Can you take Acarbose with Insulin glargine?
1 drug interaction and 19 additional warnings found for the following 2 drugs:
- acarbose
- insulin glargine
Drug interactions
Moderate drug interactions
Moderate:
acarbose insulin glargine
Applies to: acarbose and insulin glargine
Using acarbose together with insulin glargine may increase the risk of hypoglycemia, or low blood sugar.
Symptoms of hypoglycemia include:
- headache
- dizziness
- drowsiness
- nervousness
- confusion
- tremor
- nausea
- hunger
- weakness
- perspiration
- palpitation
- rapid heartbeat
Talk to your doctor if you have any questions or concerns.
You may need a dose adjustment or more frequent monitoring of your blood sugar to safely use both medications.
It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
acarbose Food/Lifestyle
Applies to: acarbose
Alcohol may affect blood glucose levels in patients with diabetes. Both hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) may occur, depending on how much and how often you drink.
You should avoid using alcohol if your diabetes is not well controlled or if you have:
- high triglycerides
- neuropathy (nerve damage)
- pancreatitis
Moderate alcohol consumption generally does not affect blood glucose levels if your diabetes is under control. However, it may be best to limit alcohol intake to one drink daily for women and two drinks daily for men (1 drink = 5 oz wine, 12 oz beer, or 1.5 oz distilled spirits) in conjunction with your normal meal plan.
Avoid drinking alcohol on an empty stomach or following exercise, as it may increase the risk of hypoglycemia.
It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Moderate:
insulin glargine Food/Lifestyle
Applies to: insulin glargine
Alcohol may affect blood glucose levels in patients with diabetes. Both hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) may occur, depending on how much and how often you drink.
You should avoid using alcohol if your diabetes is not well controlled or if you have:
- high triglycerides
- neuropathy (nerve damage)
- pancreatitis
Moderate alcohol consumption generally does not affect blood glucose levels if your diabetes is under control. However, it may be best to limit alcohol intake to one drink daily for women and two drinks daily for men (1 drink = 5 oz wine, 12 oz beer, or 1.5 oz distilled spirits) in conjunction with your normal meal plan.
Avoid drinking alcohol on an empty stomach or following exercise, as it may increase the risk of hypoglycemia.
It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Disease interactions
17 potential interactions Applies to: 15 conditions, including Hypokalemia, Hypoglycemia, Adrenal Insufficiency, Liver Disease, and Cirrhosis.
Adrenal Insufficiency
Major:
insulin glargine
Insulin glargine has a major potential interaction with Adrenal Insufficiency.
The use of insulin is contraindicated during episodes of hypoglycemia. Hypoglycemia may commonly occur during treatment with insulin and/or oral hypoglycemic agents. Care should be taken in patients who may be particularly susceptible to the development of hypoglycemic episodes during the use of these drugs, including but not limited to those who are debilitated or malnourished, those with renal or hepatic impairment, those with defective counterregulatory mechanisms (e.g., autonomic neuropathy and adrenal or pituitary insufficiency), and those with reduced awareness of hypoglycemia. Symptomatic awareness of hypoglycemia may be reduced in patients with longstanding diabetes, diabetic nerve disease, recurrent hypoglycemia, or concomitant medications that block the sympathetic nervous system (e.g., beta-blockers). Changes to any glucose-lowering medications, meal pattern, or physical activity may also increase risk of hypoglycemia. Increased frequency of glucose monitoring is recommended in patients at higher risk for hypoglycemia.
Anorexia/Feeding Problems
Major:
insulin glargine
Insulin glargine has a major potential interaction with Anorexia/Feeding Problems.
The use of insulin is contraindicated during episodes of hypoglycemia. Hypoglycemia may commonly occur during treatment with insulin and/or oral hypoglycemic agents. Care should be taken in patients who may be particularly susceptible to the development of hypoglycemic episodes during the use of these drugs, including but not limited to those who are debilitated or malnourished, those with renal or hepatic impairment, those with defective counterregulatory mechanisms (e.g., autonomic neuropathy and adrenal or pituitary insufficiency), and those with reduced awareness of hypoglycemia. Symptomatic awareness of hypoglycemia may be reduced in patients with longstanding diabetes, diabetic nerve disease, recurrent hypoglycemia, or concomitant medications that block the sympathetic nervous system (e.g., beta-blockers). Changes to any glucose-lowering medications, meal pattern, or physical activity may also increase risk of hypoglycemia. Increased frequency of glucose monitoring is recommended in patients at higher risk for hypoglycemia.
Autonomic Neuropathy
Major:
insulin glargine
Insulin glargine has a major potential interaction with Autonomic Neuropathy.
The use of insulin is contraindicated during episodes of hypoglycemia. Hypoglycemia may commonly occur during treatment with insulin and/or oral hypoglycemic agents. Care should be taken in patients who may be particularly susceptible to the development of hypoglycemic episodes during the use of these drugs, including but not limited to those who are debilitated or malnourished, those with renal or hepatic impairment, those with defective counterregulatory mechanisms (e.g., autonomic neuropathy and adrenal or pituitary insufficiency), and those with reduced awareness of hypoglycemia. Symptomatic awareness of hypoglycemia may be reduced in patients with longstanding diabetes, diabetic nerve disease, recurrent hypoglycemia, or concomitant medications that block the sympathetic nervous system (e.g., beta-blockers). Changes to any glucose-lowering medications, meal pattern, or physical activity may also increase risk of hypoglycemia. Increased frequency of glucose monitoring is recommended in patients at higher risk for hypoglycemia.
Cirrhosis
Major:
acarbose
Acarbose has a major potential interaction with Cirrhosis.
The use of acarbose is contraindicated in patients with primary cirrhosis.
Colonic Ulceration
Major:
acarbose
Acarbose has a major potential interaction with Colonic Ulceration.
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.
Diabetic Ketoacidosis
Major:
acarbose
Acarbose has a major potential interaction with Diabetic Ketoacidosis.
The use of alpha-glucosidase inhibitors is contraindicated for the treatment of patients with diabetic ketoacidosis.
Hypoglycemia
Major:
insulin glargine
Insulin glargine has a major potential interaction with Hypoglycemia.
The use of insulin is contraindicated during episodes of hypoglycemia. Hypoglycemia may commonly occur during treatment with insulin and/or oral hypoglycemic agents. Care should be taken in patients who may be particularly susceptible to the development of hypoglycemic episodes during the use of these drugs, including but not limited to those who are debilitated or malnourished, those with renal or hepatic impairment, those with defective counterregulatory mechanisms (e.g., autonomic neuropathy and adrenal or pituitary insufficiency), and those with reduced awareness of hypoglycemia. Symptomatic awareness of hypoglycemia may be reduced in patients with longstanding diabetes, diabetic nerve disease, recurrent hypoglycemia, or concomitant medications that block the sympathetic nervous system (e.g., beta-blockers). Changes to any glucose-lowering medications, meal pattern, or physical activity may also increase risk of hypoglycemia. Increased frequency of glucose monitoring is recommended in patients at higher risk for hypoglycemia.
Hypokalemia
Moderate:
insulin glargine
Insulin glargine has a moderate potential interaction with Hypokalemia.
Hypokalemia may commonly occur during treatment with insulin. Use with caution and monitor potassium levels in patients who may be particularly at risk of developing hypokalemia (e.g., patients using potassium-lowering medications, patients taking medications sensitive to serum potassium concentrations).
Intestinal Obstruction
Major:
acarbose
Acarbose has a major potential interaction with Intestinal Obstruction.
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.
Liver Disease
Moderate:
acarbose
Acarbose has a moderate potential interaction with Liver Disease.
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.
Moderate:
insulin glargine
Insulin glargine has a moderate potential interaction with Liver Disease.
Insulin requirements may be diminished in patients with renal or hepatic impairment due to reduced insulin metabolism and, in the latter case, also to reduced capacity for gluconeogenesis. Lower initial dosages may be appropriate, with careful monitoring of plasma glucose levels and dosing adjustments.
Malabsorption Syndrome
Major:
acarbose
Acarbose has a major potential interaction with Malabsorption Syndrome.
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.
Malnourishment
Major:
insulin glargine
Insulin glargine has a major potential interaction with Malnourishment.
The use of insulin is contraindicated during episodes of hypoglycemia. Hypoglycemia may commonly occur during treatment with insulin and/or oral hypoglycemic agents. Care should be taken in patients who may be particularly susceptible to the development of hypoglycemic episodes during the use of these drugs, including but not limited to those who are debilitated or malnourished, those with renal or hepatic impairment, those with defective counterregulatory mechanisms (e.g., autonomic neuropathy and adrenal or pituitary insufficiency), and those with reduced awareness of hypoglycemia. Symptomatic awareness of hypoglycemia may be reduced in patients with longstanding diabetes, diabetic nerve disease, recurrent hypoglycemia, or concomitant medications that block the sympathetic nervous system (e.g., beta-blockers). Changes to any glucose-lowering medications, meal pattern, or physical activity may also increase risk of hypoglycemia. Increased frequency of glucose monitoring is recommended in patients at higher risk for hypoglycemia.
Noninfectious Colitis
Major:
acarbose
Acarbose has a major potential interaction with Noninfectious Colitis.
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.
Panhypopituitarism
Major:
insulin glargine
Insulin glargine has a major potential interaction with Panhypopituitarism.
The use of insulin is contraindicated during episodes of hypoglycemia. Hypoglycemia may commonly occur during treatment with insulin and/or oral hypoglycemic agents. Care should be taken in patients who may be particularly susceptible to the development of hypoglycemic episodes during the use of these drugs, including but not limited to those who are debilitated or malnourished, those with renal or hepatic impairment, those with defective counterregulatory mechanisms (e.g., autonomic neuropathy and adrenal or pituitary insufficiency), and those with reduced awareness of hypoglycemia. Symptomatic awareness of hypoglycemia may be reduced in patients with longstanding diabetes, diabetic nerve disease, recurrent hypoglycemia, or concomitant medications that block the sympathetic nervous system (e.g., beta-blockers). Changes to any glucose-lowering medications, meal pattern, or physical activity may also increase risk of hypoglycemia. Increased frequency of glucose monitoring is recommended in patients at higher risk for hypoglycemia.
Renal Dysfunction
Major:
acarbose
Acarbose has a major potential interaction with Renal Dysfunction.
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.
Moderate:
insulin glargine
Insulin glargine has a moderate potential interaction with Renal Dysfunction.
Insulin requirements may be diminished in patients with renal or hepatic impairment due to reduced insulin metabolism and, in the latter case, also to reduced capacity for gluconeogenesis. Lower initial dosages may be appropriate, with careful monitoring of plasma glucose levels and dosing adjustments.
More resources
acarbose
A total of 336 drugs are known to interact with acarbose.
- Acarbose is in the drug class alpha-glucosidase inhibitors.
-
Acarbose is used to treat the following conditions:
- Dumping Syndrome (off-label)
- Type 2 Diabetes
insulin glargine
A total of 457 drugs are known to interact with insulin glargine.
- Insulin glargine is in the drug class insulin.
- Insulin glargine is used to treat the following conditions:
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.