Warfarin Institute of America
DEDICATED TO YOUR HEALTH SINCE 2000
ACARBOSE INTERACTION WITH WARFARIN (Coumadin, Jantoven)
Brand Name: Precose
Acarbose is used for the treatment of types I & II diabetes mellitus by influencing the metabolism and absorption of carbohydrates by inhibiting enzymes in the intestinal brush border and pancreatic amylase. Acarbose is not absorbed systemically. It is thought that the mechanism of the interaction is to cause an increase in warfarin (Coumadin, Jantoven) absorption. There is one case report found in the literature.
Case report: A 66 year-old man with a history of hypertension, coronary artery disease, diabetes mellitus, peripheral vascular disease, and below knee amputation was stable on 42.5 mg warfarin (Coumadin, Jantoven)/week X 10 months with an INR between 2.53 to 3.13. He began acarbose to help with his diabetes and his INR rose from 3.09 to 4.85 in two weeks. No other causative factors were found that might have been responsible for this response. Acarbose was discontinued and the INR returned to 2.84 in 14 days. No bleeding episode occurred.
In Mr. Lodwick's experience there are many patients who experience changes of this magnitude without any obvious explanation. Since this was reported seven years ago and there have not been other reports to substantiate this, I doubt that it is a significant cause of INR increases.
References:
Morreale AP, Janetzky K. Probable interaction of warfarin and acarbose. Am J Health-Syst Pharm 1997; 54: 1551-2.
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© 2001 Patricia Chuong. Used by permission.
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Last updated June 14, 2007