Acarbose interactions

Food & lifestyle

• alcohol

  Moderate

  Others

  Alcohol may cause hypoglycemia or hyperglycemia in patients with diabetes. Hypoglycemia most frequently occurs during acute consumption of alcohol. Even modest amounts can lower blood sugar significantly, especially when the alcohol is ingested on an empty stomach or following exercise. The mechanism involves inhibition of both gluconeogenesis as well as the counter-regulatory response to hypoglycemia. Episodes of hypoglycemia may last for 8 to 12 hours after ethanol ingestion. By contrast, chronic alcohol abuse can cause impaired glucose tolerance and hyperglycemia. Moderate alcohol consumption generally does not affect blood glucose levels in patients with well controlled diabetes. A disulfiram-like reaction (e.g., flushing, headache, and nausea) to alcohol has been reported frequently with the use of chlorpropamide and very rarely with other sulfonylureas.

  What to do: Patients with diabetes should avoid consuming alcohol if their blood glucose is not well controlled, or if they have hypertriglyceridemia, neuropathy, or pancreatitis. Patients with well controlled diabetes should limit their alcohol intake to one drink daily for women and two drinks daily for men (1 drink = 5 oz wine, 12 oz beer, or 1.5 oz distilled spirits) in conjunction with their normal meal plan. Alcohol should not be consumed on an empty stomach or following exercise.

  10 sources

  1. Jerntorp P, Almer LO "Chlorpropamide-alcohol flushing in relation to macroangiopathy and peripheral neuropathy in non-insulin dependent diabetes." Acta Med Scand 656 (1981): 33-6
  2. Jerntorp P, Almer LO, Holin H, et al. "Plasma chlorpropamide: a critical factor in chlorpropamide-alcohol flush." Eur J Clin Pharmacol 24 (1983): 237-42
  3. Barnett AH, Spiliopoulos AJ, Pyke DA, et al. "Metabolic studies in chlorpropamide-alcohol flush positive and negative type 2 (non-insulin dependent) diabetic patients with and without retinopathy." Diabetologia 24 (1983): 213-5
  4. Hartling SG, Faber OK, Wegmann ML, Wahlin-Boll E, Melander A "Interaction of ethanol and glipizide in humans." Diabetes Care 10 (1987): 683-6
  5. "Product Information. Diabinese (chlorpropamide)." Pfizer U.S. Pharmaceuticals (2002):
  6. "Product Information. Glucotrol (glipizide)." Pfizer U.S. Pharmaceuticals (2002):
  7. "Product Information. Diabeta (glyburide)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  8. Skillman TG, Feldman JM "The pharmacology of sulfonylureas." Am J Med 70 (1981): 361-72

  Show all 10 sourcesShow fewer sources

  9. "Position Statement: evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes related complications. American Diabetes Association." Diabetes Care 25(Suppl 1) (2002): S50-S60
  10. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

Conditions

Conditions in which Acarbose needs care, as documented in this source.

• Diabetic Ketoacidosis

  Major

  The use of alpha-glucosidase inhibitors is contraindicated for the treatment of patients with diabetic ketoacidosis.

  2 sources

  1. "Product Information. Precose (acarbose)." Bayer (2001):
  2. "Product Information. Glyset (miglitol)." Bayer (2001):

• Fibrosis

  Major

  The use of acarbose is contraindicated in patients with primary cirrhosis.

  1 source

  1. "Product Information. Precose (acarbose)." Bayer (2001):

• Intestinal Diseases

  Major

  The use of alpha-glucosidase inhibitors is contraindicated in patients with inflammatory bowel disease, colonic ulceration, partial intestinal obstruction, or any chronic intestinal disease associated with marked disorders of digestion or absorption. Alpha-glucosidase inhibitors competitively inhibit enzymes involved in the digestion of carbohydrates. Increased gas formation in the intestines due to fermentation of the undigested carbohydrates can worsen or aggravate intestinal problems.

  5 sources

  1. Hollander P "Safety profile of acarbose, an alpha-glucosidase inhibitor." Drugs 44 Suppl 3 (1992): 47-53
  2. Clissold SP, Edwards C "Acarbose. A preliminary review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential." Drugs 35 (1988): 214-43
  3. "Product Information. Precose (acarbose)." Bayer (2001):
  4. Nishii Y, Aizawa T, Hashizume K "Ileus: a rare side effect of acarbose." Diabetes Care 19 (1996): 1033
  5. "Product Information. Glyset (miglitol)." Bayer (2001):

• Kidney Diseases

  Major

  Acarbose may accumulate in patients with renal impairment. Following oral administration, 35% of a dose is recovered in the urine as either the parent drug or metabolites. However, long-term clinical trials in diabetic patients with significant renal dysfunction (serum creatinine > 2.0 mg/dL) have not been conducted. Therapy with acarbose should be administered cautiously in patients with renal dysfunction. The manufacturer does not recommend its use in patients with significantly impaired renal function.

  3 sources

  1. Clissold SP, Edwards C "Acarbose. A preliminary review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential." Drugs 35 (1988): 214-43
  2. Balfour JA, McTavish D "Acarbose. An update of its pharmacology and therapeutic use in diabetes mellitus [published erratum appears in Drugs 1994 Dec;48(6):929]." Drugs 46 (1993): 1025-54
  3. "Product Information. Precose (acarbose)." Bayer (2001):

• Liver Diseases

  Moderate

  The use of acarbose has been associated with dose-related elevations in serum transaminase levels and, rarely, hyperbilirubinemia and jaundice. Hepatic adverse effects may be more likely to occur at dosages exceeding 50 mg three times a day. Therapy with acarbose should be administered cautiously in patients with liver disease. Monitoring of serum transaminases is recommended every 3 months during the first year of treatment and periodically thereafter. If hepatotoxicity is suspected at any time, a dosage reduction or withdrawal of therapy may be indicated.

  5 sources

  1. Hollander P "Safety profile of acarbose, an alpha-glucosidase inhibitor." Drugs 44 Suppl 3 (1992): 47-53
  2. Clissold SP, Edwards C "Acarbose. A preliminary review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential." Drugs 35 (1988): 214-43
  3. Balfour JA, McTavish D "Acarbose. An update of its pharmacology and therapeutic use in diabetes mellitus [published erratum appears in Drugs 1994 Dec;48(6):929]." Drugs 46 (1993): 1025-54
  4. "Product Information. Precose (acarbose)." Bayer (2001):
  5. Andrade RJ, Lucena MI, Rodriguezmendizabal M "Hepatic injury caused by acarbose." Ann Intern Med 124 (1996): 931