Acarbose and Ozanimod: 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
Ozanimod
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.
Ozanimod (a medicine used for conditions like multiple sclerosis or ulcerative colitis) has some mild activity like an older class of drugs called MAOIs. Acarbose is a diabetes medicine that helps lower your blood sugar. When they are taken together, your blood sugar could drop lower than expected. This is called hypoglycemia, and it can make you feel shaky, sweaty, dizzy, or confused.
The good news is that this is very manageable. Your care team can watch your blood sugar more closely and adjust your diabetes dose if needed. Please keep taking both medicines as prescribed and talk with your pharmacist or doctor about how to check your sugar.
Effect: Additive risk of hypoglycemia when ozanimod is combined with acarbose.
- Mechanism: Ozanimod is a weak MAO-B inhibitor; MAOI activity may enhance the glucose-lowering effect of hypoglycemic agents (possible hyperinsulinemia in type 2 patients with retained insulin secretion). Exact mechanism unknown.
- Direction: Increased hypoglycemic effect (neither drug is a prodrug requiring activation).
- Onset: Rapid. Evidence: Probable. Severity: Moderate.
- Management: Monitor blood glucose closely when ozanimod is started or stopped. Lower doses of acarbose may be needed, or discontinuation of one agent if hypoglycemia is significant.
What happens
An increased risk of hypoglycemia
Interaction Deep Dive
Certain MAOIs taken alongside hypoglycemic agents can enhance the blood glucose lowering action of those agents 23. In individuals with type 2 diabetes who still retain the ability to secrete insulin, MAOIs may produce hyperinsulinemia 7. When an MAOI is introduced to, or withdrawn from, the regimen of a patient already taking a hypoglycemic agent, blood glucose should be monitored closely. It may be necessary to reduce the dose of insulin or of oral hypoglycemic agents 12, or alternatively to stop one of the interacting drugs 4.
Why it happens (mechanism)
Unknown
How to manage this interaction
This interaction can be managed well with a few practical steps. Keep taking both medicines as prescribed unless your prescriber tells you otherwise.
- Your team may monitor your blood glucose more closely, especially when ozanimod is being started or stopped.
- Your acarbose dose may need to be adjusted and individualized by your care team.
- Learn the signs of low blood sugar (shakiness, sweating, dizziness, confusion) and know how to treat it quickly.
Talk with your pharmacist or doctor about a blood sugar checking plan and report any low-sugar episodes.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
2 reports — tap to read
a) MAOI agents can potentiate the blood glucose lowering action of hypoglycemic medications. The suggested mechanism was that MAOI drugs interfere with the homeostatic adrenergic response to hypoglycemia 5, although this mechanism was not verified 6. MAOIs seem to produce hyperinsulinemia 7.
b) Administration of selegiline (a selective MAO-B inhibitor) resulted in severe hypoglycemia in a 70-year old man who had Parkinson's disease. The hypoglycemia was associated with hyperinsulinemia and continued for one week following discontinuation of selegiline 8.
Common questions
Can I take Acarbose and Ozanimod together?
Combining ozanimod and acarbose may lower your blood sugar more than expected, so watch for signs of hypoglycemia and check your glucose closely, especially when starting or stopping ozanimod. Your care team can adjust your diabetes dose as needed. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Acarbose and Ozanimod interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "rapid". Effects can appear quickly, often within about 24 hours of combining the drugs.
How is the Acarbose and Ozanimod interaction managed?
This interaction can be managed well with a few practical steps. Keep taking both medicines as prescribed unless your prescriber tells you otherwise. Your team may monitor your blood glucose more closely, especially when ozanimod is being started or stopped. Your acarbose dose may need to be adjusted and individualized by your care team. Learn the signs of low blood sugar (shakiness, sweating, diz… 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 Ozanimod 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 (8)
- 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: Starlix(R) oral tablets, nateglinide oral tablets. Novartis Pharmaceuticals Corporation (per FDA), East Hanover, NJ, 2011. DailyMed
- Product Information: ZYVOX(R) intravenous injection, oral tablets suspension, linezolid intravenous injection, oral tablets suspension. Pfizer Inc. (per FDA), New York, NY, 2013. DailyMed
- Cooper AJ & Ashcroft G: Modification of insulin and sulfonylurea hypoglycemia by monoamine-oxidase inhibitor drugs. Diabetes 1967; 16:272-274. PubMed
- Adnitt PI: Hypoglycemic action of monoamineoxidase inhibitors (MAOI'S). Diabetes 1968; 17:628-633. PubMed
- Bressler R, Vargas-Cord M, & Lebovitz HE: Tranylcypromine: a potent insulin secretagogue and hypoglycemic agent. Diabetes 1968; 17:617-624. PubMed
- Rowland MJ, Bransome ED Jr. & Hendry LB: Hypoglycemia caused by selegiline, an antiparkinsonian drug: can such side effects be predicted?. J Clin Pharmacol 1994; 34:80-85. DOI
Keep reading about Ozanimod
Keep reading about Acarbose
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