Precose: Control Post-Meal Blood Sugar with Alpha-Glucosidase Inhibition
| Product dosage: 50mg | |||
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Synonyms | |||
Precose (acarbose) is an oral alpha-glucosidase inhibitor medication designed specifically for the management of type 2 diabetes. It functions by delaying the digestion of complex carbohydrates and disaccharides in the small intestine, thereby reducing the rapid spike in blood glucose levels following meals. This mechanism offers a targeted approach to postprandial glycemic control, often used as monotherapy or in combination with other antidiabetic agents like sulfonylureas, metformin, or insulin. By moderating carbohydrate absorption, Precose helps stabilize daily glucose fluctuations and supports long-term metabolic health, making it a valuable tool in a comprehensive diabetes management plan.
Features
- Active ingredient: Acarbose
- Drug class: Alpha-glucosidase inhibitor
- Available in 25 mg, 50 mg, and 100 mg oral tablets
- Delays carbohydrate digestion in the small intestine
- Reduces postprandial hyperglycemia without stimulating insulin secretion
- Not systemically absorbed; acts locally within the gastrointestinal tract
Benefits
- Effectively lowers post-meal blood glucose spikes, aiding in daily glycemic stability.
- Reduces HbA1c levels by targeting postprandial hyperglycemia, a key contributor to overall glycemic control.
- Minimizes risk of weight gain and hypoglycemia when used as monotherapy.
- May improve lipid profiles by moderately reducing triglyceride levels.
- Compatible with other antidiabetic medications for combination therapy.
- Supports long-term cardiovascular health by improving glycemic metrics linked to diabetic complications.
Common use
Precose is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. It is particularly effective for individuals who experience significant postprandial glucose excursions. It may be used as initial monotherapy in patients for whom metformin is contraindicated or not tolerated, or as part of a combination regimen with other oral antidiabetic drugs or insulin when glycemic targets are not achieved with single-agent therapy.
Dosage and direction
The initial dosage of Precose is 25 mg taken orally three times daily at the start (with the first bite) of each main meal. The dosage may be increased gradually at 4–8 week intervals based on tolerability and therapeutic response. Maintenance doses typically range from 50 mg to 100 mg three times daily. For individuals with a body weight below 60 kg, the maximum recommended dose is 50 mg three times daily; for those above 60 kg, the maximum is 100 mg three times daily. Tablets should be chewed with the first bite of food or swallowed whole with a few sips of liquid, but not taken on an empty stomach.
Precautions
- Gastrointestinal symptoms such as flatulence, diarrhea, and abdominal pain are common, especially during initial therapy; these often diminish with continued use.
- Not recommended for patients with significant renal impairment (serum creatinine >2.0 mg/dL).
- Avoid use in patients with inflammatory bowel disease, colonic ulceration, or partial intestinal obstruction due to potential for gastrointestinal side effects.
- Monitor liver enzymes periodically; although rare, elevated transaminases have been reported.
- Not intended for use in type 1 diabetes or for the treatment of diabetic ketoacidosis.
- Use during pregnancy only if clearly needed; insufficient data available on fetal risk.
Contraindications
- Hypersensitivity to acarbose or any component of the formulation.
- Patients with diabetic ketoacidosis.
- Cirrhosis or severe hepatic impairment.
- Inflammatory bowel disease, colonic ulceration, or chronic intestinal diseases associated with marked disorders of digestion or absorption.
- Conditions that may deteriorate as a result of increased gas formation in the intestine (e.g., hernia, intestinal obstruction).
Possible side effects
- Very common (>10%): Flatulence, soft stools, diarrhea, abdominal pain.
- Common (1–10%): Elevated serum transaminases.
- Uncommon (0.1–1%): Skin reactions such as rash or erythema.
- Rare (<0.1%): Edema, jaundice, hepatitis, ileus, thrombocytopenia.
- Hypoglycemia may occur when used in combination with other antidiabetic agents; note that sucrose (table sugar) is less effective for treating acarbose-associated hypoglycemia due to inhibited digestion—use glucose (dextrose) instead.
Drug interaction
- May reduce the bioavailability of digoxin; monitor levels accordingly.
- Concomitant use with cholestyramine, intestinal adsorbents, or digestive enzyme preparations may reduce the efficacy of acarbose and should be avoided.
- Charcoal and other adsorbents may decrease the effects of Precose.
- Neomycin may enhance the hypoglycemic effect and increase gastrointestinal side effects.
- When used with sulfonylureas or insulin, the risk of hypoglycemia increases; dose adjustments of these agents may be necessary.
Missed dose
If a dose is missed, it should be omitted if it is almost time for the next scheduled dose. Do not double the dose. Take the next tablet at the usual time with the first bite of the next meal.
Overdose
An overdose of Precose alone is not expected to cause hypoglycemia. However, when taken in combination with other glucose-lowering agents, hypoglycemia may occur. In case of suspected overdose, monitor blood glucose and provide oral glucose (dextrose) if hypoglycemia is present. Since acarbose delays carbohydrate absorption, intravenous glucose may be necessary in severe cases. Supportive and symptomatic treatment is recommended.
Storage
Store Precose tablets at room temperature (15–30°C or 59–86°F) in a dry place, protected from moisture. Keep the container tightly closed and out of reach of children. Do not use beyond the expiration date printed on the packaging.
Disclaimer
This information is intended for educational purposes and does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before starting or changing any medication regimen. Individual patient needs and responses may vary.
Reviews
Clinical studies and post-marketing surveillance indicate that Precose is effective in reducing postprandial glucose and HbA1c levels, particularly in patients with prominent post-meal hyperglycemia. Many users report improved daily glucose stability, though gastrointestinal side effects are a common reason for discontinuation in some patients. Overall, it is regarded as a useful option for targeted glycemic control, especially when combined with other antidiabetic therapies under medical supervision.