Home Drug Guide Acarbose

Drug Guide

Generic Name

Acarbose

Brand Names Precose

Classification

Therapeutic: Antidiabetic agent

Pharmacological: Alpha-glucosidase inhibitor

FDA Approved Indications

  • Type 2 diabetes mellitus to improve glycemic control

Mechanism of Action

Inhibits alpha-glucosidase enzymes in the intestinal brush border, delaying carbohydrate digestion and absorption, thereby reducing postprandial blood glucose levels.

Dosage and Administration

Adult: Start with 25 mg three times daily at the beginning of each meal. Dosage may be increased based on response and tolerability, up to 100 mg three times daily.

Pediatric: Not typically used in children.

Geriatric: Use with caution; monitor for adverse effects.

Renal Impairment: Adjust dose based on creatinine clearance; usually not recommended if severe impairment.

Hepatic Impairment: Use with caution; limited data available.

Pharmacokinetics

Absorption: Minimal systemic absorption.

Distribution: Not significantly distributed into tissues.

Metabolism: Primarily through hydrolysis in the intestine.

Excretion: Excreted unchanged in feces; minimal renal excretion.

Half Life: Not applicable due to minimal systemic absorption.

Contraindications

  • Innhalation disorders such as intestinal obstruction, inflammatory bowel disease, colonic ulceration.
  • Hypersensitivity to acarbose.

Precautions

  • Use cautiously in patients with hepatic disease, gastrointestinal conditions, or renal impairment. Hypoglycemia can occur if used with other antidiabetic agents—treat with glucose, not sucrose.

Adverse Reactions - Common

  • Gas (flatulence) (Common)
  • Abdominal pain (Common)
  • Diarrhea (Common)

Adverse Reactions - Serious

  • Hepatotoxicity (rare) (Rare)
  • Hypoglycemia (when combined with other agents) (Uncommon)
  • Elevated liver enzymes (Uncommon)

Drug-Drug Interactions

  • Metformin—may increase risk of lactic acidosis when combined.

Drug-Food Interactions

  • Sucrose—should avoid due to hypoglycemia risk during overdose or missed dose.

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood glucose levels regularly. Liver function tests periodically.

Diagnoses:

  • Risk for unstable blood glucose levels.
  • Potential for altered gastrointestinal motility.

Implementation: Administer with the first bite of each main meal. Educate patient on signs of hypoglycemia and the importance of adhering to dietary recommendations.

Evaluation: Assess postprandial blood glucose levels to determine therapeutic effectiveness.

Patient/Family Teaching

  • Take medication exactly as prescribed with meals.
  • Report signs of gastrointestinal intolerance.
  • Watch for hypoglycemia; treat with glucose, not sucrose.
  • Maintain a consistent diet.

Special Considerations

Black Box Warnings:

  • None specific.

Genetic Factors: None known.

Lab Test Interference: May cause elevated liver enzymes, requiring monitoring.

Overdose Management

Signs/Symptoms: Gastrointestinal symptoms such as diarrhea, flatulence, abdominal pain; hypoglycemia if used with other agents.

Treatment: Discontinue medication; treat hypoglycemia with glucose (not sucrose).

Storage and Handling

Storage: Store at room temperature, 20°C to 25°C (68°F to 77°F).

Stability: Stable for up to 2 years if storage conditions are maintained.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.