Acarbose
Pharmacologic profile and clinical uses
Description/Definition
Acarbose is an alpha-glucosidase inhibitor used in the management of type 2 diabetes mellitus.
Mechanism of action
It works by delaying the digestion and absorption of carbohydrates in the intestines, thereby reducing the postprandial increase in blood glucose levels.
Indications
Primarily indicated for the management of type 2 diabetes as part of a comprehensive treatment plan that includes diet and exercise.
Key aspects of drug therapy management
Dosage and administration
- Starting dose: Typically 25 mg orally three times daily with the first bite of each main meal.
- Titration: Dose may be increased based on clinical response and tolerance, usually to 50 mg three times daily, potentially up to 100 mg three times daily.
Side effects
Common side effects include gastrointestinal disturbances such as flatulence, diarrhea, and abdominal pain, which are due to fermentation of undigested carbohydrates in the colon.
Contraindications
Contraindicated in patients with inflammatory bowel disease, colonic ulceration, or partial intestinal obstruction.
Drug interactions
May reduce the absorption of digoxin; monitoring is recommended when co-administered.
Monitoring
- Regular monitoring of liver enzymes is recommended due to potential hepatotoxicity.
- Patient education: Patients should be counseled on the importance of adhering to dietary recommendations to minimize gastrointestinal side effects.
- Prognosis: Acarbose is effective in improving glycemic control when used as part of a comprehensive diabetes management strategy, particularly in patients with elevated postprandial glucose.
