Hepatotoxicity Associated with Acarbose Therapy

Hsiao, Shu Hwa; Liao, Lina; Cheng, Pin Nan; Wu, Ta Jen

doi:10.1345/aph.1g336

Cited by 64 publications

(39 citation statements)

References 16 publications

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“…However, it is advised that a combination of bedaquiline and other hepatotoxic drugs should be avoided. Therefore, special attention should be given to the concurrent use of bedaquiline and thiazolidinediones and acarbose, also known for their hepatotoxic potential 93,94…”

Section: Adverse Drug Reactionsmentioning

confidence: 99%

Use of bedaquiline and delamanid in diabetes patients: clinical and pharmacological considerations

Zheng

Gao

2016

DDDT

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Antituberculosis (anti-TB) treatment may be affected by both diabetes and hypoglycemic agents in patients with these 2 comorbidities. However, data supporting this conclusion relate only to standard anti-TB therapies. Sirturo® (bedaquiline) and Deltyba® (delamanid), novel drugs for multidrug-resistant tuberculosis (MDR-TB), are recommended for diabetes patients when another effective treatment regimen cannot be provided. Currently, there are no clinical data related to the use of these agents in diabetes patients. Possible alterations in the pharmacokinetics of these novel drugs induced by changes in subcutaneous adipose blood flow, gastric emptying, or nephropathy in diabetes patients, and possible drug–drug interactions with hypoglycemic agents, are of special interest, since the efficacy of bedaquiline and delamanid is concentration dependent. Moreover, it is of fundamental importance to avoid possible additive or synergistic effects of adverse drug reactions in this already vulnerable patient group. We reviewed clinical particularities related to the use of bedaquiline and delamanid in patients with type 1 and 2 diabetes mellitus (DM), as well as pharmacological aspects of the concurrent use of these agents with oral and injectable hypoglycemic agents. Bedaquiline shares liver metabolic pathways with several oral hypoglycemic agents, whereas delamanid may compete with several oral hypoglycemic agents and insulin analogs at protein-binding sites. Special concern exists regarding the use of bedaquiline and delamanid in diabetes patients aged >65 years and patients with severe renal or hepatic impairment or electrolyte disturbances. Concurrent use of bedaquiline and delamanid with insulin analogs, and other hypoglycemic agents that prolong the heart rate-corrected QT interval, such as sulfonylureas and glinides, may enhance this adverse reaction. Hepatic-related adverse reactions may develop more frequently when these drugs are combined with thiazolidinediones and acarbose. Data from Phase III and postmarketing studies are needed to elucidate the effect of DM and hypoglycemic agents on bedaquiline and delamanid effects in MDR-TB patients.

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Section: Adverse Drug Reactionsmentioning

confidence: 99%

Use of bedaquiline and delamanid in diabetes patients: clinical and pharmacological considerations

Zheng

Gao

2016

DDDT

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“…A case report described a patient with possible acarbose-induced hepatotoxicity and compared other reported cases from the literature [130].…”

Section: 4alpha-glucosidase Inhibitorsmentioning

confidence: 99%

Pharmacokinetic and toxicological considerations for the treatment of diabetes in patients with liver disease

Scheen

2014

Expert Opinion on Drug Metabolism & Toxicology

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“…Hepatotoxicity is a very rare adverse effect, which is reversible on discontinuation of the drug ( 67 ). The abdominal discomfort, increased borborygmi, and fl atulence are responsible for a very high rate of drug discontinuation.…”

Section: Alpha-glucosidase Inhibitorsmentioning

confidence: 99%

2. Pharmacological Treatment of Type 2 Diabetes: Advantages and Dilemmas

Prato¹

2012

Translational Endocrinology &Amp; Metabolism: Metabolic Surgery Update

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Hepatotoxicity Associated with Acarbose Therapy

Abstract: Although acarbose-induced hepatotoxicity appears to be uncommon, diabetic patients receiving long-term acarbose therapy should be closely monitored for this adverse effect.

Cited by 64 publications

References 16 publications

Use of bedaquiline and delamanid in diabetes patients: clinical and pharmacological considerations

Use of bedaquiline and delamanid in diabetes patients: clinical and pharmacological considerations

Pharmacokinetic and toxicological considerations for the treatment of diabetes in patients with liver disease

2. Pharmacological Treatment of Type 2 Diabetes: Advantages and Dilemmas

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