How It Works
Acarbose works by blocking an enzyme in the small intestine that breaks complex carbohydrates down into simple sugars. By blocking this process, your body absorbs less sugar (glucose) from the foods you eat. It also delays carbohydrate digestion, which helps prevent blood sugar spikes after meals.
| Quick Facts | |
|---|---|
| Common Brands | Precose (discontinued) |
| Drug Class | Alpha-glucosidase inhibitor |
| Generic Status | Generic is available |
| Availability | Prescription only |
Dosing
Acarbose tablets come in 25 mg, 50 mg, and 100 mg dosage strengths.
The recommended starting dose is 25 mg taken by mouth three times daily with the first bite of each main meal.
After 4 to 8 weeks, your provider may adjust your dose based on how well the medication controls your blood sugar levels. A typical maintenance dose usually ranges from 50 mg to 100 mg taken by mouth three times daily with the first bite of each main meal.
Note: Dosing information below is educational only. Your prescribing physician will determine your specific dose based on your individual health needs. Always follow your healthcare provider’s instructions for exact dosing.
Uses
FDA-Approved Uses
Acarbose tablets are FDA-approved for managing type 2 diabetes.
Off-Label Uses
You may see acarbose tablets prescribed for uses that are not “FDA-approved.” This is a very common and legal practice called “off-label” prescribing, where a doctor uses their clinical judgment to prescribe a drug for a different (but well-researched) purpose.
There are currently no common off-label uses for acarbose.
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Side Effects
Like all medications, acarbose tablets can cause side effects. Some common side effects may improve over time as your body adjusts to the medication. Other side effects may be serious and require medical attention.
Common Side Effects
- Excessive gas
- Diarrhea
- Abdominal bloating
- Stomach pain or cramps
Serious Side Effects
Serious side effects are rare, but it’s important to know what to look for if they do occur. Stop using acarbose tablets and call your doctor immediately if you experience:
- Severe allergic reactions: Symptoms include swelling of the face, lips, tongue, or throat; difficulty breathing or swallowing; racing heart; severe rash or itching; and/or fever.
- Low blood sugar (hypoglycemia): Acarbose can cause low blood sugar when combined with insulin or other diabetes medications. Symptoms include fast heartbeat, sweating, blurry vision, dizziness, slurred speech, hunger, headache, shakiness, and seizures.
- Pneumatosis cystoides intestinalis: This is a rare condition where air becomes trapped in the intestinal walls. Symptoms include severe diarrhea, constipation, or mucus discharge or rectal bleeding.
Call your doctor immediately if you experience any concerning or prolonged symptoms.
Pharmacist Tips
Take Your Dose With The First Bite Of Each Meal
Acarbose works best when it’s taken at the beginning of your main meals of the day.
Carry Glucose Tablets With You
Low blood sugar can occur if you take acarbose with other medications that lower blood sugar, such as insulin or sulfonylureas. Regular table sugar (sucrose) will not work quickly enough to raise your blood sugar, so it’s important to have glucose (dextrose) tablets on hand.
Consider Limiting Alcohol
It is recommended to limit alcohol consumption when taking acarbose, as it can affect blood sugar levels in people with diabetes.
Store At Room Temperature
Acarbose tablets should be stored at 68°F to 77°F (20°C to 25°C) in a cool, dry place.
Tell Your Provider If You’re Pregnant Or Breastfeeding
It is not known if acarbose tablets can affect pregnancy or pass into breast milk, so risk cannot be ruled out. Tell your healthcare provider if you are pregnant or breastfeeding so they can advise whether this medication is safe for you to use.
Try To Avoid Missing A Dose
If you miss a dose of acarbose, take it as soon as you remember, unless it’s already been a while since you ate. In that case, skip the missed dose and take your next dose as scheduled with your next main meal. Do not take double or extra doses of acarbose to make up for a missed one.
Drug Interactions
Certain medications and substances can interact with acarbose tablets, potentially altering how it works or increasing the risk of side effects. For example:
- Diabetes medications: Taking acarbose with insulin or sulfonylureas like glipizide increases the risk of low blood sugar (hypoglycemia).
- Charcoal: Acarbose should not be taken with charcoal as it can affect how well acarbose works.
- Digestive enzymes: Medications containing amylase or pancreatin (such as Creon or Zenpep) can interfere with how well acarbose works.
- Digoxin: Acarbose can interact with this medication.
- Blood sugar-altering drugs: Certain medications — such as thiazides, corticosteroids, birth control pills, and estrogens — have the potential to raise blood sugar levels. Abruptly stopping them while on acarbose could lead to a drop in blood sugar.
- Blood pressure medications: Beta-blockers (like metoprolol and propranolol) and other medications for high blood pressure can mask the warning signs of low blood sugar.
Always give your doctor and pharmacist a complete list of all your medications, vitamins, and supplements to check for potential interactions.
FAQs
What happens if I forget my pill?
If you forget a dose and remember shortly after your meal, you can still take it. But if it has been a while since you ate, the medication may not work as well since the food has already been digested. In that case, skip the missed dose and resume your normal schedule with your next meal. Never take double doses of acarbose.
Can I skip my dose if I am eating a zero-carb or keto meal?
Acarbose is designed to slow the breakdown of complex carbohydrates into sugars. It’s best to ask your healthcare provider whether you can skip a dose when eating a strictly zero-carb meal.
Will taking acarbose help me lose weight like Ozempic or Wegovy does?
Acarbose is not meant to be used as a weight loss medication.
Can I safely take over-the-counter Gas-X, Phazyme, or Beano to stop indigestion?
You should speak with your provider before taking OTC gas medications like Beano. Some of these products can prevent acarbose from working properly.
Is it safe to take this at the same time as my daily metformin or glipizide pills?
Acarbose can often be safely taken with metformin, as they work in different parts of the body to lower blood sugar. However, taking acarbose with glipizide (a sulfonylurea) increases your risk of experiencing low blood sugar, so it’s best to ask your healthcare provider.
Will taking this medication by itself cause my blood sugar to crash?
When used on its own, acarbose is not likely to cause hypoglycemia (low blood sugar).
Is there a difference between brand name Precose and generic acarbose?
The brand name Precose has been officially discontinued, so the medication is currently only available under its generic name, acarbose.
Is it safe to use this medication if I am currently pregnant or breastfeeding?
It is not known if acarbose tablets can affect pregnancy or pass into breast milk. Tell your healthcare provider if you are pregnant, breastfeeding, or planning to become pregnant so they can advise whether this medication is safe for you to use.
Does acarbose interact badly with cholesterol medications?
Acarbose is not known to directly interact with cholesterol medications like statins. However, it’s always recommended to share a full list of medications and supplements with your healthcare provider so they can check for possible interactions.
Do you have to take acarbose with your first bite of your meal?
Yes. To be most effective, it is highly recommended to take acarbose with the first bite of each main meal. This allows it to work directly in your gut within minutes of eating.
Comparable Medications
Acarbose tablets, metformin (Glucophage), empagliflozin (Jardiance), semaglutide (Ozempic), or glipizide?
There are several medications that your doctor can prescribe in place of acarbose tablets. Here are a few possible alternatives below.
Metformin
From $24.99
An oral biguanide medication used to manage type 2 diabetes.
Empagliflozin
An oral SGLT-2 inhibitor used to manage type 2 diabetes and chronic kidney disease.
Semaglutide
A weekly GLP-1 injection used to manage type 2 diabetes.
Glipizide
From $24.99
An oral sulfonylurea used to manage type 2 diabetes.
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Important: Information on this page is for educational purposes only. Prescribing decisions are made by independent, licensed providers. TelyRx operates technology-enabled pharmacies and a telehealth platform that connects patients with board-certified licensed providers. Prescriptions, when provider-approved and issued, are filled and shipped by TelyRx-affiliated pharmacies. We do not employ physicians or make prescribing decisions. Learn more about our editorial standards here.