Glucobay Drug Interactions

When administered alone, Glucobay does not cause hypoglycaemia. It may, however, act to potentiate the hypoglycaemic effects of insulin, metformin and sulphonylurea drugs, and the dosages of these agents may need to be modified accordingly. In individual cases hypoglycaemic shock may occur (i.e. clinical sequelae of glucose levels < 1 mmol/L such as altered conscious levels, confusion or convulsions).
Episodes of hypoglycaemia occurring during therapy must, where appropriate, be treated by the administration of glucose, not sucrose. This is because acarbose will delay the digestion and absorption of disaccharides, but not monosaccharides.
Sucrose (cane sugar) and foods containing sucrose often cause abdominal discomfort or even diarrhoea during treatment with Glucobay tablets as a result of increased carbohydrate fermentation in the colon.
Intestinal adsorbents (e.g. charcoal) and digestive enzyme preparations containing carbohydrate splitting enzymes (e.g. amylase, pancreatin) may reduce the effect of Glucobay and should not therefore be taken concomitantly.
The concomitant administration of neomycin may lead to enhanced reductions of postprandial blood glucose and to an increase in the frequency and severity of gastrointestinal side-effects. If the symptoms are severe, a temporary dose reduction of Glucobay may be warranted.
The concomitant administration of cholestyramine may enhance the effects of Glucobay, particularly with respect to reducing postprandial insulin levels. Simultaneous administration of Glucobay and colestyramine should, therefore, be avoided. In the rare circumstance that both acarbose and cholestyramine therapy are withdrawn simultaneously, care is needed as a rebound phenomenon has been observed with respect to insulin levels in non-diabetic subjects.
In individual cases Glucobay may affect digoxin bioavailability, which may require dose adjustment of digoxin. Monitoring of serum digoxin levels should be considered.
In a pilot study to investigate a possible interaction between Glucobay and nifedipine, no significant or reproducible changes were observed in the plasma nifedipine profiles.