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This medication comes with several important safety warnings and contraindications. It is crucial to familiarize yourself with them and discuss any concerns with your healthcare provider.

• Risk of Low Blood Sugar: When combined with other diabetes medications like insulin or sulfonylureas, acarbose may cause dangerously low blood sugar levels. Symptoms include a rapid heartbeat, sweating, pale skin, shakiness, confusion, and irritability. Always have glucose tablets handy, as sucrose is ineffective for quick blood sugar correction in this situation.

• Liver Function Changes: Some patients on acarbose have experienced changes in liver function tests, which typically normalize after discontinuation. Regular monitoring through lab tests is essential. Seek immediate medical attention if you notice symptoms such as nausea, stomach pain, clay-colored stools, or yellowing of the skin or eyes, as these may indicate liver issues. Women and those on higher doses are at increased risk.

• Blood Sugar Control Loss: Acarbose might eventually become ineffective in controlling blood sugar, especially during stress from fever, trauma, infection, or surgery. In such cases, a switch to insulin may be necessary. Regular blood sugar monitoring and adherence to follow-up appointments are critical.

Contraindications:

Avoid using this medication if you have any of the following conditions, as it could lead to severe health complications:

• Diabetic ketoacidosis
• Liver damage, such as cirrhosis
• Inflammatory bowel disease
• Colon ulcers
• Intestinal blockages
• Digestive or absorption disorders
• Conditions aggravated by excessive intestinal gas

Consult your healthcare provider if any of these contraindications apply to you.

When taking Precose (acarbose), it's important to be aware of potential interactions with other medications and substances that can affect its effectiveness or your blood sugar levels.

Medications That May Increase Blood Sugar Levels:

Certain drugs can raise blood glucose, potentially reducing the effectiveness of Precose. These include:

• Diuretics (e.g., thiazides)
• Corticosteroids
• Phenothiazines
• Thyroid products
• Estrogens and oral contraceptives
• Phenytoin
• Nicotinic acid
• Sympathomimetics
• Calcium channel blockers
• Isoniazid

If you're prescribed any of these while on Precose, your doctor may need to monitor your blood sugar more closely and adjust your treatment plan accordingly.

Medications That May Lower Blood Sugar Levels:

Combining Precose with other diabetes medications like sulfonylureas or insulin can further lower blood glucose, increasing the risk of hypoglycemia (low blood sugar). If you experience symptoms like dizziness, sweating, or confusion, contact your healthcare provider. They may need to adjust the dosages of your medications to maintain balanced blood sugar levels.

Substances That May Reduce Precose's Effectiveness:

Some substances can interfere with how Precose works:

• Intestinal adsorbents (e.g., charcoal)
• Digestive enzyme supplements containing amylase or pancreatin

It's advisable to avoid taking these at the same time as Precose to ensure it works properly.

Interaction with Digoxin:

Precose can alter the absorption of digoxin, a medication used for heart conditions. If you're taking both, your doctor might need to adjust your digoxin dose and monitor its levels in your blood.

Alcohol Consumption:

Alcohol can unpredictably affect blood sugar levels, leading to either hypoglycemia or hyperglycemia. If you have diabetes, it's best to limit alcohol intake and avoid drinking on an empty stomach or after exercise to reduce the risk of low blood sugar episodes.

Always inform your healthcare provider about all medications, supplements, and substances you're using to manage potential interactions effectively.