アカルボース
Acarbose
Complex oligosaccharide
別名: Precose · Glucobay · Prandase · Glucor · Glumida · Bay-g-5421 · Asucrose · Glicobase
VetSheet 獣医チームが監修更新日 2026年4月5日エビデンスに基づく獣医学リファレンス
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
動物種別用量
🌎 NA — North America🌍 EU — Europe
犬
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| 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.
猫
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| 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.
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
概要
アカルボースは、犬や猫の糖尿病の補助治療として主に使用される経口抗高血糖薬です。食後の腸管からのグルコース吸収速度と量を減少させます。単独療法としては効果が薄いため、通常はインスリンや食事療法と併用されます。
作用機序
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.
安全性・警告
禁忌
- 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
有害事象
- 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)
注意事項
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.
医薬品相互作用
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.
監視
- Serum glucose concentrations
- Adverse GI effects (diarrhea, flatulence, weight loss)
- Serum aminotransferase levels (rarely elevated with long-term high-dose use)
薬物動態
吸収
In dogs, about 4% of an oral dose is absorbed systemically. In humans, only about 2% is absorbed.
代謝
Practically all remaining drug in the gut is metabolized locally in the GI tract by intestinal bacteria.
消失
The small fraction of the drug that is absorbed systemically is excreted by the kidneys.
過剰投与
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).
製品
製剤
- Oral tablets
ヒト用医薬品
- Acarbose Oral Tablets: 25 mg, 50 mg & 100 mg (Precose®, generic)
規制ステータス
規制データなし: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
保管・安定性
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.
飼主向け情報
最も効果を得るために、食事の直前に投与してください。最も一般的な副作用は下痢やガス（放屁）です。アカルボース単独で低血糖を引き起こすことはありませんが、インスリンと併用すると低血糖のリスクが高まる可能性があります。発作、虚脱、後肢の衰弱などの低血糖の兆候に注意してください。緊急時に糖分を与える場合は、コーンシロップやブドウ糖を使用し、普通の砂糖（ショ糖）は使用しないでください（この薬が砂糖の吸収を妨げるため）。効果が最大になるまで最大2週間かかる場合があります。
VetSheet医薬品リファレンスは獣医専門家の臨床意思決定支援を目的としており、専門的判断または製造業者の最新医薬品情報の代替にはなりません。