Dangerous Drug: Pioglitazone(pie oh glit’ ah zohn)
Actos, Apo-Pioglitazone (CAN), ratio-Pioglitazone (CAN)
PREGNANCY CATEGORY C
Drug Classes
Antidiabetic
Thiazolidinedione
Therapeutic Actions
Resensitizes tissues to insulin; stimulates insulin receptor sites to lower blood glucose and improve the action of insulin; decreases hepatic gluconeogenesis and increases insulin-dependent muscle glucose uptake.
Indications
Monotherapy as an adjunct to diet and exercise to improve glucose control in patients with type 2 diabetes
As part of combination with a sulfonylurea, metformin, or insulin when diet, exercise plus a single agent alone do not result in adequate glycemic control in type 2 diabetes
Unlabeled uses: Polycystic ovary syndrome; prevention of stent restenosis
Contraindications and Cautions
Contraindicated with allergy to any thiazolidinedione, type 1 diabetes, ketoacidosis, New York Heart Association Class III or IV HF, lactation, bladder cancer or history of bladder cancer.
Use cautiously with advanced heart disease, liver failure, pregnancy.
Available Forms
Tablets—15, 30, 45 mg
Dosages
Adults
15–30 mg daily as a single oral dose; if adequate response is not seen, dosage may be increased to a maximum 45 mg daily PO.
Combination therapy with sulfonylurea or metformin: 15–30 mg daily PO added to the established dose of the other agent; if hypoglycemia occurs, reduce the dose of the other agent.
Combination therapy with insulin: Initiate pioglitazone at 15 or 30 mg PO while maintaining insulin dose. Decrease insulin dose by 10%–25% if hypoglycemic or if glucose is less than 100 mg/dL.
Pediatric patients
Safety and efficacy not established.
Patients with hepatic impairment
Use caution and monitor patient closely. Do not administer if ALT exceeds 2.5 times the upper limit of normal.
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