How to use "oral hypoglycemic drug" acarbose?

Only for medical professionals to read and refer to clinical decision-making, it can be simpler 01 Type 2 Diabetes 1.
1 Adults (domestic usage) ▎1.
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1 Indications In conjunction with diet control, it is used: Type 2 Diabetes reduces the postprandial blood sugar of people with impaired glucose tolerance
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2 Usage and Dosage Swallow the whole tablet immediately before eating or chew with the first few mouthfuls of food.
The dosage varies from person to person
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The general recommended dose is: the starting dose is 50 mg once, 3 times a day, and then gradually increased to 100 mg once, 3 times a day
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In individual cases, it can be increased to 200mg once, 3 times a day
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Or follow the doctor's advice
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If the patient is not effective after taking the medicine for 4-8 weeks, the dose can be increased
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If the patient adheres to a strict diabetic diet and is still uncomfortable, the dose cannot be increased, and sometimes the dose needs to be appropriately reduced.
The average dose is 100 mg once, 3 times a day [1-3]
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2 Adults (FDA usage) ▎2.
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1 Indications can be used as an auxiliary means of diet and exercise to improve blood sugar control in adult patients with type 2 diabetes
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2 Usage and dosage There is no fixed-dose regimen for the treatment of diabetes with this product or any other drugs
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The dosage of this product must be individually adjusted based on effectiveness and drug resistance, and should not exceed the maximum recommended dosage of 100 mg 3 times a day
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This product should be swallowed immediately before a meal or chewed together with the first mouthful of food, 3 times a day
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This product should be administered at a low dose and gradually increased to reduce gastrointestinal side effects and reach the minimum dose required to ensure that the patient fully controls blood sugar
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If you do not follow the doctor's instructions to regulate your diet, it may aggravate the intestinal side effects
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If you still experience severe painful symptoms while adhering to a diabetic diet, you must consult a doctor and reduce the dose temporarily or permanently
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In the initial stage of treatment and dose adjustment, the blood glucose of 1 hour after a meal can be used to determine the patient's response to the treatment of this product and determine the minimum effective dose
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After that, glycated hemoglobin is measured every about 3 months
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The goal of treatment should be to reduce the postprandial blood glucose and glycosylated hemoglobin levels to normal or close to normal levels by using the lowest effective dose of this product as a single drug or in combination with sulfonylureas, insulin or metformin
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■Initial dose: 25mg orally, 3 times a day, at the beginning of each meal (first mouth)
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Some patients who need to minimize gastrointestinal side effects are recommended to gradually increase the dose, starting with 25 mg orally once a day, and then gradually increasing the frequency of administration to 25 mg orally, 3 times a day
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■Maintenance dose: After reaching 25mg orally, 3 times a day, the dose should be adjusted according to the level of blood glucose or glycosylated hemoglobin 1 hour after meal and tolerability, with an interval of 4-8 weeks
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The dose can be increased from 25 mg 3 times a day to 50 mg 3 times a day
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In some patients, the dose was further increased to 100 mg, and benefited after 3 times a day
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The maintenance dose range is 50 mg, 3 times a day to 100 mg, 3 times a day
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However, since the risk of elevated serum transaminases in low-weight patients may increase, only patients with a body weight of >60kg can consider a dose of more than 50mg, 3 times a day
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If 100mg, no further decrease of postprandial glucose or glycosylated hemoglobin level is observed after 3 times a day, the dosage of this product should be considered
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Once the effective and tolerable dose of this product is determined, the dose should be maintained
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■Maximum dose: The maximum recommended dose for patients with body weight ≤60kg is 50mg, 3 times a day
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The maximum recommended dose for patients weighing more than 60kg is 100mg, 3 times a day [4]
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02 Medication for Special Populations 2.
1 The plasma concentration of this product in adult (kidney damage) volunteers with kidney damage is directly proportional to the degree of renal insufficiency
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Long-term clinical trials have not been conducted on diabetic patients with significant renal insufficiency (serum creatinine>2.
0mg/dL)
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Therefore, this product is not recommended for this type of patients [4]
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2 Adults (liver damage) / 2.
3 Children's safety and effectiveness in pediatric patients have not been determined [4]
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4 Elderly usage In the United States, 27% of subjects in clinical studies of this product are patients 65 years and older, and 4% are patients 75 years and older
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No overall differences in safety and effectiveness were observed between these subjects and young subjects
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The average steady-state area under the curve (AUC) of the elderly and the maximum concentration of this product are approximately 1.
5 times that of the young; however, these differences are not statistically significant [4]
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5 Patients receiving sulfonylurea or insulin therapy Sulfonylurea or insulin can cause hypoglycemia
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The combined use of acarbose with sulfonylurea or insulin will further reduce blood sugar and may increase the chance of hypoglycemia
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Once hypoglycemia occurs, the dosage of these drugs should be adjusted appropriately [4]
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6 The safety of acarbose during pregnancy for pregnant women has not been determined
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There are no adequate and well-controlled studies on the use of acarbose in pregnant women
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At present, sufficient and controllable research data with pregnant women as the main body are not yet sufficient
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Animal reproduction research cannot fully predict human response, so this product can only be used during pregnancy when it is clearly needed
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Current information clearly points out that abnormal blood glucose levels during pregnancy are related to the high incidence of congenital abnormalities and the increase in neonatal morbidity and mortality.
Most experts recommend using insulin during pregnancy to keep blood glucose levels as close to normal as possible
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7 Drugs during lactation After the administration of radiolabeled product, a small amount of radioactivity was found in the milk of lactating rats
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It is not clear whether this drug is excreted through breast milk
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Because many drugs can be excreted through breast milk, they should not be given to lactating women [4]
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 References: [1] Drug Information: Bai Tang Ping, Acarbose Tablets, National Medicine Standard H19990205 [2] Drug Information: Bech, Acarbose Capsules, National Medicine Standard H20020391 [3] Drug Information: Akka Botang chewable tablets, National Medicine Standard H20150012[4]Product Information: PRECOSE®,acarbose tablets, Bayer HealthCare Pharmaceuticals Inc.
2015/3/11.