Acarbose slows the digestion of carbohydrates in the body, which helps control blood sugar levels.

Acarbose is used together with diet and exercise to treat type 2 diabetes. Acarbose is sometimes used in combination with insulin or other diabetes medications you take by mouth.

Acarbose may also be used for purposes not listed in this medication guide.

You should not use acarbose if you have inflammatory bowel disease, an ulcer or blockage in your intestines, or cirrhosis of the liver. Do not use acarbose if you are in a state of diabetic ketoacidosis (call your doctor for treatment with insulin).

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Take acarbose with the first bite of a main meal, unless your doctor tells you otherwise.

Your blood sugar will need to be checked often, and you may need other blood tests at your doctor's office.

If you take acarbose with insulin or other diabetes medications, your blood sugar could get too low.

Low blood sugar (hypoglycemia) can happen to everyone who has diabetes. Symptoms include headache, hunger, sweating, confusion, irritability, dizziness, or feeling shaky. Always keep a source of dextrose (D-glucose) with you in case you have low blood sugar. When taking acarbose, dextrose will work better than cane sugar or table sugar in treating hypoglycemia. Sources of dextrose include honey, dates, raisins, plums, dried prunes, grapes, or glucose tablets. Be sure your family and close friends know how to help you in an emergency.

If you have severe hypoglycemia and cannot eat or drink, use a glucagon injection. Your doctor can prescribe a glucagon emergency injection kit and tell you how to use it.

Also watch for signs of high blood sugar (hyperglycemia) such as increased thirst, increased urination, hunger, dry mouth, fruity breath odor, drowsiness, dry skin, blurred vision, and weight loss.

Check your blood sugar carefully during times of stress, travel, illness, surgery or medical emergency, vigorous exercise, or if you drink alcohol or skip meals. These things can affect your glucose levels and your dose needs may also change. Do not change your medication dose or schedule without your doctor's advice.

Acarbose is only part of a complete treatment program that may also include diet, exercise, weight control, regular blood sugar testing, and special medical care. Follow your doctor's instructions very closely.

Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.

Usual Adult Dose for Diabetes Type 2:

Individualize dose based on efficacy and tolerability:

Initial dose: 25 mg orally 3 times a day
-Adjust dose at 4 to 8 week intervals based on efficacy and tolerability
Maintenance dose: 50 mg to 100 mg orally 3 times a day
Maximum dose: Weight 60 kg or less: 50 mg orally 3 times a day; Weight greater than 60 kg: 100 mg orally 3 times a day

Comments:
-Take at the start (with first bite) of each main meal; patients should be adhering to a diabetic diet to minimize GI side effects.
-Some patients benefit from starting at 25 mg orally once a day with subsequent titration to 3 times a day to minimize GI side effects.
-If no further reduction in postprandial glucose or HbA1c is observed with titration to 100 mg three times a day, consider lowering the dose.

Use: As an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes mellitus.

You should not use acarbose if you are allergic to it, or if you have:

• inflammatory bowel disease;

• a blockage in your intestines;

• a digestive disorder affecting your intestines;

• intestinal ulcer (of your colon);

• cirrhosis of the liver; or

• diabetic ketoacidosis (call your doctor for treatment with insulin).

To make sure acarbose is safe for you, tell your doctor if you have:

• liver disease;

• kidney disease;

• a bowel or intestinal disorder; or

• a stomach disorder.

acarbose is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether acarbose passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using acarbose.

Acarbose is not approved for use by anyone younger than 18 years old.

Take the missed dose as soon as you remember (be sure to take it with a meal). If it has been longer than 15 minutes since you started your meal, you may still take acarbose but it may be less effective than taking it with the first bite of the meal. Do not take acarbose between meals, and do not take extra medicine to make up a missed dose.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

In case of overdose, do not eat or drink anything containing carbohydrates for the next 4 to 6 hours.

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

Be sure to follow all exercise and dietary recommendations made by your doctor or dietitian. It is important to eat a healthful diet.

Alcohol may cause a decrease in blood sugar. Ask your doctor about the safe use of alcoholic beverages while you are taking acarbose.

Avoid drinking alcohol. It can lower your blood sugar.

Avoid taking a digestive enzyme such as pancreatin, amylase, or lipase at the same time you take acarbose. These enzymes can make it harder for your body to absorb acarbose. Products that contain digestive enzymes include Arco-Lase, Cotazym, Donnazyme, Pancrease, Creon, and Ku-Zyme.

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Acarbose may cause serious side effects. Call your doctor at once if you have:

• severe constipation;

• severe stomach pain, diarrhea that is watery or bloody;

• easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin; or

• liver problems--nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Common side effects of acarbose may include:

• stomach discomfort, gas, bloating;

• mild diarrhea; or

• mild skin rash or itching.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

You may be more likely to have hyperglycemia (high blood sugar) if you take acarbose with other drugs that can raise blood sugar, such as:

• isoniazid (for treating tuberculosis);

• niacin (Advicor, Niaspan, Niacor, Simcor, Slo Niacin, and others), nicotine patches or gum;

• birth control pills and other hormones;

• a diuretic or "water pill";

• heart or blood pressure medicine;

• insulin or oral diabetes medicine;

• diet pills, stimulants, or medicines to treat asthma, colds or allergies;

• phenothiazines (Compazine and others);

• seizure medications (Dilantin and others);

• steroids (prednisone and others); or

• thyroid medicine (Synthroid and others).

This list is not complete. Other drugs may interact with acarbose, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to acarbose. Your doctor will also tell you how to check your response to this medication by measuring your blood or urine sugar levels at home. Follow these instructions carefully

You should always wear a diabetic identification bracelet to be sure you get proper treatment in an emergency.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.