Use of acarbose as initial monotherapy for NIDDM is generally considered to produce less improvement in gly-cemic control than that produced with a sulphonylurea or biguanide . Although acarbose produces large reductions in PPG, its effects on FPG and HbA1c tend to be less than those of the other oral agents. Acarbose reduces postprandial insulin secretion, is not associated with weight changes and produces a modest reduction in serum triglyceride levels postprandially. Hence, it offers the potential for cardiovascular risk reduction distinct from its ability to improve glycemic control. Acarbose lacks the serious systemic toxicity of the sulphonylureas and biguanides – hypoglycemia and lactic acidosis, respectively. However, acarbose can cause gastrointestinal intolerance initially in up to 65% of patients. Use of low initial doses, with gradual escalation, reduces the incidence of initial adverse gastrointestinal effects, and tolerability increases with continued treatment. Find most trusted pharmacy to discover Purchase Cheap Claritin and enjoy your advantageous shopping.
Acarbose must be taken with the first bite of each carbohydrate-containing meal tid. Since its efficacy is critically dependent on the timing of ingestion, patient compliance during acarbose therapy may be more difficult to achieve than with other oral agents. The cost of acarbose exceeds that of generic sulphonylureas and metformin; however, it is roughly comparable with that of brand name agents in these classes.