Pioglitazone + Glimepiride


Thông tin thuốc gốc
Chỉ định và Liều dùng
Oral
Type 2 diabetes mellitus
Adult: Each tab contains pioglitazone 15 mg or 30 mg and glimepiride 2 mg or 4 mg: Initially, 1 tab once daily then titrate gradually as needed.
Elderly: Should start w/ glimepiride 1 mg/day prior to initiating pioglitazone + glimepiride combination.
Renal Impairment
CrCl <22 mL/min: Should start w/ glimepiride 1 mg/day prior to initiating pioglitazone + glimepiride combination.
Hepatic Impairment
Should start w/ glimepiride 1 mg/day prior to initiating pioglitazone + glimepiride combination.
Cách dùng
Should be taken with food. Take w/ 1st main meal of the day.
Chống chỉ định
History of allergic reaction to sulfonamide derivative. Patient w/ established CHF (NYHA class III or IV). Not intended for treatment of type 1 DM or diabetic ketoacidosis.
Thận trọng
Patients w/ prior history of active bladder cancer; anaemia, G6PD deficiency, symptomatic heart failure. Premenopausal/anovulatory females. May exacerbate CHF. Do not initiate in patient w/ active liver disease of ALT >2.5 times the upper limit of normal at baseline. Hepatic and renal impairment. Pregnancy and lactation.
Phản ứng phụ
Fracture, macular oedema, hypoglycaemia, wt gain, peripheral oedema, upper resp tract infection, headache, nausea, anaemia, diarrhoea, UTI, limb pain.
Potentially Fatal: CHF, severe hypoglycaemia, oedema, haemolytic anaemia, hepatic failure.
MonitoringParameters
Monitor for signs and symptoms of heart failure (e.g. excessive, rapid wt gain, oedema, dyspnoea) after initiation.
Quá liều
Glimepiride: Symptoms: Severe hypoglycaemia w/ coma, seizure, or neurological impairment. Management: Admin glucagon or IV glucose. Additional carbohydrate intake may be necessary as hypoglycaemia may recur after apparent clinical recovery.
Tương tác
Increased plasma levels w/ CYP2C8 inhibitors (e.g. gemfibrozil) and CYP2C9 inhibitors (e.g. fluconazole). Decreased plasma levels w/ CYP2C8 inducers (e.g. rifampicin). Colesevelam may reduce the max plasma concentration and total exposure of glimepiride. Concominant use w/ oral miconazole may lead to severe hypoglycaemia.
Food Interaction
Alcohol may increase hypoglycaemic effect.
Tác dụng
Description: Pioglitazone, a thiazolidinedione, reduces blood glucose by improving target cell response to insulin w/o increasing pancreatic insulin secretion and is dependent on the presence of insulin for activity. Glimepiride, a sulfonylurea, stimulates insulin release from the pancreatic β-cells. It also reduces glucose output from the liver and increases insulin sensitivity at peripheral target sites.
Pharmacokinetics:
Absorption: Pioglitazone: Rapidly absorbed from the GI tract. Time to peak plasma concentrations: W/in 2 hr. Bioavailability: >80%. Glimepiride: Completely absorbed from the GI tract. Time to peak plasma concentrations: 2-3 hr.
Distribution: Pioglitazone: Plasma protein binding: >99%. Glimepiride: Highly protein bound.
Metabolism: Pioglitazone: Extensively metabolised mainly by CYP2C8 isoenzyme to both active and inactive metabolites. Glimepiride: Extensively metabolised to hydroxy derivative by CYP2C9 isoenzyme and to carboxy derivative by cytosolic enzymes.
Excretion: Pioglitazone: Via urine and faeces. Plasma half-life: Up to 7 hr. Half-life: Up to 24 hr (active metabolites). Glimepiride: Via urine (approx 60%) and faeces (40%). Half-life: Approx 9 hr (after multiple doses).
Bảo quản
Store at 25°C.
Phân loại MIMS
References
Anon. Pioglitazone and Glimepiride. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 30/06/2014.

Buckingham R (ed). Glimepiride. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 01/07/2014.

Buckingham R (ed). Pioglitazone. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 01/07/2014.

Duetact Tablet (Takeda Pharmaceuticals America, Inc). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 01/07/2014.

Wickersham RM. Pioglitazone/Glimepiride. Facts and Comparisons [online]. St. Louis, MO. Wolters Kluwer Clinical Drug Information, Inc. https://www.wolterskluwercdi.com/facts-comparisons-online/. Accessed 01/07/2014.

Thông báo miễn trừ trách nhiệm: Thông tin này được MIMS biên soạn một cách độc lập dựa trên thông tin của Pioglitazone + Glimepiride từ nhiều nguồn tài liệu tham khảo và được cung cấp chỉ cho mục đích tham khảo. Việc sử dụng điều trị và thông tin kê toa có thể khác nhau giữa các quốc gia. Vui lòng tham khảo thông tin sản phẩm trong MIMS để biết thông tin kê toa cụ thể đã qua phê duyệt ở quốc gia đó. Mặc dù đã rất nỗ lực để đảm bảo nội dung được chính xác nhưng MIMS sẽ không chịu trách nhiệm hoặc nghĩa vụ pháp lý cho bất kỳ yêu cầu bồi thường hay thiệt hại nào phát sinh do việc sử dụng hoặc sử dụng sai các thông tin ở đây, về nội dung thông tin hoặc về sự thiếu sót thông tin, hoặc về thông tin khác. © 2021 MIMS. Bản quyền thuộc về MIMS. Phát triển bởi MIMS.com
Register or sign in to continue
Asia's one-stop resource for medical news, clinical reference and education
Sign up for free
Already a member? Sign in