Acarbose and Indapamide: 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
Indapamide
No brand names on recordAcarbose
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.
Indapamide is a water pill (diuretic) that helps lower blood pressure. Acarbose is a diabetes medicine that helps keep your blood sugar from spiking after meals. Here's the thing: water pills like indapamide can sometimes nudge your blood sugar up, which may work against your diabetes control and make your acarbose (or other diabetes medicines) less able to keep things in range.
The good news is this is very manageable. Your care team can simply check your blood sugars a little more often and adjust your diabetes medicine if needed. Please don't stop either drug on your own. Just let your doctor or pharmacist know you take both so they can keep an eye on your numbers.
Interaction: Indapamide, a thiazide-like diuretic, may impair glucose tolerance and raise blood glucose, potentially reducing glycemic control achieved with acarbose. Antidiabetic (including insulin) requirements may increase, decrease, or remain unchanged.
- Mechanism: Altered glucose metabolism (diuretic-induced impairment of glucose tolerance); pharmacodynamic, not a PK/enzyme interaction. Neither agent is affected by prodrug considerations here.
- Direction: Potential loss of glycemic control (hyperglycemia).
- Evidence: Theoretical; severity rated major. Onset unspecified.
- Management: Monitor glucose more frequently, including upon diuretic withdrawal. Individualize/adjust antidiabetic dosing as indicated.
What happens
An increased risk of hyperglycemia and an increased insulin requirement
Interaction Deep Dive
Some diuretics can affect glucose tolerance or blood glucose concentrations, which may put the patient at risk of hyperglycemia or a loss of glycemic control. The need for insulin could rise123, fall, or remain the same 4. When a particular diuretic and an antidiabetic drug must be given together, glucose should be checked more often, including when the diuretic is discontinued 56. Adjusting the dose of insulin or oral antidiabetic medications may become necessary 78.
Why it happens (mechanism)
Altered glucose metabolism
How to manage this interaction
Keep taking both medicines as prescribed unless your prescriber tells you otherwise. This interaction is manageable with a few simple steps.
- Your care team may check your blood sugar more often when you start, change, or stop the water pill.
- Your diabetes medicine dose may need to be adjusted and individualized by your care team depending on your numbers.
- Watch for signs of high blood sugar (more thirst, frequent urination, tiredness) and report them.
Ask your pharmacist or doctor before making any changes, and be sure they know you take both drugs.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Acarbose and Indapamide together?
Indapamide can raise blood sugar and may weaken your diabetes control, so your team may check glucose more often and adjust your diabetes medicine. Keep taking both as prescribed and report high-sugar symptoms. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Acarbose and Indapamide interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Acarbose and Indapamide interaction managed?
Keep taking both medicines as prescribed unless your prescriber tells you otherwise. This interaction is manageable with a few simple steps. Your care team may check your blood sugar more often when you start, change, or stop the water pill. Your diabetes medicine dose may need to be adjusted and individualized by your care team depending on your numbers. Watch for signs of high blood sugar (more… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Acarbose or Indapamide 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 a safer alternative to one of these medications for me?
References (8)
- Product Information: TOUJEO(R) subcutaneous injection, insulin glargine subcutaneous injection. sanofi-aventis (per manufacturer), Bridgewater, NJ, 2015. DailyMed
- Product Information: Tresiba subcutaneous injection solution, insulin degludec subcutaneous injection solution. Novo Nordisk A/S (per EMA), Bagsvaerd, Denmark, 2013. DailyMed
- Product Information: SEMGLEE(R) subcutaneous injection, insulin glargine-yfgn subcutaneous injection. Mylan Pharmaceuticals Inc (per FDA), Morgantown, WV, 2023. DailyMed
- Product Information: chlorthalidone oral tablets, chlorthalidone oral tablets. Pliva,Inc, East Hanover, NJ, 2004. DailyMed
- Product Information: XIGDUO(TM) XR oral extended release tablets, dapagliflozin metformin HCl oral extended release tablets. AstraZeneca Pharmaceuticals LP (per manufacturer), Wilmington, DE, 2014. DailyMed
- Product Information: GLUMETZA(R) oral extended-release tablets, metformin HCl oral extended-release tablets. Santarus, Inc. (per Manufacturer), San Diego, CA, 2013. DailyMed
- Product Information: ACCURETIC(TM) oral tablets, quinapril HCl hydrochlorothiazide oral tablets. Parke-Davis (per FDA), New York, NY, 2015.
- Product Information: DYRENIUM(R) oral capsules, triamterene oral capsules. Wellspring Pharmaceutical Corporation, Ontario, Canada, 2005. DailyMed
Keep reading about Indapamide
Keep reading about Acarbose
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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