Pioglitazone

Indications
 Oral
Type 2 diabetes mellitus
Adult: 15-30 mg once daily increased in increments if necessary. Max dose: 45 mg/day.
Contraindications
 Hypersensitivity. Type 1 diabetes mellitus, symptomatic or history of heart failure, diabetic ketoacidosis, childn <18 yr. Lactation.
Warnings / Precautions
 Increased risk of hypoglycaemia when used with insulin or oral hypoglycaemics. Oedema, congestive heart failure, hepatic dysfunction, jaundice, anaemia. May cause ovulation in premenopausal, anovulatory women. Monitor liver function before and during treatment. Monitor glycaemic control. Pregnancy. Caution when oral contraceptives or hormonal replacement therapy is used in diabetics due to increased risk of arterial diseases. Stop treatment if ALT increases and remains >3 times above the upper limit of normal or if jaundice develops.
Adverse Reactions
 Pharyngitis, oedema, headache, upper resp tract infection, sinusitis, anaemia; GI disturbances, wt gain, visual disturbances, dizziness, arthralgia, haematuria, impotence.
Drug Interactions
 Ketoconazole and gemfibrozil may increase the plasma concentrations of pioglitazone while enzyme inducers such as rifampicin may decrease the plasma concentrations. Increased risk of fluid retention when used with NSAIDs.
See Below for More pioglitazone Drug Interactions
Lab Interactions
 Transient elevations in creatine phosphokinase levels were observed.
Mechanism of Actions
 Pioglitazone is as a potent and highly selective agonist for the peroxisome proliferator activated receptor-gamma (PPAR). Activation of these receptors promotes the production of gene products involved in lipid and glucose metabolism. It also improves insulin response to target cells witho increasing the pancreatic secretion of insulin.
Onset: Delayed.
Absorption: Peak plasma concentrations after 2 hr.
Distribution: Protein-binding: >99%.
Metabolism: Extensively metabolised by hydroxylation and oxidation.
Excretion: Urine (15-30%); faeces (as metabolites); 3-7 hr (elimination half-life, parent drug).
Administration
 May be taken with or without food.
Storage Conditions
 Oral: Store at 25°C.
ATC Classification
 A10BG03 - pioglitazone ; Belongs to the class of thiazolidinediones. Used in the treatment of diabetes.
Storage
 Oral: Store at 25°C.
Available As
  • Pioglitazone 15 mg
  • Pioglitazone 30 mg
  • Pioglitazone 45 mg
  • Pioglitazone 500 mg
  • Pioglitazone 7.5 mg
  • Pioglitazone 75 mg

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