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Acarbose vs Metformin: What Studies Say

<p>Acarbose vs Metformin: What Studies Say</p>
Dr. Constance Odom, MD Picture of Dr. Constance Odom, MD

Medically reviewed by

Written by our editorial team.

Last Edited 6 min read

When it comes to finding the right drug for diabetes, the name, Metformin, often comes to mind. Acarbose, a medication for type 2 diabetes mellitus, has also grown in popularity. However, studies have drawn accurate conclusions about their effectiveness.

According to PubMed, the effectiveness of Metformin as a monotherapy is the same as the effectiveness of Acarbose. When compared, both of these drugs lower glucose levels at the same level. However, research has found that Metformin is slightly more effective. It is a popular drug, and is often the first drug prescribed for diabetes.

As a first line of treatment, Metformin is effective when used alone. However, experts say it is unsafe to take Metformin alongside a number of other drugs. Doing so can increase your risk of developing lactic acidosis. You should not take Metformin if you take acetazolamide, topiramate, or zonisamide.

Taking acetazolamide increases your risk of lactic acidosis. Topiramate is also known to interact with a number of other drugs, which include:

  • Alfentanil

  • Benzhydrocodone

  • Bromazepam

  • Butorphanol

  • Buprenorphine

But what about Metformin? How does it compare to Acarbose? According to experts, Metformin and Acarbose are relatively comparable, but Metformin is “at least as effective” as Acarbose. Acarbose is used widely in China. A study carried out in 2015 found that both of these drugs produce the same effects.

A total of 75 studies reached the same conclusion. Eight clinical trials found that Metformin lowered glycosylated hemoglobin (HbA1c) 0.06 percent times more than Acarbose. No notable differences were found between these medications. The study, which used sulphonylureas and placebos, found that Metformin significantly reduced HbA1c levels when compared to acarbose.

Of course, you can’t always depend on medication alone to treat diabetes. For Metformin to be effective, it is important to combine it with regular exercise and a healthy diet. It is also important to get proper medical care on a regular basis. How you take care of yourself also impacts the effect of Metformin on your body.

Metformin is one of the first drugs recommended to be taken alongside other medications. In addition to treating diabetes and facilitating weight loss, Metformin has been found to have positive effects on the brain. Patients who take Metformin typically have a slower rate of cognitive decline as they age. 

Patients on Metformin also take a longer period of time before they experience problems, such as stroke. Those who do not take Metformin usually develop these problems at a faster rate than those who don’t take Metformin. Metformin may slow the aging process, making it less likely that you will develop diseases that are brought on by age. In this respect, Metformin has become a wonder drug. Studies have also found that Metformin may prolong your lifespan. Metformin is approved to treat type 2 diabetes in the United States, and many people have become interested in this drug, because of its phenomenal abilities.

According to experts, Metformin can relieve pain, prevent and treat cancer, and prevent you from developing cardiovascular disease. Metformin’s history technically dates back hundreds of years. The herb, Galega officinalis, was once used to treat urinary problems, digestive issues, and many other problems. In 1918, a scientist found that one of this herb’s ingredients could lower blood sugar.

But what about Acarbose? How is it different?

While Metformin has been found slightly more effective in treating diabetes, acarbose is more effective than Metformin in facilitating weight loss. One study found that, on average, Acarbose helps patients lose 0.52 kilograms. That equates to roughly one and a half pounds, when compared to its competitors. 

However, there is evidence that Acarbose can cause constipation, rectal bleeding, mucus discharge, and diarrhea. If you experience any of these side effects, contact your doctor immediately. Other warnings exist about Acarbose. According to experts, Acarbose can cause Pneumatosis cystoides intestinalis. These are cysts that are filled with gas and attach to your intestinal walls.

With Acarbose, there is also the potential for liver problems. Acarbose can damage your liver and produces a number of symptoms. You may, for example, feel pain in the upper right section of your stomach, or you may experience stomach swelling or “yellowing” of your eyes or skin. 

In the event that these symptoms arise, you should contact your doctor immediately. Unfortunately, these are not the only problems Acarbose can cause. Additionally, there is a potential to develop an allergic skin reaction. According to Healthline, Acarbose can cause your skin to swell and become red. 

Acarbose has also been found to cause rashes. However, there is good news. There are ways to control the side effects of Acarbose. However, you need to ask yourself if the benefits of this drug outweigh the risks. According to the Mayo Clinic, you can minimize your chances of developing these symptoms by doing a number of things.

In some cases, Acarbose can produce symptoms of low blood sugar. If this happens, eat honey and glucose tablets or gel. It may also help to drink fruit juice to alleviate symptoms. However, sodas do not counteract the negative side effects of Acarbose. If you are unsure if this drug is good for you, discussing it with your doctor can help.

Studies on Acarbose have only been conducted on adult patients, so there is no documented evidence about the drug’s effect on children. The effects of this drug on patients of other ages have not yet been established. Elderly patients on Acarbose have been studied, and studies have found no solid evidence that the aging population is affected differently by this medication.

Acarbose should not be taken with a number of medications, including the following:

  • Aspirin

  • Chlorpropamide

  • Grepafloxacin

  • Sitagliptin

  • Tolbutamide

While experts don’t recommend mixing Acarbose with these medications, there may be situations where it is necessary. If you must take one of these medications with Acarbose, your doctor may modify your dosage or change how often you take these medications. 

While it may seem like Acarbose comes with only serious side effects, it does have some benefits. Acarbose comes in tablet form. Acarbose comes in generic form as well. While the generic form is less expensive, it does not come in the same form or strength as the brand name version. Because of this, you may have to pay more to get the dosage you want.

Although it has interactions with a number of other drugs, Acarbose can be taken in conjunction with other prescription medications. Acarbose comes from a class of drugs called alpha-glucosidase inhibitors. 

Metformin comes from a biguanide class of drugs. Biguanides are often prescribed and stop hepatic glucose production in the body. They also increase the uptake of peripheral glucose and can lower cholesterol levels. If you are trying to make a decision about which of these drugs you should take, it helps to know the cons of Metformin as well.

According to experts, Metformin can cause a metallic taste in your mouth, weakness, diarrhea, upset stomach, and nausea. Vomiting has also been reported in studies. Studies assert that upset stomach and diarrhea are the most common side effects of Metformin. This side effect is believed to subside over time.

Hypoglycemia and a Vitamin B12 deficiency are also potential side effects of Metformin. Metformin also comes with some serious side effects. Because there is a potential for lactic acidosis, it helps to know the symptoms of this condition. Symptoms of this condition include cold skin with a bluish tint, muscle pain, dizziness, nausea, and fast breathing. It is possible to have trouble breathing with this condition. 

Lactic acidosis develops when an overabundance of acid builds up in your blood. It helps to know other causes of lactic acidosis, should you develop it when taking one or both of these medications. Intense exercise has been found to cause lactic acidosis. When you exercise, your body breaks down glucose to get energy. 

When you exercise, you might not get enough oxygen for glucose to break down. As a result, lactic acid builds up to the point that your body can no longer keep up and burn glucose. Then, there comes a point where the body can no longer handle the excess amount of lactic acid in your body.  

However, a number of other conditions can lead to lactic acidosis. These include seizures, cancer, liver failure, or sepsis. Sepsis is a condition that causes inflammation of the entire body. Shock can also lead to lactic acidosis. 

While both Metformin and Acarbose have side effects and risks, it appears that Metformin is the clear winner in terms of safety and effectiveness. Acarbose is not used in patients with conditions, such as diabetic ketoacidosis, hypersensitivity, and colonic ulceration. Individuals with inflammatory bowel disease should not take Acarbose, experts say.

There may be cases where Metformin is combined with Acarbose. Roughly 1,500 studies were carried out on the use of these medications, and results found that patients who received treatment between two weeks and six months saw favorable results. Studies have found that patients who take these drugs in tandem typically see measurable results after three months of therapy. 



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This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your physician about the risks and benefits of any treatment. Nu Image Medical may not offer the medications or services mentioned in this article.