Acarbose
Complex oligosaccharide
Also known as: Precose · Glucobay · Prandase · Glucor · Glumida · Bay-g-5421 · Asucrose · Glicobase
Reviewed by the VetSheet Veterinary TeamUpdated Apr 5, 2026Evidence-based veterinary reference
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Dosing by species
🌎 NA — North America🌍 EU — Europe
Dogs
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| For dogs poorly controlled with insulin and dietary therapy when another reason for the poor control cannot be identified | Initially 12.5-25 mg total dose per dog PO with each meal. May increase dose after two weeks to 50 mg per dog and then to 100 mg per dog (in large dogs, >25 kg) if response has been inadequate. | PO | with each meal | — | 🌎 NA |
| Adjunctive glycemic control | 12.5-20 mg (total dose) per meal PO | PO | per meal | — | 🌎 NA |
- For dogs poorly controlled with insulin and dietary therapy when another reason for the poor control cannot be identified: Give only at the time of feeding. There is a greater chance of diarrhea at the higher dosages.
Cats
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Improve glycemic control and reduce insulin dependence | 12.5-25 mg (total dose) PO with meals. | PO | with meals | — | 🌎 NA |
| Reduce insulin dosage and thereby reduce hypoglycemia occurrence | 12.5 mg per cat PO twice daily with meals. | PO | twice daily | — | 🌎 NA |
| Adjunctive glycemic control | 12.5-20 mg (total dose) per meal PO | PO | per meal | — | 🌎 NA |
- Improve glycemic control and reduce insulin dependence: When acarbose is used with a low carbohydrate diet it may improve glycemic control and reduce insulin dependence.
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Overview
Acarbose is an oral antihyperglycemic agent used primarily as an adjunctive treatment for diabetes mellitus in dogs and cats.
- Primary Use: It reduces the rate and amount of glucose absorbed from the gastrointestinal tract after a meal, making it useful for mild reductions in blood glucose (typically in the 250-350 mg/dL range).
- Clinical Pearl: Acarbose is highly unlikely to provide adequate glycemic control when used as a sole therapy. It is best utilized in conjunction with dietary management (e.g., low-carbohydrate diets) and primary antihyperglycemic agents like insulin.
- Administration: Because its action depends on the presence of food in the gut, it must be given with meals (preferably right before) and is generally ineffective for animals fed ad libitum.
Mechanism of action
Acarbose acts locally within the gastrointestinal tract and does not stimulate insulin secretion.
- It competitively inhibits pancreatic alpha-amylase and intestinal brush-border alpha-glucosidases (such as sucrase, maltase, and isomaltase).
- Mechanism Pathway: Inhibition of these enzymes → delayed digestion of complex carbohydrates and disaccharides into absorbable monosaccharides → glucose is absorbed further down the GI tract at a slower rate → blunts the postprandial blood glucose spike → reduces overall insulin requirements.
- Note: Acarbose has no inhibitory effect on lactase.
Safety & warnings
Contraindications
- Underweight animals (may have deleterious effects on nutritional status)
- Known hypersensitivity to acarbose
- Diabetic ketoacidosis
- Inflammatory bowel disease
- Colonic ulceration
- Partial intestinal obstruction or predisposition to obstruction
- Chronic intestinal disease with marked disorders of digestion or absorption
- Conditions where excessive gas formation would be detrimental
Adverse effects
- Flatulence
- Soft stools
- Diarrhea (dose-dependent)
- Weight loss (reported in dogs)
- May contribute to hypoglycemia if used concurrently with other hypoglycemic agents (e.g., insulin)
Precautions
Important Precautions:
- Hepatic/Renal Impairment: Use with caution in patients with renal dysfunction or severe liver disease. Patients with severe renal dysfunction may attain serum levels approximately 5 times those of normal subjects.
- Pregnancy: Safety in pregnancy has not been established (FDA Category B in humans). Weigh potential risks versus benefits.
- Hypoglycemia Risk: While acarbose alone does not cause hypoglycemia, it can exacerbate it when used with insulin. If oral treatment for hypoglycemia is needed, use pure glucose (dextrose), NOT sucrose, as acarbose blocks the breakdown of sucrose.
Drug interactions
Intestinal adsorbents may reduce the efficacy of acarbose.
Acarbose may reduce digoxin blood concentrations.
May negate the antihyperglycemic effects of acarbose.
Exogenous enzyme formulations may reduce the efficacy of acarbose.
Monitoring
- Serum glucose concentrations
- Adverse GI effects (diarrhea, flatulence, weight loss)
- Serum aminotransferase levels (rarely elevated with long-term high-dose use)
Pharmacokinetics
Absorption
In dogs, about 4% of an oral dose is absorbed systemically. In humans, only about 2% is absorbed.
Metabolism
Practically all remaining drug in the gut is metabolized locally in the GI tract by intestinal bacteria.
Elimination
The small fraction of the drug that is absorbed systemically is excreted by the kidneys.
Overdose
Acute overdosages are likely to cause only diarrhea and flatulence. No specific treatment should be necessary for the GI upset.
Hypoglycemia Warning: Should acute hypoglycemia occur secondary to concurrent use of other antihypoglycemics (like insulin), parenteral glucose should be administered. If treating orally, you MUST use glucose/dextrose (do not use sucrose/table sugar, as acarbose prevents its breakdown and absorption).
Available products
Formulations
- Oral tablets
Human-labeled
- Acarbose Oral Tablets: 25 mg, 50 mg & 100 mg (Precose®, generic)
Regulatory status
No regulatory data for: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Storage & stability
Do not store tablets above 25°C (77°F); protect from moisture. Tablets may be split or crushed and mixed with food just prior to administration.
Client information
Acarbose helps control your pet's blood sugar by slowing down the digestion of carbohydrates in their food.
- Timing is crucial: Give this medication right before feeding for the best results. It will not work well if your pet grazes on food throughout the day.
- Side Effects: Diarrhea and/or excessive gas are the most likely side effects. Contact your veterinarian if these become serious or do not resolve.
- Low Blood Sugar (Hypoglycemia): Acarbose alone does not cause low blood sugar, but it can increase the risk if your pet is also receiving insulin. Watch closely for signs of low blood sugar: seizures (convulsions), collapse, rear leg weakness or paralysis, muscle twitching, unsteadiness, tiredness, or depression. If these occur, call your veterinarian immediately.
- Emergency Sugar: If your pet experiences low blood sugar and you need to give sugar by mouth, use corn syrup or pure glucose (like Karo syrup). Do NOT use regular table sugar (sucrose), as this medication stops table sugar from being absorbed.
- Patience: It may take up to two weeks for the drug to reach its peak effect in controlling blood sugar.
VetSheet drug reference is intended for licensed veterinary professionals as a clinical decision-support aid, not a substitute for professional judgement or the manufacturer’s current label.