Acarbose (Precose)

By | 2012-11-17

Oral Antidiabetic

Highlights Of Prescribing Information

  • Antihyperglycemic agent that reduces the rate & amount of glucose absorbed from the gut after a meal; may be useful for mild reductions in blood glucose in dogs or cats
  • Contraindications: Underweight animals, known hypersensitivity, diabetic ketoacidosis, inflammatory bowel disease, colonic ulceration, partial intestinal obstruction or predisposition to obstruction, chronic intestinal disease with marked disorders of digestion or absorption & when excessive gas formation would be detrimental
  • Dose-dependent diarrhea & flatulence are the adverse effects most likely to be noted
  • Give with meals (preferably right before)
  • Expense may be an issue

What Is Acarbose Used For?

May be useful for mild reductions in blood glucose concentrations (250-350 mg/dl range) in dogs and cats with non-insulin-dependent diabetes mellitus and as adjunctive treatment of insulin dependent diabetes mellitus.

Before you take Acarbose

Contraindications / Precautions / Warnings

Acarbose is contraindicated in patients with known hypersensitivity to the drug, diabetic ketoacidosis, inflammatory bowel disease, colonic ulceration, partial intestinal obstruction or predisposition to obstruction, chronic intestinal disease with marked disorders of digestion or absorption, and when excessive gas formation would be detrimental. Acarbose is not indicated in patients of low body weight (some say normal body weight as well) as it may have deleterious effects on nutrition status. Use caution in patients with renal dysfunction or severe liver disease.

Adverse Effects

Adverse effects reported in cats include flatulence, soft stools and diarrhea; in dogs, diarrhea and weight loss. Adverse effects are more likely at higher doses.

While acarbose alone does not cause hypoglycemia, it may contribute to it by reducing the rate and amount of glucose absorbed when the patient is receiving other hypoglycemic agents (insulin, oral hypoglycemics).

Overdosage / Acute Toxicity

Acute overdosages are likely to cause only diarrhea and flatulence. No treatment should be necessary. Should acute hypoglycemia occur secondary to other antihypoglycemics, parenteral glucose should be administered. If treating orally, use glucose (do not use sucrose).

How to use Acarbose

Acarbose dosage for dogs:

a) For dogs poorly controlled with insulin and dietary therapy when another reason for the poor control cannot be identified: Initially 12.5-25 mg total dose per dog PO with each meal. Give only at the time of feeding. May increase dose after two weeks to 50 mg per dog and then to 100 mg per dog (in large dogs, >25 kg) if response has been inadequate. Greater chance of diarrhea at the higher dosages. ()

b) 12.5-20 mg (total dose) per meal PO ()

Acarbose dosage for cats:

a) 12.5-25 mg (total dose) PO with meals. When acarbose is used with a low carbohydrate diet it may improve glycemic control and reduce insulin dependence. ()

b) 12.5 mg per cat PO twice daily with meals. May be able to reduce insulin dosage and thereby reduce hypoglycemia occurrence. ()

c) 12.5-20 mg (total dose) per meal PO ()

Client Information

  • ■ Give immediately prior to feeding for best results
  • ■ If diarrhea becomes a problem, contact veterinarian
  • ■ Acarbose does not cause low blood sugar, but it may contribute to it if the animal is receiving other hypoglycemic agents (insulin, oral hypoglycemics)
  • ■ May take up to two weeks for maximal effect

Chemistry / Synonyms

A complex oligosaccharide antihyperglycemic agent, acarbose occurs as white to off-white powder, is soluble in water and has a pKa of 5.1.

Acarbose may also be known as: Bay-g-5421, Precose, Asucrose, Glicobase, Glucobay, Glucor, Glumida, or Prandase.

Storage / Stability

Do not store tablets above 25°C (77°F); protect from moisture.

Dosage Forms / Regulatory Status

Veterinary-Labeled Products: None

Human-Labeled Products: Acarbose Tablets: 25 mg, 50 mg & 100 mg; Precose (Bayer); (Rx)