Acarbose
Precose®
Precose®
Dosage forms
Tablet
- 25 mg
- 50 mg
- 100 mg
Dosing
Type two diabetes
- Starting: 25 mg three times a day with meals
- Maintenance: 50 - 100 mg three times a day with meals
- Max:
- ≤ 132 pounds (60 kg)
- 50 mg three times a day
- > 132 pounds (60 kg)
- 100 mg three times a day
- Increase dose at intervals of 4 - 8 weeks
- Patients who weigh < 132 pounds (60 kg) should not exceed 50 mg three times a day
- In some patients, a starting dose of 25 mg once daily with gradual increases may be desirable to prevent gastrointestinal side effects
- Take with the first bite of each main meal
Generic / Price
- YES/$
Miglitol
Glyset®
Glyset®
Dosage forms
Tablet
- 25 mg
- 50 mg
- 100 mg
Dosing
Type two diabetes
- Starting: 25 mg three times a day with meals
- Maintenance: 50 - 100 mg three times a day with meals
- Max: 100 mg three times a day with meals
- Increase dose at intervals of 4 - 8 weeks
- In some patients, a starting dose of 25 mg once daily with gradual increases may be desirable to prevent gastrointestinal side effects
- Take with the first bite of each main meal
Generic / Price
- YES/$$
- Kidney disease dosing
- Acarbose (Precose®)
- Acarbose blood levels are elevated in patients with kidney disease
- Acarbose should not be taken by patients with significant kidney disease [1]
- Miglitol (Glyset®)
- Miglitol blood levels are elevated in patients with kidney disease
- Patients with CrCl < 25 ml/min taking miglitol 25mg three times a day had a greater than two-fold increase in miglitol levels
- There is little information on the safety of miglitol in patients with significant kidney disease
- Miglitol should be avoided in patients with significant kidney disease [2]
- Liver disease dosing
- Acarbose (Precose®)
- Acarbose should not be taken by patients with cirrhosis [1]
- Miglitol (Glyset®)
- No dosage adjustment is necessary in liver disease [2]
DRUG INTERACTIONS
- NOTE: The drug interactions presented here are NOT all-inclusive. Other interactions may exist. Drug interaction checkers provide the most efficient and practical way to check for interactions among multiple medications. A free interaction checker is available from Drugs.com (see Drugs.com interactions checker).
- Acarbose and Miglitol
- Diabetes medications - when taken with other diabetes medications (particularly sulfonylureas, insulins, and meglitinides), the risk of hypoglycemia is increased. Use caution when first combining.
- Digoxin - Acarbose and miglitol have both been shown to decrease blood levels of digoxin. It is unclear if this interaction is clinically significant.
- Miglitol (Glyset®)
- Glyburide (DiaBeta®) - miglitol has been shown to decrease blood levels of glyburide. It is unclear if this interaction is clinically significant.
- Ranitidine (Zantac®) - miglitol has been shown to decrease blood levels of ranitidine by 60%
- Propranolol (Inderal®) - miglitol has been shown to decrease blood levels of propranolol by 40%.
- Metabolism and clearance
- Acarbose is metabolized in the small intestine, primarily by bacteria
- Miglitol is not metabolized
Pricing legend
- $ = 0 - $50
- $$ = $51 - $100
- $$$ = $101 - $150
- $$$$ = > $150
- Pricing based on one month of therapy at standard dosing in an adult
- Pricing based on information from GoodRX.com®
- Pricing may vary by region and availability
BIBLIOGRAPHY
- Manufacturer's package insert