. Who needs to take acarbose?

Individuals with type 2 diabetes mellitus who need help controlling their blood sugar levels may benefit from acarbose. It's often prescribed alongside other diabetes medications or as a standalone treatment when diet and exercise aren't enough.

3. Is it bad to use acarbose every day?

Acarbose is generally safe for daily use as prescribed by a doctor. It's designed for long-term treatment to manage blood sugar levels effectively. However, patients should monitor for side effects and follow their doctor's instructions closely.

4. Is acarbose safe? 

Acarbose is generally safe when used as prescribed. However, like all medications, it can cause side effects. Common side effects are abdominal pain, bloating, and diarrhoea. Rare but serious side effects may include hypoglycaemia, allergic reactions, or liver problems. Always consult your doctor about potential risks and benefits.

5. Who should not use acarbose? 

People should not use acarbose in:

• Allergies to acarbose or its ingredients
• Diabetic ketoacidosis
• Cirrhosis
• Inflammatory bowel disease
• Colonic ulceration
• Intestinal obstruction
• Chronic intestinal problems 
• People with kidney ailments should consult their doctor before using acarbose.
• Is acarbose safe for people with kidney problems? 

Acarbose should not be used if your kidneys are not functioning correctly. If there's concern about your kidney health, your doctor may conduct renal function tests to determine if your kidneys are working well enough for you to take this medication safely.

6. Can I take acarbose at night? 

Acarbose is typically not taken at night. It should be taken with meals to slow the absorption of carbohydrates. Taking it at night without food does not provide the intended benefits and could cause side effects.

7. What is the best time of day to take acarbose? 

The best time to take acarbose is with the first bite of each main meal, usually three times a day. Taking each dose at the beginning of your meal is crucial for the medication to work effectively in slowing down carbohydrate absorption.