Interactions
Some medications can weaken the effect of acarbose. These include steroids (e.g. cortisone), the “pill” (oral contraceptives), medicines to treat epilepsy (antiepileptic drugs, such as phenytoin), certain drugs to treat high blood pressure or heart disease (calcium channel blockers), water tablets (diuretics), thyroid hormones (e.g.
L-thyroxine), hormones (e.g. estrogen), certain tuberculosis drugs (isoniazid) and cholesterol-lowering drugs (e.g. cholestyramine). Acarbose can affect the uptake of digoxin (heart medicine), so the dose may need to be adjusted. Care must be taken when combining it with other medicines for the treatment of diabetes mellitus (antidiabetics, e.g. sulphonylureas, metformin, insulin) as there is a risk of excessive reduction in blood sugar (hypoglycaemia).
Dose
Acarbose is available as a tablet with 50 or 100 mg active ingredient. The usual initial dosage is 3 times 50 mg per day (150 mg daily dose). In order to reduce the typical gastrointestinal complaints, a slow-release dosage of only 1-2 times 50 mg per day at the beginning can be tried. It is possible to increase the dose up to 300 mg per day.
Application of Acarbose
Acarbose is used for the treatment of non-insulin-dependent diabetes. It can be combined with other antidiabetics. Thus, a combination treatment of acarbose with sulfonylureas, metformin or insulin is permitted.
Contraindication
Acarbose must not be taken if the function of the liver and kidneys is severely impaired. Chronic intestinal diseases that are associated with a significant disturbance of the digestion and absorption of food components are also considered contraindications. Diseases that can worsen due to increased gas formation in the intestine (e.g. inguinal or diaphragmatic hernias, Roemheld syndrome, intestinal ulcers, intestinal constriction) are also contraindications for the intake of acarbose.
Acarbose should still not be used in children under 18 years of age or during pregnancy and lactation. Acarbose should not be taken in cases of severe impairment of renal function – i.e. in cases of pronounced renal insufficiency. If you have such a restriction of kidney function, acarbose should not be prescribed.
As a rule, the GFR (glomerular filtration rate) is used as a parameter for assessing renal insufficiency. A value below 25ml/min is considered highly critical and is a contraindication. However, when diabetes mellitus is diagnosed, very strict attention is paid to whether the function of the kidney is intact, as diabetes itself can also restrict it.
On private prescription, a pack of 105 tablets of acarbose á 50 mg costs 34 euros, a dose of 100 mg 40 euros. When prescribing via a panel prescription, only the usual prescription fee is charged.
