The main adverse effects of acarbose occur locally in the gastrointestinal tract and consist primarily of flatulence, abdominal distension or discomfort, borborygmus (a rumbling noise in the intestines caused by propulsion of gas, also termed ‘meteorism’) and diarrhea. Most of these gastrointestinal symptoms are of mild or moderate intensity and tend to be dose-related. However, the incidence of flatulence (66%) and diarrhea (26%) is high (Table 1). In North American clinical trials, the rate of treatment withdrawal due to adverse events is quoted in the product monograph as 13% in acarbose recipients compared with 4% in patients receiving placebo. These figures are higher than those recently published in a postmarketing surveillance study by Bayer AG in Germany. In this report, the incidence of flatulence, meteorism and abdominal discomfort was only 19%; that of diarrhea was just 3%; and that of treatment withdrawal due to adverse effects was 3%. It was explained that the higher incidence in clinical trials was due to the use of higher fixed doses of acarbose and, in some cases, forced escalation of dose according to the study protocol. In contrast, dosage in the primary care setting can be individualized and titrated according to patient tolerability. Now that you know all about this health problem, it may be time to finally take control of things and visit the canadian neighbor pharmacy. This pharmacy will give you the best choice of efficient drugs and very fast delivery, turning your shopping experience into pure pleasure.
TABLE 1 Incidence of adverse events
|Adverse event||Acarbose incidence||Placebo incidence|
Data from reference 5
Evidence that adverse gastrointestinal effects are dose-related is provided by comparative data from American trials and data from Bayer. Some American trials titrated the acarbose daily dose upwards to 600 or 900 mg, while studies included in the Bayer data pool rarely used dosages of more than 300 to 450 mg/day. As a result, 76% of American acar-bose recipients and only 56% of those in the Bayer trials reported adverse effects (compared with 32% of placebo recipients in both cases). Furthermore, while trial data from the United States indicated a rate of treatment withdrawal of 13%, the corresponding rate in the Bayer pool was just 5%.