Details of the Drug

General Information of Drug (ID: DMRM3AW)

• Drug Name: Acarbose
• Synonyms: acarbose; 56180-94-0; Glucobay; Precose; Prandase; C25H43NO18; CHEBI:2376; CHEMBL3734896; BAY-g 5421; 4,6-dideoxy-4-{[(1S,4R,5S,6S)-4,5,6-trihydroxy-3-(hydroxymethyl)cyclohex-2-en-1-yl]amino}-alpha-D-glucopyranosyl-(1->4)-alpha-D-glucopyranosyl-(1->4)-D-glucopyranose; SMR000466376; SR-01000759407; Acarbose/; Acarbose [USAN:BAN:INN:JAN]; Acarbose,(S); Precose (TN); AC1L26GM; Acarbose (JAN/USAN/INN); MLS006011898; MLS000759506; MLS001424056; SPECTRUM1505172; SCHEMBL5316305; CHEMBL404271; BDBM23406; MolPort-002-507-369

Indication

Disease Entry	ICD 11	Status	REF
Diabetic complication	5A2Y	Approved	[1]
Non-insulin dependent diabetes	5A11	Approved	[2]
Cardiovascular disease	BA00-BE2Z	Phase 3	[1]

• Therapeutic Class: Hypoglycemic Agents
• Drug Type: Small molecular drug
• #Ro5 Violations (Lipinski): 4:
  Molecular Weight (mw); 645.6
  Logarithm of the Partition Coefficient (xlogp); -8.5
  Rotatable Bond Count (rotbonds); 9
  Hydrogen Bond Donor Count (hbonddonor); 14
  Hydrogen Bond Acceptor Count (hbondacc); 19
• ADMET Property:
  BDDCS Class: Biopharmaceutics Drug Disposition Classification System (BDDCS) Class 1: high solubility and high permeability [3]
  Clearance: The drug present in the plasma can be removed from the body at the rate of 2.2 mL/min/kg [4]
  Elimination: What little drug material is absorbed into the systemic circulation (approximately 34% of an orally administered dose) is excreted primarily by the kidneys, suggesting renal excretion would be a significant route of elimination if the parent drug was more readily absorbed - this is further supported by data in which approximately 89% of an intravenously administered dose of acarbose was excreted in the urine as active drug (in comparison to <2% following oral administration) within 48 hours [5]
  Half-life: The concentration or amount of drug in body reduced by one-half in 2 hours [6]
  Metabolism: The drug is metabolized via the intestinal bacteria and to a lesser extent by digestive enzymes [6]
  MRTD: The Maximum Recommended Therapeutic Dose (MRTD) of drug that ensured maximising efficacy and moderate side effect is 6.63816 micromolar/kg/day [7]
  Vd: Fluid volume that would be required to contain the amount of drug present in the body at the same concentration as in the plasma 0.32 L/kg [4]
• Chemical Identifiers:
  Formula: C25H43NO18
  IUPAC Name: (3R,4R,5S,6R)-5-[(2R,3R,4R,5S,6R)-5-[(2R,3R,4S,5S,6R)-3,4-dihydroxy-6-methyl-5-[[(1S,4R,5S,6S)-4,5,6-trihydroxy-3-(hydroxymethyl)cyclohex-2-en-1-yl]amino]oxan-2-yl]oxy-3,4-dihydroxy-6-(hydroxymethyl)oxan-2-yl]oxy-6-(hydroxymethyl)oxane-2,3,4-triol
  Canonical SMILES: C[C@@H]1[C@H]([C@@H]([C@H]([C@H](O1)O[C@@H]2[C@H](O[C@@H]([C@@H]([C@H]2O)O)O[C@@H]3[C@H](OC([C@@H]([C@H]3O)O)O)CO)CO)O)O)N[C@H]4C=C([C@H]([C@@H]([C@H]4O)O)O)CO
  InChI: InChI=1S/C25H43NO18/c1-6-11(26-8-2-7(3-27)12(30)15(33)13(8)31)14(32)19(37)24(40-6)43-22-10(5-29)42-25(20(38)17(22)35)44-21-9(4-28)41-23(39)18(36)16(21)34/h2,6,8-39H,3-5H2,1H3/t6-,8+,9-,10-,11-,12-,13+,14+,15+,16-,17-,18-,19-,20-,21-,22-,23?,24-,25-/m1/s1
  InChIKey: XUFXOAAUWZOOIT-UGEKTDRHSA-N
• Cross-matching ID:
  PubChem CID: 41774
  ChEBI ID: CHEBI:2376
  CAS Number: 56180-94-0
  DrugBank ID: DB00284
  TTD ID: D0AD5C
  VARIDT ID: DR00978
  ACDINA ID: D00007
• Repurposed Drugs (RPD): Click to Jump to the Detailed RPD Information of This Drug

Molecular Interaction Atlas of This Drug

Drug Therapeutic Target (DTT)

DTT Name	DTT ID	UniProt ID	MOA	REF
Intestinal maltase-glucoamylase (MGAM)	TTXWASR	MGA_HUMAN	Modulator	[8]

Molecular Expression Atlas of This Drug

• The Studied Disease: Diabetic complication
• ICD Disease Classification: 5A2Y

Molecule Name	Molecule Type	Gene Name	p-value	Fold-Change	Z-score
Intestinal maltase-glucoamylase (MGAM)	DTT	MGAM	4.59E-01	-0.02	-0.24

Drug-Drug Interaction (DDI) Information of This Drug

Coadministration of a Drug Treating the Disease Different from Acarbose (Comorbidity)

DDI Drug Name	DDI Drug ID	Severity	Mechanism	Comorbidity	REF
Remdesivir	DMBFZ6L	Moderate	Increased risk of hepatotoxicity by the combination of Acarbose and Remdesivir.	1D6YCoronavirus Disease 2019 [1D6YCoronavirus Disease 2019]	[9]
Thioguanine	DM7NKEV	Moderate	Increased risk of hepatotoxicity by the combination of Acarbose and Thioguanine.	Acute myeloid leukaemia [2A60]	[10]
Clarithromycin	DM4M1SG	Moderate	Decreased metabolism of Acarbose caused by Clarithromycin mediated inhibition of CYP450 enzyme.	Bacterial infection [1A00-1C4Z]	[11]
Pexidartinib	DMS2J0Z	Major	Increased risk of hepatotoxicity by the combination of Acarbose and Pexidartinib.	Bone/articular cartilage neoplasm [2F7B]	[12]
Cannabidiol	DM0659E	Moderate	Increased risk of hepatotoxicity by the combination of Acarbose and Cannabidiol.	Epileptic encephalopathy [8A62]	[13]
Digoxin	DMQCTIH	Moderate	Decreased absorption of Acarbose due to adsorption of Digoxin.	Heart failure [BD10-BD1Z]	[14]
Digitoxin	DMWVIGP	Moderate	Decreased absorption of Acarbose due to adsorption of Digitoxin.	Heart failure [BD10-BD1Z]	[14]
Brentuximab vedotin	DMWLC57	Moderate	Increased risk of hepatotoxicity by the combination of Acarbose and Brentuximab vedotin.	Hodgkin lymphoma [2B30]	[15]
Efavirenz	DMC0GSJ	Moderate	Increased risk of hepatotoxicity by the combination of Acarbose and Efavirenz.	Human immunodeficiency virus disease [1C60-1C62]	[16]
Mipomersen	DMGSRN1	Major	Increased risk of hepatotoxicity by the combination of Acarbose and Mipomersen.	Hyper-lipoproteinaemia [5C80]	[17]
Teriflunomide	DMQ2FKJ	Major	Increased risk of hepatotoxicity by the combination of Acarbose and Teriflunomide.	Hyper-lipoproteinaemia [5C80]	[18]
BMS-201038	DMQTAGO	Major	Increased risk of hepatotoxicity by the combination of Acarbose and BMS-201038.	Hyper-lipoproteinaemia [5C80]	[19]
Methotrexate	DM2TEOL	Moderate	Increased risk of hepatotoxicity by the combination of Acarbose and Methotrexate.	Leukaemia [2A60-2B33]	[13]
Idelalisib	DM602WT	Moderate	Increased risk of hepatotoxicity by the combination of Acarbose and Idelalisib.	Mature B-cell leukaemia [2A82]	[20]
Clofarabine	DMCVJ86	Moderate	Increased risk of hepatotoxicity by the combination of Acarbose and Clofarabine.	Mature B-cell lymphoma [2A85]	[21]
Gatifloxacin	DMSL679	Major	Antagonize the effect of Acarbose when combined with Gatifloxacin.	Respiratory infection [CA07-CA4Z]	[22]
Leflunomide	DMR8ONJ	Major	Increased risk of hepatotoxicity by the combination of Acarbose and Leflunomide.	Rheumatoid arthritis [FA20]	[18]
Trabectedin	DMG3Y89	Moderate	Increased risk of hepatotoxicity by the combination of Acarbose and Trabectedin.	Solid tumour/cancer [2A00-2F9Z]	[13]
Epirubicin	DMPDW6T	Moderate	Increased risk of hepatotoxicity by the combination of Acarbose and Epirubicin.	Solid tumour/cancer [2A00-2F9Z]	[9]
Naltrexone	DMUL45H	Moderate	Increased risk of hepatotoxicity by the combination of Acarbose and Naltrexone.	Substance abuse [6C40]	[23]
Albiglutide	DM1JEGF	Minor	Altered absorption of Acarbose due to GI dynamics variation caused by Albiglutide.	Type 2 diabetes mellitus [5A11]	[24]
Metformin	DM89QE1	Minor	Altered absorption of Acarbose due to GI dynamics variation caused by Metformin.	Type 2 diabetes mellitus [5A11]	[25]
Pramlintide	DM0EZ9Q	Moderate	Altered absorption of Acarbose due to GI dynamics variation caused by Pramlintide.	Type-1/2 diabete [5A10-5A11]	[26]

Drug Inactive Ingredient(s) (DIG) and Formulation(s) of This Drug

DIG

DIG Name	DIG ID	PubChem CID	Functional Classification
Carmellose sodium	E00625	Not Available	Disintegrant
Magnesium stearate	E00208	11177	lubricant
Silicon dioxide	E00670	Not Available	Anticaking agent; Opacifying agent; Viscosity-controlling agent

Pharmaceutical Formulation

Formulation Name	Drug Dosage	Dosage Form	Route
Acarbose 100 mg tablet	100 mg	Oral Tablet	Oral
Acarbose 25 mg tablet	25 mg	Oral Tablet	Oral
Acarbose 50 mg tablet	50 mg	Oral Tablet	Oral

Jump to Detail Pharmaceutical Formulation Page of This Drug

References

• [1] URL: http://www.guidetopharmacology.org Nucleic Acids Res. 2015 Oct 12. pii: gkv1037. The IUPHAR/BPS Guide to PHARMACOLOGY in 2016: towards curated quantitative interactions between 1300 protein targets and 6000 ligands. (Ligand id: 6791).
• [2] Acarbose FDA Label
• [3] BDDCS applied to over 900 drugs
• [4] Trend Analysis of a Database of Intravenous Pharmacokinetic Parameters in Humans for 1352 Drug Compounds
• [5] Health Canada Product Monograph: Acarbose oral tablets
• [6] DailyMed: Acarbose oral tablets
• [7] Estimating the safe starting dose in phase I clinical trials and no observed effect level based on QSAR modeling of the human maximum recommended daily dose
• [8] Drugs@FDA. U.S. Food and Drug Administration. U.S. Department of Health & Human Services.
• [9] Cerner Multum, Inc. "Australian Product Information.".
• [10] Product Information. Aubagio (teriflunomide). Genzyme Corporation, Cambridge, MA.
• [11] Bussing R, Gende A "Severe hypoglycemia from clarithromycin-sulfonylurea drug interaction." Diabetes Care 25 (2002): 1659-61. [PMID: 12196446]
• [12] Product Information. Turalio (pexidartinib). Daiichi Sankyo, Inc., Parsippany, NJ.
• [13] Cerner Multum, Inc. "UK Summary of Product Characteristics.".
• [14] Product Information. Precose (acarbose). Bayer, West Haven, CT.
• [15] Product Information. Adcetris (brentuximab vedotin). Seattle Genetics Inc, Bothell, WA.
• [16] Elsharkawy AM, Schwab U, McCarron B, et al. "Efavirenz induced acute liver failure requiring liver transplantation in a slow drug metaboliser." J Clin Virol 58 (2013): 331-3. [PMID: 23763943]
• [17] Product Information. Kynamro (mipomersen). Genzyme Corporation, Cambridge, MA.
• [18] Canadian Pharmacists Association.
• [19] Product Information. Juxtapid (lomitapide). Aegerion Pharmaceuticals Inc, Cambridge, MA.
• [20] Product Information. Zydelig (idelalisib). Gilead Sciences, Foster City, CA.
• [21] Product Information. Clolar (clofarabine). sanofi-aventis, Bridgewater, NJ.
• [22] Greenberg AL, Decerbo M, Fan J "Gatifloxacin therapy associated with hypoglycemia." Clin Infect Dis 40 (2005): 1210-1. [PMID: 15791528]
• [23] Product Information. ReVia (naltrexone). DuPont Pharmaceuticals, Wilmington, DE.
• [24] EMEA. European Medicines Agency "EPARs. European Union Public Assessment Reports.".
• [25] Scheen AJ, de Magalhaes AC, Salvatore T, Lefebvre PJ "Reduction of the acute bioavailability of metformin by the a-glucosidase inhibitor acarbose in normal man." Eur J Clin Invest 24 Suppl 3 (1994): 50-4. [PMID: 7818725]
• [26] Product Information. Symlin (pramlintide). Amphastar Pharmaceuticals Inc, South El Monte, CA.