Probable interaction of warfarin and acarbose

Morreale, Anthony P.; Janetzky, Katherine

doi:10.1093/ajhp/54.13.1551

Cited by 17 publications

(4 citation statements)

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“…It has been stated that warfarin therapy is linked to altered glucose homeostasis through the blockade of protein c-carboxylation (25). However, the referenced report (26) deals with a single case in which an interaction between warfarin and acarbose was observed (26,27). Although our study did not demonstrate an increase in serum glucose concentrations after a reduction in ucOC concentrations and suggests that ucOC is not involved in glucose homeostasis in humans, there were limitations to our study.…”

Section: Discussionmentioning

confidence: 56%

Effect of phylloquinone supplementation on glucose homeostasis in humans

Kumar

Binkley

Vella

2010

The American Journal of Clinical Nutrition

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Section: Discussionmentioning

confidence: 56%

Effect of phylloquinone supplementation on glucose homeostasis in humans

Kumar

Binkley

Vella

2010

The American Journal of Clinical Nutrition

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“…If combination therapy is being used and hypoglycemia occurs, the patient should be educated to use milk (lactose) or glucose for treatment since sucrose may not work .40 Drug interactions with acarbose have been reported with digoxin and warfarin. [45][46][47] The a-glucosidase inhibitors are advantageous since they lower postprandial glucose levels. Unfortunately, the undesirable side effect profile and modest efficacy decrease their utility especially as first-line agents in the treatment of type 2 diabetes.…”

Section: A-glucosidase Inhibitorsmentioning

confidence: 99%

Management of Type 2 Diabetes in the Geriatric Patient

Campbell¹

2000

Journal of Pharmacy Practice

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Type 2 diabetes is prevalent in the elderly population. In the past five years, there has been an increased number of drugs with unique mechanisms of action which have become available for the treatment of type 2 diabetes. Recent studies have shown that attaining optimal glycemic control in patients with type 2 diabetes will prevent or delay the complications associated with this disease. This article will review the management of type 2 diabetes.

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“…They are frequently associated with gastrointestinal side effects, mainly flatulence and diarrhea, which is a common cause for the discontinuation of the treatment among diabetic patients [ 14 ]. In addition, several case reports described drug-drug interactions of acarbose particularly with digoxin (reduced absorption) and warfarin (increased absorption), which are used in the treatment of heart conditions and as an anticoagulant, respectively [ 20 , 21 ]. When long-term medications in the case of chronic diseases such as type 2 diabetes are required, treatment efficacy, convenience, accessibility, and the safety of the therapy are equally considered.…”

Section: Introductionmentioning

confidence: 99%

In vitro α-glucosidase inhibitory activity of Tamarix nilotica shoot extracts and fractions

et al. 2022

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α-glucosidase inhibitors represent an important class of type 2 antidiabetic drugs and they act by lowering postprandial hyperglycemia. Today, only three synthetic inhibitors exist on the market, and there is a need for novel, natural and more efficient molecules exhibiting this activity. In this study, we investigated the ability of Tamarix nilotica ethanolic and aqueous shoot extracts, as well as methanolic fractions prepared from aqueous crude extracts to inhibit α-glucosidase. Both, 50% ethanol and aqueous extracts inhibited α-glucosidase in a concentration-dependent manner, with IC50 values of 12.5 μg/mL and 24.8 μg/mL, respectively. Importantly, α-glucosidase inhibitory activity observed in the T. nilotica crude extracts was considerably higher than pure acarbose (IC50 = 151.1 μg/mL), the most highly prescribed α-glucosidase inhibitor on the market. When T. nilotica crude extracts were fractionated using methanol, enhanced α-glucosidase inhibitory activity was observed in general, with the highest observed α-glucosidase inhibitory activity in the 30% methanol fraction (IC50 = 5.21 μg/mL). Kinetic studies further revealed a competitive reversible mechanism of inhibition by the plant extract. The phytochemical profiles of 50% ethanol extracts, aqueous extracts, and the methanolic fractions were investigated and compared using a metabolomics approach. Statistical analysis revealed significant differences in the contents of the crude extracts and fractions and potentially identified the molecules that were most responsible for these observed variations. Higher α-glucosidase inhibitory activity was associated with an enrichment of terpenoids, fatty acids, and flavonoids. Among the identified molecules, active compounds with known α-glucosidase inhibitory activity were detected, including unsaturated fatty acids, triterpenoids, and flavonoid glycosides. These results put forward T. nilotica as a therapeutic plant for type 2 diabetes and a source of α-glucosidase inhibitors.

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Probable interaction of warfarin and acarbose

Cited by 17 publications

References 0 publications

Effect of phylloquinone supplementation on glucose homeostasis in humans

Effect of phylloquinone supplementation on glucose homeostasis in humans

Management of Type 2 Diabetes in the Geriatric Patient

In vitro α-glucosidase inhibitory activity of Tamarix nilotica shoot extracts and fractions

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