Acarbose is an inhibitor of alpha-glucosidase (or maltase, which is the enzyme that promotes the splitting of maltose into glucose). Thanks to the inhibition of alpha-glucosidase, acarbose slows the enzymatic breakdown of sugars in the small intestine, causing a delay in their dose-dependent digestion: glucose derived from carbohydrates is then released into the blood more slowly.


What is Acarbose?


Acarbose is an active ingredient useful to control blood sugar levels in the blood. The acarbose does not stimulate insulin secretion, but reduces the load on beta cells by reducing the rise in blood sugar, avoiding postprandial compensatory hyperinsulinemia, significantly decreasing the fasting blood glucose and glycated hemoglobin values.


It is particularly recommended in the treatment of diabetes mellitus non-insulin dependent (type 2) when diet and exercise alone are not enough to control your blood sugar. Thus it is used to appropriately reduce the absorption of starch and disaccharides and it is also used in the treatment of type 1 diabetes as a supplement to insulin therapy.


How should Acarbose be taken?


Acarbose can be administered orally. The dosage should be determined by the attending physician, while the efficacy and tolerability vary from patient to patient.


Side effects associated with Acarbose


Among the main recognizable side effects of acarbose, the most common are gastrointestinal disorders. Moreover, there are other common side effects, including:


  • Flatulence
  • Borborygmi
  • Abdominal distention
  • Diarrhea
  • Gastrointestinal pain and abdominal pain


Other less common side effects include:


  • Nausea and vomiting
  • Dyspepsia
  • Increased transaminases (within the scope of hepatobiliary disorders)


The rare side effects of acarbose include:


  • Edema (in the context of vascular lesions)
  • Jaundice (Hepatobiliary disorders)





Contraindications and warnings associated with the use of Acarbose


Since safety and efficacy of Acarbose in children and adolescents below 18 years of age have not been established, the use of Acarbose is indicated in patients older than 18 years.


The acarbose has an antihyperglycemic effect, but by itself it does not induce hypoglycemia. Cases of hypoglycemia may occur, however, in the case where the Acarbose is prescribed in combination with other hypoglycemic drugs (sulfonylureas, metformin, or insulin).


In some cases the treatment with acarbose may cause hepatitis fulminant. Although the underlying mechanism of these episodes is still unknown, it is now known that acarbose affects liver health: thus it is recommended to regularly monitor the levels of liver enzymes in the first months of therapy.

In patients who have undergone gastric resection, acarbose can get into the small intestine more quickly and cause a more rapid pharmacological response: the doctor will therefore take this into account to determine the proper dosage.

There is no available clinical trial data on the use of Acarbose in pregnant women, therefore its use is not recommended during pregnancy.