Precose (acarbose) is an oral alpha-glucosidase inhibitor medication designed specifically for the management of type 2 diabetes. It functions by delaying the digestion of complex carbohydrates and disaccharides in the small intestine, thereby reducing the postprandial rise in blood glucose. This mechanism offers a targeted approach to glycemic control, particularly after meals, and is often used as part of a combination therapy regimen alongside diet, exercise, and other antidiabetic agents. By moderating carbohydrate absorption, Precose helps stabilize daily glucose fluctuations and supports long-term metabolic health.

Features

• Active ingredient: Acarbose 50mg or 100mg per tablet
• Drug class: Alpha-glucosidase inhibitor
• Administration: Oral tablet, taken with the first bite of each main meal
• Delays carbohydrate digestion in the small intestine
• Reduces postprandial hyperglycemia without stimulating insulin secretion
• Compatible with other antidiabetic medications including metformin, sulfonylureas, or insulin

Benefits

• Effectively lowers post-meal blood glucose spikes, contributing to improved daily glycemic stability
• May reduce HbA1c levels by 0.5%–1.0% when used as monotherapy or in combination
• Does not cause hypoglycemia when used alone; works locally in the GI tract with minimal systemic absorption
• May support modest weight maintenance or loss due to reduced carbohydrate absorption
• Low risk of lactic acidosis or significant drug-induced organ toxicity
• Provides a complementary mechanism of action to other antidiabetic agents, allowing for personalized treatment plans

Common use

Precose is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. It is particularly useful in individuals who experience significant postprandial hyperglycemia despite lifestyle modifications. It may be used as monotherapy or in combination with other oral antidiabetic agents or insulin when glycemic targets are not achieved with single-agent therapy. It is not indicated for type 1 diabetes or diabetic ketoacidosis.

Dosage and direction

The initial dosage of Precose is 25 mg taken orally three times daily at the start (with the first bite) of each main meal. The dosage may be increased gradually at 4–8 week intervals based on tolerability and therapeutic response. The maintenance dosage is typically 50 mg three times daily, though some patients may benefit from 100 mg three times daily. Maximum recommended dosage is 100 mg three times daily for patients weighing > 60 kg; for those ≤ 60 kg, maximum is 50 mg three times daily. Tablets should be swallowed whole with a little liquid, not chewed or crushed.

Precautions

Precose may cause gastrointestinal symptoms such as flatulence, diarrhea, and abdominal pain, especially during the initial treatment phase. These effects often diminish with continued use. Renal impairment requires dosage adjustment or avoidance—do not use if serum creatinine > 2 mg/dL. Not recommended in patients with significant hepatic impairment or inflammatory bowel disease. Periodic monitoring of liver enzymes is advised. Hypoglycemia may occur when used with other antidiabetic drugs; must be treated with glucose (not sucrose). Not suitable for patients under 18 years.

Contraindications

Precose is contraindicated in patients with known hypersensitivity to acarbose or any component of the formulation. It is also contraindicated in patients with diabetic ketoacidosis, cirrhosis, inflammatory bowel disease, colonic ulceration, or partial intestinal obstruction. Should not be used in patients with chronic intestinal diseases associated with marked disorders of digestion or absorption, or in conditions that may deteriorate as a result of increased gas formation in the intestine.

Possible side effects

The most common side effects are gastrointestinal, including flatulence (74%), diarrhea (31%), and abdominal pain (19%). These are dose-related and often decrease over time. Less common side effects may include elevated serum transaminases. Rare cases of ileus, jaundice, or hepatitis have been reported. Hypoglycemia may occur when used in combination with other antidiabetic drugs. Skin reactions such as rash or urticaria are uncommon.

Drug interaction

Precose may reduce the bioavailability of digoxin and propranolol. Digestive enzymes (e.g., amylase, pancreatin) may reduce the efficacy of acarbose and should not be used concurrently. Charcoal-containing preparations may decrease its effects. Thiazide diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid may reduce the hypoglycemic effect of acarbose.

Missed dose

If a dose is missed, it should be omitted if it is not taken with the meal. Do not take a double dose to make up for a missed one. Resume the regular dosing schedule with the next meal.

Overdose

An overdose of Precose alone is not expected to cause hypoglycemia. However, when taken in combination with sulfonylureas or insulin, hypoglycemia may occur. In case of overdose, monitor blood glucose and provide supportive care. Treat hypoglycemia with oral glucose (dextrose); sucrose (table sugar) may be ineffective due to inhibited digestion.

Storage

Store Precose tablets at room temperature (15°–30°C or 59°–86°F) in a dry place, protected from moisture. Keep in the original container tightly closed. Do not store in the bathroom or near sinks. Keep out of reach of children and pets.

Disclaimer

This information is intended for educational purposes and does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before starting or changing any medication regimen. Individual patient needs and responses may vary.

Reviews

Clinical studies and patient reports indicate that Precose is effective in reducing postprandial glucose levels, particularly in individuals who struggle with high readings after meals. Many users note improved day-to-day glucose stability, though gastrointestinal side effects are a common initial drawback. Physicians often value its unique mechanism and safety profile, especially in combination therapy. Long-term users frequently report that side effects diminish over time, making it a tolerable and useful option for targeted glycemic control.