acarbose vs pioglitazone
Side-by-side comparison of acarbose and pioglitazone Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.
Precose
Actos
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.
Pioglitazone (Actos) is a medicine that helps control blood sugar levels in adults with type 2 diabetes. It works along with diet and exercise.
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.
Pioglitazone is used to help manage blood sugar in adults who have type 2 diabetes. It is used in addition to diet and exercise. This medicine will not work for type 1 diabetes or diabetic ketoacidosis.
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.
Pioglitazone belongs to a class of drugs called thiazolidinediones. It makes your body more sensitive to insulin, which helps lower blood sugar. It works by activating a certain receptor in your body called PPAR gamma.
- • Gas
- • Diarrhea
- • Abdominal pain
- • Upper respiratory infection
- • Headache
- • Sinus infection
- • Muscle pain
- • Sore throat
- Low blood sugar 269
- Feeling sick to your stomach 203
- High blood sugar 200
- Feeling lightheaded 160
- Loose, watery stools 147
- Cancer of the bladder 8,736
- Increased blood sugar 3,385
- Feeling sick to your stomach 2,917
- Weight loss 2,084
- Loose or watery stools 1,680
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.
Pioglitazone can cause or worsen heart failure in some people. Watch for signs like rapid weight gain, shortness of breath, and swelling. If you have heart failure, it should be managed, and stopping or lowering the dose of pioglitazone should be considered. If you have severe heart failure (NYHA Class III or IV), you should not start taking pioglitazone.
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.
It is not known if pioglitazone can harm an unborn baby. Talk to your doctor if you are pregnant or plan to become pregnant. It is also not known if pioglitazone passes into breast milk, so talk to your doctor about breastfeeding while taking this medicine.
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How to Read This acarbose vs pioglitazone Comparison
acarbose is classified in the Alpha-Glucosidase Inhibitor drug class, while pioglitazone sits within the Thiazolidinedione 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 pioglitazone has 18,802. 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 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.