Acarbose Disease Interactions

The use of acarbose is contraindicated in patients with primary cirrhosis.

Acarbose may accumulate in patients with renal impairment. Following oral administration, 35% of a dose is recovered in the urine as either the parent drug or metabolites. However, long-term clinical trials in diabetic patients with significant renal dysfunction (serum creatinine > 2.0 mg/dL) have not been conducted. Therapy with acarbose should be administered cautiously in patients with renal dysfunction. The manufacturer does not recommend its use in patients with significantly impaired renal function.

The use of alpha-glucosidase inhibitors is contraindicated for the treatment of patients with diabetic ketoacidosis.

The use of alpha-glucosidase inhibitors is contraindicated in patients with inflammatory bowel disease, colonic ulceration, partial intestinal obstruction, or any chronic intestinal disease associated with marked disorders of digestion or absorption. Alpha-glucosidase inhibitors competitively inhibit enzymes involved in the digestion of carbohydrates. Increased gas formation in the intestines due to fermentation of the undigested carbohydrates can worsen or aggravate intestinal problems.

The use of acarbose has been associated with dose-related elevations in serum transaminase levels and, rarely, hyperbilirubinemia and jaundice. Hepatic adverse effects may be more likely to occur at dosages exceeding 50 mg three times a day. Therapy with acarbose should be administered cautiously in patients with liver disease. Monitoring of serum transaminases is recommended every 3 months during the first year of treatment and periodically thereafter. If hepatotoxicity is suspected at any time, a dosage reduction or withdrawal of therapy may be indicated.