Brand Name : DIABAY
Generic Name : Acarbose
Preparations : 25 mg / 50 mg Tablets
Pharmacological Category : Antidiabetic Drug (Alpha Glucosidase Inhibitor)

Mechanism of Action (MOA)
DIABAY (Acarbose) is a competitive inhibitor of intestinal alpha-glucosidases with maximum specific inhibitory activity against sucrose. DIABAY also blocks the activity of pancreatic alpha amylase. DIABAY dose-dependently delays the digestion of starch and sucrose into absorbable monosaccharides in the small intestine.

Pharmacokinetics

  • Absorption : 35% is absorbed in the form of metabolites
  • Metabolism : By intestinal enzyme and by the microbial flora
  • Excretion : Urine and faeces

Indications and Dosage
As an adjunct to diet and exercise to improve glycaemic control in type II Diabetes Mellitus, and Polycystic Ovarian Syndrome (PCOS)

  • Diabetes Mellitus :
    • Initial dose : One tablet of DIABAY 25 mg three times a day with the first bite of each main meal.
    • Maximum dose :
      60 kg or less : One tablet of DIABAY 50 mg three times a day
      >60 kg : Two tablets of DIABAY 50 mg three times a day
  • PCOS : DIABAY 150 to 300 mg per day for 3 months

Side Effects
MOST COMMON : Flatulence, abdominal distension, diarrhoea, pain
REPORTED : Elevated liver transaminases
RARE : Ileus, skin reaction
VERY RARE : Edema

Contraindications
Diabetic ketoacidosis, cirrhosis, inflammatory bowel disease, colonic ulceration, partial intestinal obstruction or predisposition to it, chronic intestinal diseases with marked disorders of digestion or absorption, and conditions that may deteriorate from increased intestinal gas formation

Warnings / Precautions

  • Use oral glucose (dextrose) instead of sucrose (cane sugar) in treatment of mild to moderate hypoglycaemia.
  • Elevated serum transaminase levels, fulminant hepatitis, and hyperbilirubinemia reported. Reduce dose or discontinue if elevated serum transaminases persist.
  • A temporary loss of control of blood glucose may occur when exposed to stress; temporary insulin therapy may be necessary.
  • Pneumatosis cystoides intestinalis reported. Reduce dose temporarily or permanently if strongly distressing symptoms develop in spite of adherence to the diabetic diet.

Drug Interactions

  • Acarbose may inhibit the absorption of digoxin.
  • With other antidiabetics including insulin reduction in dose may be needed.
  • Gastrointestinal adsorbents and digestive enzyme preparations can diminish the effects of acarbose and should be avoided.
  • Neomycin and cholestyramine may enhance the effects of acarbose.
  • Closely observe for loss of blood glucose control with thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid.

Pregnancy Category : B

Presentations
DIABAY 25 mg : A box of 20 strips, each strip of 10 tablets
DIABAY 50 mg : A box of 10 strips, each strip of 10 tablets