Anemia has been observed in fewer than 1% of acarbose-treated patients in American trials, but was not documented in the Bayer pool. In one trial from the United States, five of 86 acarbose recipients had reductions in hemoglobin values, which were transient, clinically insignificant and reversible with continuedtreatment. This rare reduction in hemoglobin and hematocrit has been attributed to iron malabsorption; however, others have failed to confirm this effect ofacarbose. No reductions in serum folate or cyanocobalamin levels have been observed. Chiasson et al, in their 12-month, multicentreCanadian trial, reported thatacarbose had no effect on the vitamin or mineral status of patients.
Rare cutaneous hypersensitivity reactions may occur and manifest as erythema, exanthema and urticaria.
DOSAGE AND ADMINISTRATION
It is important that acarbosebe ingested with the first bite of each meal to allow prompt inhibition of carbohydrate digestion and to diminish postprandial hyperglycemia. The dose of acarboseshould be low initially to reduce the potential for gastrointestinal intolerance. Patient compliance may depend greatly upon early experience with adverse effects. As well, considering the interpatient variability in response to acarbosetherapy, starting with a low dose allows identification of the minimum effective dose for each individual. Your most trusted pharmacyis going to be this one, since it gives you high quality flovent for asthma with no prescription required and make sure you always get yourdrugs delivered as soon as you need them without overcharging.
Although the product monograph recommends an initialdosageof 25mgtid,acarboseis available as 50mgtablets; because they are not scored, administration of half a tablet is impractical. Therefore, an alternative initialdosagetitration has been suggested: week 1-50mgonce daily with supper; week 2-50mgbid with the major meals; week 3-50mgtid with each meal. After four to eight weeks, based on results of 2 h postprandial blood glucose levels, the daily dose can be increased, as tolerated, to a maximum of 300mg. Although some additional benefit may be derived in certain patients when the daily dose is raised above 300mg, the modest improvement in effectiveness is outweighed by the risk of liver enzyme elevations associated with use of these higher doses.