Acarbose

Introduction

Written by Kirstyn Hill, PharmD, MPH
Medically reviewed by Melissa Badowski, PharmD, MPH, FCCP
Updated on August 15, 2023

Acarbose (AY car bose) is a generic medication prescribed for lowering blood sugar levels in adults with type 2 diabetes. Acarbose belongs to a group of drugs called alpha-glucosidase inhibitors.

Common questions about acarbose

Below you’ll find answers to a few commonly asked questions about acarbose.

What is acarbose’s mechanism of action (how it works)?

Acarbose works by slowing certain enzymes in your body that break down food into sugar. This helps slow down carbohydrate digestion, which keeps your blood sugar from becoming very high after you eat.

Acarbose doesn’t lower blood sugar levels by itself if you take it between meals. If you take the drug consistently with meals, your blood sugar should decrease almost immediately.

If you’d like to know more about how acarbose works, talk with your doctor or pharmacist.

Are there brand-name versions of acarbose available?

No, acarbose isn’t available in a brand-name version. Precose, a brand-name prescription drug containing acarbose as its active ingredient, used to be available. But it’s been discontinued.

A generic medication is an identical copy of the active drug in a brand-name medication. (An active drug is the ingredient that makes a medication work.) Generic drugs are believed to be as effective and safe as brand-name drugs. And generic drugs typically cost less than brand-name drugs. For more information on brand versus generic drugs, see this article.

Can acarbose be used for weight loss?

Acarbose isn’t approved for weight loss. However, acarbose is prescribed with a balanced diet and exercise. Following this treatment plan may cause weight loss in some people.

If you’d like to know more about weight loss during acarbose treatment, talk with your doctor or pharmacist.

Is acarbose similar to metformin?

Acarbose and metformin (Glumetza, Fortamet) are used to lower blood sugar in adults with type 2 diabetes.

Both medications may be prescribed with a balanced diet and exercise to manage type 2 diabetes. However, they work differently within the body. It’s possible to take both acarbose and metformin to manage your blood sugar if your doctor recommends doing so.

The two drugs come as oral tablets, but metformin also comes in other forms. Both may be prescribed to adults, but certain forms of metformin are also approved for children ages 10 years and older.

If you’d like to know more about how acarbose and metformin compare, talk with your doctor or pharmacist.

Side effects of acarbose

Acarbose may cause mild or serious side effects. More common mild side effects of acarbose and its serious side effects are listed below. This article doesn’t include all possible side effects of the drug. Side effects can vary based on your age, overall health, and any other medications you take.

To learn more about acarbose’s side effects, ask your doctor or pharmacist. You can also refer to the prescribing information for acarbose listed in the “Resources” section.

Mild side effects

More common mild side effects reported with some forms of acarbose are listed below.

This article doesn’t include all possible mild side effects of the drug. To learn more about acarbose’s side effects, refer to the prescribing information for acarbose listed in the “Resources” section.

With many drugs, mild side effects may go away within a few days or a couple of weeks. If the side effects are bothersome, tell your doctor or pharmacist. They may be able to suggest ways to manage them.

Acarbose oral tablet’s mild side effects include:

• abdominal pain
• diarrhea
• flatulence (gas)
• mild allergic reaction*

* For details about this side effect, see the “Interactions and warnings for acarbose” section.

Serious side effects

Serious side effects of acarbose are listed below. This article doesn’t include all possible serious side effects of the drug. To learn more about acarbose’s side effects based on the form, refer to the prescribing information for acarbose listed in the “Resources” section.

With many drugs, serious side effects are possible but not common. If you have serious side effects from this drug, call your doctor right away. If you’re having severe symptoms or a medical emergency, call 911 or a local emergency number.

In general, acarbose’s serious side effects include:

• elevated liver enzymes, which could be a sign of liver problems
• pneumatosis cystoides intestinalis (gas-filled cysts inside the intestines)*
• severe allergic reaction†

* This side effect wasn’t reported in studies of the drug. But it has occurred in people after the drug was approved for use.
† For details about this side effect, see the “Interactions and warnings for acarbose” section.

Uses of acarbose

The Food and Drug Administration (FDA) approves prescription drugs such as acarbose for certain conditions. Approved uses for acarbose are described below.

Use for lowering blood sugar levels

Doctors may prescribe acarbose oral tablets for lowering high blood sugar levels caused by type 2 diabetes. It’s used for this purpose in adults, and the drug is typically taken  with a balanced diet and exercise. It’s usually prescribed as a long-term treatment.

With type 2 diabetes, your body has a buildup of glucose (sugar) in the blood.

All cells in your body need sugar to work as usual. Sugar gets into the cells with the help of the hormone insulin. If you have type 2 diabetes, your body stops responding to insulin. As a result, sugar builds up in your blood.

Type 2 diabetes usually causes no symptoms. However, without treatment, high blood sugar levels may lead to heart attacks, strokes, kidney disease, vision problems, or loss of feeling in the hands and feet.

Acarbose is often prescribed with other medications for type 2 diabetes. Examples include the drug metformin (Glumetza, Fortamet), sulfonylurea, and insulin medications.

Interactions and warnings for acarbose

Below you’ll find information about acarbose’s possible interactions and warnings.

Interactions of acarbose

Certain things may affect how a drug works. These include getting vaccines, consuming alcohol or certain foods, or taking the drug with other medications. This effect is called a drug interaction.

Before you take acarbose drug, ask your doctor to check for possible interactions. Be sure to tell them about any of the following you take or use:

• prescription or over-the-counter drugs 
• vitamins, herbs, or supplements

To learn about drug-condition interactions, see the “Warnings for acarbose” section below.

Warnings for acarbose

Some people should not take acarbose, and others should take it cautiously.

Acarbose could cause harm to people with certain health conditions. This effect is called a drug-condition interaction. Other factors can also affect whether acarbose is a safe option for you.

Ask your doctor about specific warnings for acarbose, and be sure to tell your doctor about your:

• current health, including any allergies to medications
• past health conditions or surgeries

Allergic reaction

Acarbose can cause an allergic reaction in some people. Severe allergic reactions are rare but possible.

If you’ve had an allergic reaction to acarbose or any of its ingredients, your doctor will likely recommend that you do not take acarbose. They can tell you about medications that are safer options for you.

A mild allergic reaction may cause the following symptoms:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A severe allergic reaction may cause the following symptoms:

• swelling under your skin, usually in your hands, feet, eyelids, or lips
• swelling of your mouth, throat, or tongue, which can cause breathing problems

If you have an allergic reaction to acarbose, call your doctor right away. If you have severe symptoms, call 911 or a local emergency number.

Overdose of acarbose

You should not take more acarbose than your doctor prescribes. For some drugs, doing so may lead to harmful effects or overdose.

If you think you’ve taken too much acarbose, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have concerning symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.

Pregnancy or breastfeeding and acarbose

Information about acarbose and pregnancy and breastfeeding is described below.

Acarbose and pregnancy

It’s not known whether acarbose should be taken during pregnancy. If you’re planning a pregnancy or can become pregnant, talk with your doctor before taking this medication.

Acarbose and breastfeeding

It’s not known whether acarbose should be taken while breastfeeding. If you’re currently breastfeeding or planning to do so, talk with your doctor before taking this medication.

What to ask your doctor

Let your doctor know whether you have questions about acarbose or would like more details about it.

Here’s a list of some possible questions you may want to ask your doctor:

• Can I take acarbose with my prescribed insulin?
• What drugs should I avoid while taking acarbose?
• What happens if I miss a dose of acarbose?

Resources

• Acarbose tablets, USP. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/722ce9eb-8f7b-4651-a287-d53dd7ab3707/spl-doc
• Food and Drug Administration. (2023). Orange Book: Approved drug products with therapeutic equivalence evaluations. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm
• Metformin hydrochloride oral solution. (2022). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/73691c6c-8841-4c5d-b4a5-c3ed3b5effa1/spl-doc

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.