Comprehensive medication guide to Acarbose including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$5–$15 copay for generic acarbose; Tier 2 on most commercial and Medicare Part D plans. Quantity limits may apply. Prior authorization is generally not required.
Estimated Cash Pricing
$50–$90 retail for generic acarbose (30-day supply); as low as $19–$27 with GoodRx or SingleCare coupons. Walmart's generic program may offer it for $4–$10 per month.
Medfinder Findability Score
82/100
Summarize with AI
On this page
Acarbose is an oral prescription medication in the drug class known as alpha-glucosidase inhibitors, used as an adjunct to diet and exercise to improve blood sugar control in adults with type 2 diabetes mellitus. The brand-name version, Precose (manufactured by Bayer), has been discontinued; only generic acarbose is available as of 2026.
Unlike many diabetes medications that work systemically, acarbose acts locally in the gut. It inhibits enzymes that break down complex carbohydrates into absorbable sugars, slowing the rise in blood glucose after meals. It does not stimulate insulin secretion and rarely causes hypoglycemia when used alone.
Acarbose is available in three strengths: 25 mg, 50 mg, and 100 mg tablets, taken three times daily with the first bite of each main meal. It is not a controlled substance and can be prescribed by any licensed healthcare provider.
We have a 99% success rate finding medications, even during nationwide shortages.
Need this medication?
Acarbose works through competitive, reversible inhibition of pancreatic alpha-amylase and membrane-bound intestinal alpha-glucosidase enzymes (including sucrase, maltase, glucoamylase, and isomaltase). These enzymes are responsible for breaking down complex carbohydrates — starches, oligosaccharides, and disaccharides — into simple absorbable sugars in the small intestine.
By blocking these enzymes when taken with a meal, acarbose slows the conversion of dietary carbohydrates into glucose. This delays and reduces postprandial glucose absorption, resulting in a blunted post-meal blood sugar spike. Undigested carbohydrates pass to the colon, where gut bacteria ferment them — this fermentation is the cause of acarbose's common GI side effects (gas, bloating, diarrhea).
Less than 2% of an oral dose is absorbed as active drug; acarbose works almost entirely in the gut. It does not stimulate insulin secretion, does not act on the liver or kidneys, and has an additive effect when combined with metformin, sulfonylureas, or insulin. Clinical studies show acarbose reduces postprandial glucose by approximately 50 mg/dL and lowers A1C by about 0.7–1.0%.
25 mg — tablet
Starting dose; taken three times daily with the first bite of each main meal
50 mg — tablet
Common maintenance dose; titrate from 25 mg after 4-8 weeks based on response and tolerability
100 mg — tablet
Maximum maintenance dose; typically for patients >60 kg body weight who need further glycemic control
Acarbose is not on the FDA's official drug shortage list in 2026. The drug is available in the national supply chain and is manufactured by multiple generic companies. However, many local pharmacies do not keep it consistently on their shelves due to its relatively low prescribing volume compared to first-line diabetes medications like metformin or GLP-1 receptor agonists.
Large chain pharmacies (Walmart, CVS, Walgreens, Costco) are most likely to stock all three strengths (25 mg, 50 mg, 100 mg). Smaller or independent pharmacies may need to special-order acarbose, adding 1–2 business days to the wait. Mail-order pharmacies are the most reliable option for patients on a stable long-term dose, as they maintain broad generic inventories.
If you're struggling to find acarbose at your pharmacy, medfinder calls pharmacies near you to locate which ones have your specific strength in stock, and texts you the results — so you can skip the hold music and go straight to the right pharmacy.
Because acarbose is not a controlled substance, any licensed prescriber with prescribing authority can write a prescription for it — no DEA registration or special licensing is required. It can be initiated and maintained by:
Primary care physicians (family medicine, internal medicine)
Endocrinologists and diabetes specialists
Geriatricians
Nurse practitioners (NPs) — full prescribing authority in most states
Physician assistants (PAs) — prescribing authority in all 50 states
Bariatric surgery teams (for post-gastric bypass hypoglycemia, off-label)
Telehealth providers can prescribe acarbose in most U.S. states during a virtual visit. Platforms such as Teladoc, MDLive, and Amazon Clinic offer diabetes management consultations. Patients should provide their A1C results, current medication list, and any relevant lab work (kidney function, liver enzymes) for the visit.
No. Acarbose is not a controlled substance. It has no DEA schedule and is not subject to the prescribing, dispensing, or refill restrictions that apply to controlled medications like stimulants, opioids, or benzodiazepines.
Any licensed prescriber — including primary care physicians, internists, endocrinologists, nurse practitioners, and physician assistants — can prescribe acarbose without any special DEA authorization. It can also be prescribed via telehealth in most U.S. states. Prescriptions may be written with up to 12 months of refills, and prior authorization is generally not required for coverage.
The most common side effects of acarbose are gastrointestinal, caused by the mechanism of action itself (undigested carbohydrates fermenting in the colon):
Flatulence (gas) — occurring in up to 74% of patients
Diarrhea — occurring in up to 31% of patients
Abdominal pain or cramping — occurring in up to 19% of patients
Serious side effects (rare):
Elevated liver enzymes / hepatotoxicity — monitor LFTs every 3 months in the first year
Pneumatosis cystoides intestinalis (gas-filled intestinal cysts) — very rare; discontinue and seek imaging if suspected
Severe allergic reaction — seek emergency care for hives, swelling, difficulty breathing
Note: If hypoglycemia occurs (when acarbose is combined with insulin or sulfonylureas), treat with dextrose/glucose — NOT sucrose/table sugar. Acarbose inhibits sucrose absorption.
Know what you need? Skip the search.
Miglitol (Glyset)
Same drug class (alpha-glucosidase inhibitor); most clinically similar to acarbose; also targets postprandial glucose. May also have limited pharmacy stock.
Metformin (Glucophage)
First-line oral diabetes drug; reduces hepatic glucose production and improves insulin sensitivity. Very affordable generic, widely stocked at all pharmacies. Different mechanism from acarbose.
Sitagliptin (Januvia)
DPP-4 inhibitor; weight-neutral, low hypoglycemia risk, good postprandial glucose control. Once-daily dosing. Widely available but more expensive without insurance.
Empagliflozin (Jardiance)
SGLT2 inhibitor with proven cardiovascular and kidney protection. Once-daily oral. Widely stocked. Preferred by 2026 ADA and AACE guidelines for patients with CVD or CKD.
Prefer Acarbose? We can find it.
Insulin
majorAdditive blood sugar-lowering effect. Monitor closely; insulin dose may need reduction. If hypoglycemia occurs, treat with dextrose — NOT sucrose.
Sulfonylureas (glipizide, glyburide, glimepiride)
majorIncreased hypoglycemia risk. Rare cases of hypoglycemic shock reported. Use dextrose to treat hypoglycemia, not sucrose.
Digestive enzymes (amylase, pancreatin)
majorReduce or eliminate acarbose effectiveness. Do not take concurrently. Products include Creon, Pancrease, Cotazym.
Digoxin
moderateAcarbose may decrease digoxin blood levels. Monitor digoxin levels; dose may need to be increased 20-40%.
Corticosteroids / thiazide diuretics / estrogens / phenothiazines
moderateThese agents raise blood sugar and may counteract the blood glucose-lowering effect of acarbose. Monitor glucose when starting or stopping.
Activated charcoal
moderateAbsorbs acarbose in the gut, reducing effectiveness. Avoid concomitant use.
Acarbose is an underutilized but effective tool in the type 2 diabetes management toolkit. Its postprandial focus, lack of hypoglycemia risk when used alone, weight-neutral profile, and affordable generic pricing make it a valuable option for specific patient populations — especially those who cannot tolerate metformin, those at high hypoglycemia risk, and patients after bariatric surgery.
The primary challenges with acarbose are its GI side effects (which typically improve with slow titration) and its inconsistent pharmacy stocking. It is not in a national shortage, but many community pharmacies don't keep it on the shelf due to low volume. Large chains, mail-order pharmacies, and special orders are reliable ways to get consistent access.
If you're having difficulty finding acarbose at your local pharmacy, medfinder can call pharmacies near you to locate your specific strength in stock. Simply provide your medication, dose, and location — medfinder does the calling and texts you where it's available.
Medfinder Editorial Standards
Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
ChatGPT
Claude
Perplexity
Grok
Gemini