Acarbose

CLINICAL USE

Antidiabetic agent

DOSE IN NORMAL RENAL FUNCTION

50–200 mg 3 times a day

PHARMACOKINETICS

Molecular weight : 645.6

%Protein binding : 15

%Excreted unchanged in urine : 1.7 (35% including inactive metabolites)

Volume of distribution (L/kg) : 0.32

half-life – normal/ESRD (hrs) : 3–9/Increased

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

25–50 Dose as in normal renal function 10–25 Avoid

<10 : Avoid

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD : Unknown dialysability. Avoid

HD : Unknown dialysability. Avoid. See ‘Other Information’

HDF/high flux : Unknown dialysability. Avoid. See ‘Other Information’

CAV/VVHD : Unknown dialysability. Avoid

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

Antibacterials: hypoglycaemic effect possibly enhanced and increased gastrointestinal side effects with neomycin

Lipid lowering agents: hypoglycaemic effect possibly enhanced by colestyramine

ADMINISTRATION

Reconstition

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Route

Oral

Rate of Administration

–

Comments

OTHER INFORMATION

Only 1–2% of active drug is absorbed

In renal impairment, peak concentrations are 5 times higher than in the general population and the AUC is 6 times higher

One paper records the use of acarbose in a haemodialysis patient who had undergone a total gastrectomy to treat oxyhyperglycaemia: using a dose of 100 mg before meals. with food

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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