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acarbose vs metformin/pioglitazone

Side-by-side comparison of acarbose and metformin/pioglitazone Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.

Drug Class
acarbose Alpha-Glucosidase Inhibitor
metformin/pioglitazone Biguanide / TZD Combination
Type
acarbose Prescription
metformin/pioglitazone Prescription
Summary
acarbose

Acarbose is a medicine that helps lower blood sugar levels in people with type 2 diabetes. It works best when used with diet and exercise.

metformin/pioglitazone

Actoplus Met is a drug that combines two medicines to help control blood sugar in adults with type 2 diabetes. It should be used with diet and exercise.

What It Treats
acarbose

Acarbose is used to help control blood sugar in adults with type 2 diabetes. You should use it along with a healthy diet and regular exercise. This medicine helps to keep your blood sugar from getting too high after you eat.

metformin/pioglitazone

Actoplus Met helps lower blood sugar in adults who have type 2 diabetes. You should also follow a diet and exercise plan while taking this medicine. Actoplus Met is not for people with type 1 diabetes or diabetic ketoacidosis.

How It Works
acarbose

Acarbose slows down the digestion of carbohydrates (sugars and starches) in your body. It does this by blocking certain enzymes in your small intestine that break down carbs. This helps to prevent a sharp rise in blood sugar after meals.

metformin/pioglitazone

Actoplus Met contains pioglitazone and metformin. Pioglitazone makes your body more sensitive to insulin. Metformin reduces the amount of sugar your liver releases into your blood.

Common Side Effects
acarbose
  • Gas
  • Diarrhea
  • Abdominal pain
metformin/pioglitazone
  • Upper respiratory infection
  • Swelling
  • Diarrhea
  • Headache
  • Weight gain
FAERS Reports
acarbose
  • Low blood sugar 269
  • Feeling sick to your stomach 203
  • High blood sugar 200
  • Feeling lightheaded 160
  • Loose, watery stools 147
metformin/pioglitazone
  • Feeling sick to your stomach 21,946
  • Loose or watery stools 21,887
  • High blood sugar 18,329
  • Medicine not working 18,265
  • Feeling tired 17,252
Serious Warnings
acarbose

You should not take acarbose if you have diabetic ketoacidosis or cirrhosis. Also, do not take it if you have inflammatory bowel disease, colon ulcers, or any bowel obstruction. This medicine can cause liver problems in some people. Tell your doctor right away if you develop symptoms like yellowing of the skin or eyes.

metformin/pioglitazone

Actoplus Met can cause or worsen heart failure in some people. Watch for signs like rapid weight gain, shortness of breath, and swelling. This medicine can also cause a rare but serious condition called lactic acidosis. Get medical help right away if you have symptoms like feeling very weak, muscle pain, trouble breathing, or stomach pain.

Pregnancy
acarbose

Talk to your doctor if you are pregnant or plan to become pregnant. It is not known if acarbose will harm your unborn baby. Talk to your doctor if you are breastfeeding or plan to breastfeed. It is not known if acarbose passes into breast milk.

metformin/pioglitazone

Talk to your doctor if you are pregnant or plan to become pregnant. It is not known if Actoplus Met will harm your unborn baby. Talk to your doctor if you are breastfeeding or plan to breastfeed.

Also Compare — Nearby Drugs

Compare acarbose with

How to Read This acarbose vs metformin/pioglitazone Comparison

acarbose is classified in the Alpha-Glucosidase Inhibitor drug class, while metformin/pioglitazone sits within the Biguanide / TZD Combination class. Drugs from different classes work through distinct mechanisms, so a head-to-head comparison illustrates trade-offs rather than equivalence. Both drugs are prescription-only, so a licensed provider must authorize use.

Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, acarbose has 979 submissions while metformin/pioglitazone has 97,679. Those figures reflect cumulative reporting volume — not per-patient risk — so older, widely dispensed drugs typically look worse on count alone. No direct interaction between these two drugs is listed in our FDA-derived dataset, though co-prescription still warrants pharmacist review. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.

A table cannot substitute for clinical judgment. Effectiveness, tolerability, drug-drug interactions with your other medications, kidney and liver function, pregnancy status, insurance formulary, and price all feed into a decision that only a licensed prescriber can make responsibly. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This page is for educational purposes only, is not medical advice, and should not be used to self-switch between acarbose and metformin/pioglitazone — always consult your physician or pharmacist first.

Important: This comparison is for informational purposes only. Drug effects vary between individuals. Always consult your doctor or pharmacist for personalized medical advice.