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acarbose

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Brand names: Precose

Alpha-Glucosidase Inhibitor Rx

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.

Drug Pricing (NADAC)

Generic Price

$0.20/unit

Generic Available

Yes (3 manufacturers)

Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →

What it does

Acarbose is used to help control blood sugar in adults with type 2 diabetes.

Common side effects

Gas, Diarrhea, Abdominal pain

Key warnings

You should not take acarbose if you have diabetic ketoacidosis or cirrhosis.

How It Works

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.

How to Take It

Take acarbose three times a day with the first bite of each main meal. Start with a low dose, like 25 mg, and increase it slowly. Your doctor will adjust your dose every 4-8 weeks based on your blood sugar levels and how well you tolerate the medicine. Do not take more than 100 mg three times a day unless your doctor tells you to.

Pregnancy & Breastfeeding

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.

Missed Dose

If you miss a dose, take it with your next meal. If it is almost time for your next meal, skip the missed dose and continue with your regular schedule.

Storage

Store acarbose tablets at room temperature (68° to 77°F) and protect them from moisture. Keep the bottle tightly closed.

Side Effects (from patient reports)

Based on 1,667 FDA adverse event reports.

Low blood sugar
269
Feeling sick to your stomach
203
High blood sugar
200
Feeling lightheaded
160
Loose, watery stools
147
Medicine interfering with another medicine
142
Throwing up
142
Sudden kidney damage
139
Medicine not working
134
Using medicine for something it's not approved for
131

FDA Adverse Event Report Analysis

Detailed analysis of 3,736 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2004–2025.

Total Reports

3,736

Death-Related Reports

310

Hospitalization Reports

2,037

Top Indication

Diabetes Mellitus

Gender Distribution

Female 1,793 (51%)
Male 1,726 (49%)

Age Distribution

0–17 48
18–44 233
45–64 949
65–74 864
75+ 784

Most Reported Adverse Reactions (FAERS)

# Reaction Reports
1 HYPOGLYCAEMIA 269
2 NAUSEA 203
3 BLOOD GLUCOSE INCREASED 200
4 DIZZINESS 160
5 DIARRHOEA 147
6 DRUG INTERACTION 142
7 VOMITING 142
8 ACUTE KIDNEY INJURY 139
9 DRUG INEFFECTIVE 134
10 OFF LABEL USE 131
11 FALL 125
12 ASTHENIA 112
13 LACTIC ACIDOSIS 107
14 DYSPNOEA 103
15 DIABETES MELLITUS INADEQUATE CONTROL 99

Reactions in Death Reports

DEATH 45
CARDIAC ARREST 35
ACUTE KIDNEY INJURY 34
PNEUMONIA 30
LACTIC ACIDOSIS 28
DYSPNOEA 22
VOMITING 20
COMPLETED SUICIDE 19
METABOLIC ACIDOSIS 17
TACHYCARDIA 17

Reactions in Hospitalization Reports

HYPOGLYCAEMIA 186
BLOOD GLUCOSE INCREASED 117
NAUSEA 117
FALL 104
VOMITING 93
ACUTE KIDNEY INJURY 91
DIZZINESS 91
DRUG INTERACTION 87
LACTIC ACIDOSIS 87
DIARRHOEA 81

Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation

Serious Warnings

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.

Known Drug Interactions

These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel-blocking drugs, and isoniazid.

Mechanism: Phenytoin can make it harder to control your blood sugar, which may affect how well acarbose works.

What to do: Your doctor should check your blood sugar levels more often and may need to adjust your medicine.

minor digoxin

Digoxin concentrations decreased Acarbose, activated charcoal, albuterol, antacids, certain cancer chemotherapy or radiation therapy, cholestyramine, colestipol, extenatide, kaolin-pectin, meals high in bran, metoclopramide, miglitol, neomycin, penicillamine, phenytoin, rifampin, St.

Mechanism: Acarbose can lower the amount of digoxin that gets into your blood by interfering with its absorption.

What to do: Your doctor may need to check your blood levels and adjust your digoxin dose.

Common Questions

What should I do if I experience severe gas or diarrhea?
Talk to your doctor. They may need to lower your dose.
Can I take acarbose with other diabetes medications?
Yes, acarbose can be used with other diabetes medications like sulfonylureas, insulin, or metformin.
Will acarbose cause low blood sugar?
Acarbose alone is not likely to cause low blood sugar. However, if you take it with other diabetes medicines, especially sulfonylureas or insulin, your risk of low blood sugar may increase.
What happens if my blood sugar is low?
If your blood sugar gets low, you need to eat or drink something with sugar in it right away. Glucose tablets or gel work best. You can also have juice or regular (not diet) soda.
Are there foods I should avoid while taking acarbose?
Follow the diet your doctor or diabetes educator has recommended. If you eat a lot of sugary foods, you may have more gas and diarrhea.
How long does it take for acarbose to start working?
Acarbose starts working right away to slow down the digestion of carbohydrates in your meal.
Can acarbose cause weight gain?
Acarbose is not likely to cause weight gain. It may even help with slight weight loss in some people.
What if I forget to take Acarbose with a meal?
If you forget to take acarbose with a meal, just skip that dose. Do not double your next dose.
Does Acarbose interact with other medications?
Yes, Acarbose can interact with other medications, including some diuretics, corticosteroids, and digestive enzymes. Tell your doctor about all the medicines you take.
How will I know if the medicine is working?
Your doctor will check your blood sugar levels and A1C to see how well the medicine is working.
What are the common side effects of acarbose?
The most commonly reported side effects of acarbose include Gas, Diarrhea, Abdominal pain. Based on 1,667 FDA adverse event reports. Always consult your healthcare provider about potential side effects.
Does acarbose interact with other medications?
Yes, acarbose has 2 known drug interactions. Notable interactions include phenytoin, digoxin. Always inform your doctor about all medications you are taking.
What drug class is acarbose?
acarbose belongs to the Alpha-Glucosidase Inhibitor drug class. It requires a prescription (Rx). Acarbose is used to help control blood sugar in adults with type 2 diabetes.
Is acarbose safe during pregnancy?
Talk to your doctor if you are pregnant or plan to become pregnant. It is not known if acarbose will harm your unborn baby. Always consult your healthcare provider before using any medication during pregnancy or breastfeeding.

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What the FDA Data Shows for acarbose

The FDA label for acarbose (sold under brand names such as Precose) classifies it as a prescription-only medication in the Alpha-Glucosidase Inhibitor class. Acarbose is used to help control blood sugar in adults with type 2 diabetes. Official labeling lists 3 commonly reported side effects, including Gas, Diarrhea, Abdominal pain.

Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 1,667 voluntary reports. The database also lists 2 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated minor severity. NADAC pricing from CMS shows a generic unit cost of $0.20.

Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.

Data Sources

Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).

FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.

Last updated: August 12, 2024

All federal data sources used on this page