Gastrointestinal Symptoms
Side effects include bloating, flatulence, diarrhoea, and abdominal pain. These are common due to the nature of how the medication works and are dose dependent.
A diet lower in complex carbohydrates and cane sugar (sucrose) may reduce the side effect prolife.
Interventions:
- Dose should be taken immediately before meals or with the first mouthful, up to three times a day.
- If gastrointestinal side effects are common, referral to a dietitian trained in diabetes management should be considered.
- Diabetes MedsCheck with counselling on side effect profile.
Hypoglycaemia
Acarbose does not cause hypoglycaemia, however, if used in conjunction with insulin or sulfonylureas can result in hypoglycaemia.
Interventions:
- Use glucose to treat low blood glucose levels (under 4mmol/L). NOT sucrose since treatment will be delayed if sucrose is chosen.
- Diabetes MedsCheck with counselling on managing hypoglycaemia.
- Referral pathway for glucose monitoring.
Renal Impairment
Acarbose is contraindicated in individuals with severe renal impairment (creatinine clearance < 25 mL/min).
Interventions:
- Annual cycle of care-renal check.
- Diabetes MedsCheck with referral for annual cycle of care - renal check.
Digoxin
Acarbose may affect digoxin availability
Interventions:
- Diabetes MedsCheck with counselling on potential interactions.