Acarbose
Monitor LFT every 3 mth for 1st yr and periodically thereafter especially for doses >50 mg tid. Reduce dose or withdraw therapy if transaminases elevations persist. If hypoglycaemia occurs, give glucose orally as a 1st aid measure. Adhere strictly to the prescribed diabetic diet to avoid intensification of GI symptoms. Lactation: not known if crosses into breast milk, avoid using in nursing women.
Type 2 DM
Patients <18 yr; diabetic ketoacidosis or cirrhosis; malabsorption; inflammatory bowel disease; with or pre-disposed to intestinal obstruction; intestinal diseases that affect digestion or absorption; conditions that worsen as a result of increased gas formation e.g. hernias; colonic ulcers; hepatic impairment; CrClr< 25 ml/min/1.73m2. Pregnancy, lactation.
N/A
>10% abdominal pain (19%),diarrhea (31%),elevated serum transaminases, flatulence (74%) Potentially Fatal: Hepatotoxicity.
Acarbose competitively and reversibly inhibits pancreatic alpha-amylase and intestinal brush border alpha-glucosidases, resulting in retardation of glucose absorption from hydrolysed complex carbohydrates and reduction of blood-glucose concentrations.
May enhance effects of other antidiabetics including insulin. Diminished effects w/ GI adsorbents (e.g. charcoal) and digestive enzyme preparations containing carbohydrate splitting enzymes (e.g. amylase, pancreatin). Neomycin and colestyramine may enhance effects of acarbose. May inhibit absorption of digoxin.
Pregnancy Category: B Lactation: not known if crosses into breast milk, avoid using in nursing women
Dosage Adult: PO Initial: 25 mg/day q8hr. May adjust gradually. Maintenance: 50-100 mg 3 times/day. Max: <60 kg: 50 mg 3 times/day. >60 kg: 100 mg 3 times/day. Hepatic Impairment Severe: Contraindicated.
N/A
Renal Impairment CrCl Dosage <25 Contraindicated.
Should be taken with food. Take w/ 1st bite of each main meal.
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