Precose: Control Post-Meal Blood Sugar with Alpha-Glucosidase Inhibition
| Product dosage: 50mg | |||
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Synonyms | |||
Precose (acarbose) is an alpha-glucosidase inhibitor oral 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 postprandial (after-meal) rise in blood glucose. This mechanism offers a targeted approach to glycemic control, particularly beneficial for individuals whose blood sugar spikes significantly following carbohydrate intake. It is often used as monotherapy or in combination with other antidiabetic agents like metformin, sulfonylureas, or insulin to achieve optimal HbA1c targets.
Features
- Active ingredient: Acarbose 50 mg or 100 mg per tablet
- Drug class: Alpha-glucosidase inhibitor
- Administration: Oral tablet, taken with the first bite of each main meal
- Delays carbohydrate breakdown in the intestine
- Does not cause hypoglycemia when used alone
- Not systemically absorbed; acts locally within the GI tract
Benefits
- Effectively lowers postprandial blood glucose peaks, reducing glycemic variability
- May contribute to a modest reduction in HbA1c levels (typically 0.5%–0.8%)
- Low risk of hypoglycemia when not combined with insulin or sulfonylureas
- Does not stimulate insulin secretion, minimizing risk of weight gain
- May improve lipid profiles by slightly reducing triglyceride levels
- Compatible with other antidiabetic regimens for synergistic glycemic control
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 especially useful in patients who experience pronounced postprandial hyperglycemia. It may be used as initial pharmacotherapy in individuals for whom metformin is contraindicated or not tolerated, or as add-on therapy when monotherapy does not achieve target glucose levels. It is not indicated for type 1 diabetes or diabetic ketoacidosis.
Dosage and direction
The initial dosage is 25 mg taken orally three times daily with the first bite of each main meal. The dosage may be increased gradually at 4–8 week intervals based on tolerability and glycemic response. The maintenance dose typically ranges from 50 mg to 100 mg three times daily. Maximum recommended dose is 100 mg three times daily for patients weighing >60 kg; for those ≤60 kg, maximum is 50 mg three times daily. Tablets should be swallowed whole with a little liquid, not chewed or crushed.
Precautions
Use with caution in patients with renal impairment (serum creatinine >2.0 mg/dL); consider alternative therapy in severe cases. Not recommended in patients with significant hepatic impairment or inflammatory bowel disease. May cause elevated serum transaminases; monitor liver function tests periodically during the first year of treatment. Gastrointestinal side effects are common initially but often diminish with continued use. Not suitable for patients with conditions that may deteriorate due to increased gas formation in the intestine.
Contraindications
Hypersensitivity to acarbose or any component of the formulation; diabetic ketoacidosis; cirrhosis; inflammatory bowel disease, colonic ulceration, or partial intestinal obstruction; chronic intestinal diseases associated with marked disorders of digestion or absorption; conditions that may deteriorate due to increased intestinal gas formation.
Possible side effects
Most common: Flatulence (77%), diarrhea (33%), abdominal pain (21%). These generally decrease in frequency and intensity with continued treatment. Less common: Elevated serum transaminases (rarely requiring discontinuation). Rare: Skin reactions (rash, urticaria), edema, ileus/subileus. Hypoglycemia may occur when used in combination with other antidiabetic drugs; must be treated with glucose (not sucrose) due to inhibited disaccharide absorption.
Drug interaction
May reduce bioavailability of digoxin; monitor levels when initiating or adjusting Precose. Charcoal-containing preparations and digestive enzyme preparations (e.g., amylase, pancreatin) may reduce efficacy and should be avoided. Thiazide diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid may reduce hypoglycemic effect. May enhance effects of other hypoglycemic agents.
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 dose with the first bite of the next main meal as usual.
Overdose
An overdose may result in transient diarrhea, flatulence, and abdominal discomfort. Hypoglycemia has not been reported with acarbose monotherapy overdose. In case of overdose with combination therapy containing insulin or sulfonylureas, hypoglycemia may occur and should be treated with oral glucose (dextrose). Sucrose (cane sugar) is ineffective due to inhibited absorption.
Storage
Store at room temperature (15°–30°C or 59°–86°F) in a dry place. Keep in the original container, tightly closed. Protect from moisture. Do not use if tablets show signs of discoloration or deterioration.
Disclaimer
This information is for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider for diagnosis and individual treatment recommendations. Do not initiate, discontinue, or change dosage of any medication without professional supervision.
Reviews
Clinical studies and post-marketing surveillance demonstrate that Precose is effective in reducing postprandial glucose excursions and HbA1c, particularly in patients with high carbohydrate intake. Gastrointestinal side effects are frequently reported but often subside with continued use. It is considered a valuable option for targeting postprandial hyperglycemia, especially in combination regimens. Patient adherence may be challenged by GI effects, but dose titration and dietary counseling can improve tolerance.