Acarbose and Celiprolol: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 10, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Acarbose
Celiprolol
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
Acarbose helps lower your blood sugar, and celiprolol is a beta-blocker for your heart or blood pressure. When you take them together, two things can happen. First, your blood sugar can shift up or down a bit, so it needs a closer eye. Second, and more important, the beta-blocker can hide some of the usual warning signs of low blood sugar. You might not feel your heart racing the way you normally would, though sweating and dizziness usually still show up.
Good news: this is very manageable. Your care team can watch your sugar levels more closely and adjust your dose if needed. Just keep taking both as prescribed and let them know how you feel.
Effect: Beta-blocker plus antidiabetic combination may cause hypo- or hyperglycemia and can blunt or mask adrenergic warning signs of hypoglycemia (notably tachycardia); diaphoresis and dizziness are often preserved.
Mechanism: altered glucose metabolism plus beta-adrenergic blockade. Celiprolol is beta-1 selective, so masking risk is lower than with nonselective agents, but not absent. Neither drug is a prodrug here.
- Direction: variable glycemic effect; impaired counter-regulation/recovery possible
- Onset: delayed. Evidence: probable. Severity: moderate
- Management: increase glucose monitoring frequency; individualize acarbose dose as needed; if celiprolol is discontinued, watch for loss of glycemic control
What happens
Hypoglycemia or hyperglycemia; decreased symptoms of hypoglycemia
Interaction Deep Dive
When antidiabetic medications are taken together with beta-blockers, the result may be hypoglycemia or hyperglycemia, or the masking of hypoglycemia symptoms12. Among these symptoms, tachycardia may be affected, whereas others such as dizziness and sweating are not 6. Beta blockers that are nonselective can enhance the hypoglycemia produced by insulin and can hinder the return of serum glucose to normal levels. In individuals who have both heart failure and diabetes, hyperglycemia may worsen 7. It may become necessary to monitor glucose more often or to modify the dose of the antidiabetic drug 12. During combined use, watch carefully for signs and symptoms of hypoglycemia, and should the beta-blocker be discontinued, monitor for a loss of glycemic control 3.
Why it happens (mechanism)
Altered glucose metabolism and beta blockade
How to manage this interaction
This combination is commonly used and is manageable with attention.
- Keep taking both exactly as prescribed unless your prescriber tells you otherwise.
- Your team may check your blood sugar more often, especially early on.
- Your acarbose dose may need to be adjusted and individualized by your care team based on your readings.
- Know your low-sugar signs. The racing-heart cue may be dampened, so watch for sweating, dizziness, shakiness, or confusion.
- If the beta-blocker is ever stopped, tell your team so they can watch for higher blood sugar.
Bring your glucose logs to appointments and raise any concerns with your pharmacist or doctor.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
2 reports — tap to read
a) In elderly diabetic patients receiving either insulin or sulfonylureas, the particular antihypertensive drug selected had minimal impact on the risk of hypoglycemia; however, after adjusting for other risk factors, the lowest risk was seen with cardioselective beta blockers and the highest with non-cardioselective beta blockers, while other antihypertensive agents fell in between (N=13,559) 4.
b) In patients with hypertension and non-insulin dependent diabetes, beta blockers, but not alpha blockade or ACE inhibitors, produced a worsening of long-term glycemic control. Beta blockade was also associated with some unfavorable effects on the lipid profile. These effects were particularly evident with propranolol. Using an alpha blocker together with the beta blocker prevented the deterioration attributable to beta blockade 5.
Common questions
Can I take Acarbose and Celiprolol together?
Acarbose and celiprolol can be used together, but your blood sugar may shift and the beta-blocker can hide the racing-heart warning of a low, so monitor more closely and let your care team adjust as needed. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Acarbose and Celiprolol interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "delayed". Effects tend to build up gradually over days to weeks.
How is the Acarbose and Celiprolol interaction managed?
This combination is commonly used and is manageable with attention. Keep taking both exactly as prescribed unless your prescriber tells you otherwise. Your team may check your blood sugar more often, especially early on. Your acarbose dose may need to be adjusted and individualized by your care team based on your readings. Know your low-sugar signs. The racing-heart cue may be dampened, so watch f… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Acarbose or Celiprolol need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (7)
- Product Information: TOUJEO(R) subcutaneous injection, insulin glargine subcutaneous injection. sanofi-aventis (per manufacturer), Bridgewater, NJ, 2015. DailyMed
- Product Information: AMARYL(R) oral tablets, glimepiride oral tablets. Sanofi-Aventis U.S. LLC (per FDA), Bridgewater, NJ, 2013. DailyMed
- Product Information: Glynase(R) PresTab(R) oral micronized tablets, glyburide oral micronized tablets. Pharmacia & Upjohn Co (per FDA), New York, NY, 2013. DailyMed
- Shorr RI, Ray WA, Daugherty JR, et al: Antihypertensives and the risk of serious hypoglycemia in older persons using insulin or sulfonylureas. JAMA 1997; 278:40-43. DOI
- Whitcroft IA, Thomas JM, Rawsthorne A, et al: Effects of alpha and beta adrenoceptor blocking drugs and ACE inhibitors on long term glucose and lipid control in hypertensive non-insulin dependent diabetics. Horm Metab Res Suppl 1990; 22:42-46.
- Product Information: TENORMIN(R) oral tablets, atenolol oral tablets. AstraZeneca Pharmaceuticals LP (per FDA), Wilmington, DE, 2012. DailyMed
- Product Information: COREG CR(R) extended-release oral capsules, carvedilol phosphate extended-release oral capsules. GlaxoSmithKline, Research Triangle Park, NC, 2011. DailyMed
Keep reading about Acarbose
Keep reading about Celiprolol
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