Pharmacy Diabetes

lesson-1 test

Alpha-glucosidase Inhibitors (AGIs) inhibit the absorption of carbohydrates from the small intestine by inhibiting alpha glucosidase, an intestinal enzyme that releases glucose from larger carbohydrates. By delaying carbohydrate absorption, they reduce the rise in postprandial blood glucose concentrations.
Since degradation of complex carbohydrates into glucose is prohibited, some carbohydrate will remain in the intestine and be flushed into the colon. Here bacteria digest the carbohydrates, leading to the common side effects including flatulence, bloating and diarrhoea.

Reduces postprandial glucose levels by inhibiting alpha-glucosidase enzymes in the small intestine, causing a delay in the absorption of carbohydrates.

Dose should be taken immediately before meals or with the first mouthful, up to three times a day.

Acarbose

  • Acarbose is available in 50mg or 100mg tablets.

Treatment of type 2 diabetes in adults where physical activity and dietary management has not resulted in adequate glycaemic targets.


For the most up to date PBS therapeutic indications for sitagliptin, please see:


https://www.pbs.gov.au/medicine/item/8188Y-8189B

  • The average adult dose of acarbose is 100mg three times a day just before each meal. However occasionally there is a need to increase this to 200mg three times a day.
  • To prevent gastrointestinal side effects (boating, flatulence, nausea)
    • Start at 50mg once a day for one week.
    • Increase to 50mg twice a day for the second week.
    • Then increase to 50mg three times a day after the third week.
    • Further increases in the dose may occur depending on glucose levels 6-8 weeks later.

A diet lower in complex carbohydrates and cane sugar (sucrose) may also help reduce the side effect prolife.

  • No modification in the dose is necessary in the elderly.

  • Acarbose may affect digoxin availability.

  • Gastrointestinal side effects including diarrhoea, flatulence, nausea, and loose stools.
  • A dose reduction or a change in the diet often helps reduce these side effects.

  • Hypersensitivity to acarbose or any active ingredient
  • Individuals under the age of 18 years
  • Severe renal impairment: Acarbose is contraindicated in individuals with severe renal impairment (creatinine clearance < 25 mL/min).
    Note: Diabetes MedsCheck with referral for annual cycle of care for screening.
  • Any form of malabsorption syndrome including Crohn’s disease, ulcerative colitis, intestinal obstruction or ileus, and intestinal ulcers.

  • Only an exceedingly small amount of acarbose is absorbed (1-2%) by the gastrointestinal tract.

  • The small amount of acarbose that is absorbed is excreted unchanged by the kidneys.

For more detailed information on this product please consult the product information. 


https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2020-PI-01065-1&d=202103051016933

Side effects include bloating, flatulence, diarrhoea, and abdominal pain. These are common due to the nature of how the medication works and are dose dependent.


A diet lower in complex carbohydrates and cane sugar (sucrose) may reduce the side effect prolife.

  • Dose should be taken immediately before meals or with the first mouthful, up to three times a day.
  • If gastrointestinal side effects are common, referral to a dietitian trained in diabetes management should be considered.
  • Diabetes MedsCheck with counselling on side effect profile.

Acarbose does not cause hypoglycaemia, however, if used in conjunction with insulin or sulfonylureas can result in hypoglycaemia.

  • Use glucose to treat low blood glucose levels (under 4mmol/L). NOT sucrose since treatment will be delayed if sucrose is chosen.
  • Diabetes MedsCheck with counselling on managing hypoglycaemia.
  • Referral pathway for glucose monitoring.

Acarbose is contraindicated in individuals with severe renal impairment (creatinine clearance < 25 mL/min).

  • Annual cycle of care-renal check.
  • Diabetes MedsCheck with referral for annual cycle of care - renal check.

Acarbose may affect digoxin availability

  • Diabetes MedsCheck with counselling on potential interactions.