about Acarbose class, uses, side effects contraindications

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Acarbose

Short Description

Acarbose is an oral?diabetes??medication that, unlike other medications used to treat diabetes, stimulates the production and secretion of insulin by the pancreas, acarbose reduces the absorption of carbohydrates from the intestine and reduces postprandial hyperglycemia.
Acarbose is suitable for patients with type 2 diabetes, as it increases the effect of lowering blood sugar in patients who take drugs that stimulate the production of insulin from the pancreas, such as: Glibenclamide, because it works according to a different mechanism.

Pregnancy category: B

Indications

To control blood glucose level in patients with type 2 (non–insulin-dependent) diabetes mellitus when the level can’t be controlled by diet alone
Adults.Initial: 25 mg t.i.d. with first bite of each meal. Maintenance: Increased to maximum at 4to 8-wk intervals p.r.n. Maximum: 50 mg t.i.d. for patients weighing 65 kg (143 lb) or less; 100 mg t.i.d. for patients weighing more than 65 kg.

Mechanism of Action

Inhibits action of alpha-amylase and alphaglucoside enzymes. Normally, alphaamylase hydrolyzes complex starches to oligosaccharides in the small intestine and alpha-glucoside hydrolyzes oligosaccharides, trisaccharides, and di-saccharides to glucose and other monosaccharides in the brush border of the small intestine. In diabetic patients, acarbose inhibits these actions and delays glucose absorption, reducing blood glucose level after meals.

Contraindications

Chronic intestinal disease, cirrhosis, colonic ulceration, conditions that may deteriorate because of increased gas formation in intestines, diabetic ketoacidosis, digestive or absorption disorders, history of bowel obstruction, hypersensitivity to acarbose, inflammatory bowel disease

Interactions

calcium channel blockers, digestive enzymes (such as pancreatin), diuretics, estrogen, intestinal adsorbents (such as activated charcoal), isoniazid, nicotinic acid, oral contraceptives, phenothiazines, phenytoin, sympathomimetics, thyroid hormones: Possibly decreased therapeutic effects of acarbose digoxin: Decreased serum level and therapeutic effects of digoxin insulin, sulfonylureas: Decreased insulin action, possibly increased risk of hypoglycemia

Side Efect

CV: Edema
GI: Abdominal distention and pain, diarrhea, flatulence, hepatitis, hepatotoxicity, ileus, jaundice
SKIN: Erythema, exanthema, rash, urticaria

Cautions

WARNING Be aware that acarbose isn’t recommended for patients with significant renal dysfunction and a serum creatinine level above 2 mg/dl.

If patient is receiving acarbose and a sulfonylurea or insulin to enhance glucose control, check blood glucose level often, as appropriate.

Store drug in sealed container in cool environment.

Expect to decrease dosage to control GI upset.

Monitor glycosylated hemoglobin level as ordered every 3 months for first year to evaluate glucose control and patient compliance.

Monitor hematocrit and serum AST level every 3 months during first year of therapy and periodically thereafter, as ordered, because acarbose may decrease hematocrit and increase serum AST level.

PATIENT SAFTY

Explain importance of self-monitoring glucose level during acarbose therapy.

Teach patient to recognize hypoglycemia and hyperglycemia.

Warn patient that noncompliance with treatment can increase risk of diabetic complications, including neuropathy, retinopathy, and renal insufficiency.

Explain that temporary insulin therapy may be needed if fever, trauma, infection, illness, surgery, or other stress alters blood glucose control.

Warn patient not to take other within 2 hours of acarbose unless specifically instructed by prescriber.

Tell him to consult prescriber before taking OTC during acarbose therapy.

Advise patient who also takes another antidiabetic to carry glucose with him at all times in case hypoglycemia occurs.

Trade Name & Company Name

Trade name	Company name
GLUCOBAY 100MG TAB	BAYER SCHERING PHARMA AG
GLUCOBAY 50MG TAB	BAYER SCHERING PHARMA AG
ACAROSE 100MG TABLETS	RIYADH PHARMA
ACAROSE 25MG TABLETS	RIYADH PHARMA
ACAROSE 50MG TABLETS	RIYADH PHARMA

effect of Acarbose in Pregnancy, Fetal Health and Breast feeding

Pregnancy

. Acarbose is the subject of a large ongoing trial to determine whether its use can reduce or delay the onset of type II diabetes in patients with impaired glucose intolerance. The preliminary results indicate benefit. There are no adequate reports or well-controlled studies of acarbose in pregnant women. There is a single report of 6 pregnant women with impaired glucose tolerance treated with acarbose. Glucose levels returned to normal, and the pregnancies were reportedly uncomplicated.

Fetal Health

There are no adequate reports or well-controlled studies in human fetuses. Only 2% of the oral dose is absorbed. Rodent studies are reassuring, revealing no evidence of teratogenicity or IUGR despite the use of doses almost 10higher than those used clinically.

Breastfeeding

There is no published experience in nursing women. It is unknown whether acarbose enters human breast milk. A single rat study suggests acarbose might alter the composition of breast milk by inhibiting lipogenesis. Less than 2% of acarbose is bioavailable. It is unlikely any would be excreted into the milk and or absorbed by the neonate.

the follwing drugs will increse Acarbose by inhepiting cyp450

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the follwing drugs will decrease Acarbose by inhancing cyp450