Pioglitazone + metformin


Concise Prescribing Info
Indications/Uses
Type 2 DM.
Dosage/Direction for Use
Adult: PO Initial: 15 mg/500 mg bid or 15 mg/850 mg once daily. Patients inadequately controlled on metformin monotherapy: Initial: 15 mg/500 mg bid or 15 mg/850 mg 1-2 times/day, depending on current metformin dose. Patients inadequately controlled on pioglitazone monotherapy: Initial: 15 mg/500 mg bid or 15 mg/850 mg once daily. Max: Pioglitazone 45 mg and metformin 2,550 mg/day. As extended-release tab: Initial: 15 mg/1,000 mg or 30 mg/1,000 mg once daily. Patients inadequately controlled on metformin or pioglitazone monotherapy: 15 mg/1,000 mg bid or 30 mg/1,000 mg once daily. Max: Pioglitazone 45 mg and metformin 2,000 mg/day. Doses may be titrated gradually according to response.
Contraindications
Current or history of cardiac failure (New York Heart Association stage I to IV), active or history of bladder cancer, uninvestigated macroscopic haematuria; type 1 DM, diabetic ketoacidosis or diabetic pre-coma; acute or chronic disease which may cause tissue hypoxia (e.g. cardiac or resp failure, recent MI, shock); conditions which may alter renal function (e.g. dehydration, severe infection, shock). Acute alcohol intoxication. Hepatic or renal impairment (CrCl <60 mL/min). Lactation. Intravascular admin of iodinated contrast agents.
Special Precautions
Patient w/ oedema, anaemia. Premenopausal, anovulatory women. Pregnancy. Patient Counselling This drug may cause visual disturbance, if affected, do not drive or operate machinery. Monitoring Parameters Monitor HbA1c, serum glucose; signs and symptoms of oedema or heart failure, bladder cancer; liver enzymes, haematologic parameters, renal function; vit B12 and folate if anaemia is present. Routine ophth examination.
Adverse Reactions
Oedema, wt gain, hypoglycaemia, macular oedema, bone fractures, anaemia, upper resp infection, headache, diarrhoea, nausea, UTI, sinusitis.
Potentially Fatal: Lactic acidosis, CHF, bladder cancer, hepatic failure.
Drug Interactions
May impair vit B12 absorption. Increased plasma levels w/ strong CYP2C8 inhibitors (e.g. gemfibrozil). Decreased plasma levels w/ CYP2C8 inducers (e.g. rifampicin). Reduced metabolism w/ cationic drugs eliminated by renal tubular secretion.
CIMS Class
ATC Classification
A10BG03 - pioglitazone ; Belongs to the class of thiazolidinediones. Used in the treatment of diabetes.
A10BA02 - metformin ; Belongs to the class of biguanides. Used in the treatment of diabetes.
Disclaimer: This information is independently developed by CIMS based on pioglitazone + metformin from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to CIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, CIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2021 CIMS. All rights reserved. Powered by CIMSAsia.com
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