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 specifically designed to manage type 2 diabetes by targeting postprandial hyperglycemia. It works locally within the small intestine to delay the digestion of complex carbohydrates and disaccharides, thereby reducing the rapid spike in blood glucose levels after meals. As a non-systemic agent, it offers a complementary mechanism to other antidiabetic therapies, making it a valuable option for tailored glycemic control strategies in adults. Its use is often considered when diet and exercise alone are insufficient, or in combination with other glucose-lowering medications.
Features
- Active ingredient: Acarbose
- Drug class: Alpha-glucosidase inhibitor
- Administration: Oral tablet
- Available strengths: 25 mg, 50 mg, and 100 mg
- Prescription-only medication
- Non-systemic mode of action
Benefits
- Reduces postprandial blood glucose excursions by inhibiting carbohydrate breakdown
- Lowers HbA1c levels as part of a comprehensive diabetes management plan
- May contribute to weight neutrality or modest weight loss due to reduced carbohydrate absorption
- Can be combined with other antidiabetic agents such as metformin, sulfonylureas, or insulin
- May decrease the risk of reactive hypoglycemia when used appropriately
- Provides a mechanism of action complementary to insulin sensitizers or secretagogues
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 useful in managing postprandial hyperglycemia and may be prescribed as monotherapy or in combination with other antidiabetic medications when glycemic targets are not achieved with lifestyle modifications or other agents alone. It is not indicated for type 1 diabetes or diabetic ketoacidosis.
Dosage and direction
The initial dosage of Precose is typically 25 mg taken orally three times daily at the start (with the first bite) of each main meal. The dosage may be gradually increased at 4- to 8-week intervals based on tolerability and glycemic response. Maintenance doses typically range from 50 mg to 100 mg three times daily. For patients 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. Dosage adjustments should be made under medical supervision, particularly in patients with renal impairment.
Precautions
Precose should be used with caution in patients with renal impairment (serum creatinine >2.0 mg/dL), as acarbose and its metabolites are excreted renally. It is not recommended in patients with significant hepatic impairment or inflammatory bowel disease. Due to its mechanism of action, it may cause gastrointestinal symptoms such as flatulence, diarrhea, and abdominal pain, especially during the initial treatment phase. Periodic monitoring of transaminases is recommended, as elevated liver enzymes have been reported. Hypoglycemia may occur when used in combination with other antidiabetic agents; note that sucrose (table sugar) is ineffective for treating acarbose-associated hypoglycemia—oral glucose or intravenous dextrose must be used instead.
Contraindications
Precose is contraindicated in patients with known hypersensitivity to acarbose or any component of the formulation. It is also contraindicated in patients with diabetic ketoacidosis, cirrhosis, inflammatory bowel disease, colonic ulceration, or partial intestinal obstruction. It should not be used in patients with chronic intestinal diseases associated with marked disorders of digestion or absorption, or in conditions that may deteriorate as a result of increased gas formation in the intestine.
Possible side effects
The most common side effects are gastrointestinal and include flatulence (74%), diarrhea (31%), and abdominal pain (19%). These often diminish with continued use. Less frequently, elevated serum transaminase levels may occur. Rare side effects include ileus, jaundice, hepatitis, and skin reactions such as rash or urticaria. Hypoglycemia may occur when Precose is used in combination with sulfonylureas or insulin.
Drug interaction
Precose may interact with digestive enzyme preparations (e.g., amylase, pancreatin) or charcoal, reducing its efficacy. It may affect the absorption of other medications; drugs requiring precise peak concentrations (e.g., digoxin, propranolol) should be monitored. Thiazide diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid may reduce the hypoglycemic effect of acarbose. When used with other glucose-lowering agents, the risk of hypoglycemia increases.
Missed dose
If a dose of Precose is missed, it should be skipped entirely if it is nearly time for the next scheduled dose. Do not double the dose. Take the next dose at the usual time with the first bite of the next meal. Consistency in dosing with meals is important for optimal effect.
Overdose
An overdose of Precose alone is not expected to cause hypoglycemia. However, when taken in combination with other antidiabetic drugs, hypoglycemia may occur. Symptoms may include dizziness, sweating, confusion, and palpitations. Treatment should include oral glucose (dextrose) or intravenous dextrose; sucrose (table sugar) is ineffective due to acarbose’s inhibition of disaccharide digestion. Supportive measures and monitoring of blood glucose are recommended.
Storage
Store Precose tablets at room temperature (15–30°C or 59–86°F) in a tightly closed container. Protect from moisture and light. Keep out of reach of children and pets. 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 postprandial hyperglycemia. Gastrointestinal side effects are common but often transient. It is generally well-tolerated in patients who adhere to a controlled carbohydrate diet. Many clinicians value its weight-neutral profile and complementary mechanism of action in combination therapy.