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Pioglitazone + Metformin

Indication

It is indicated for treating Diabetes Mellitus type 2 as monotherapy or with metformin.

Dosage

Strength: 15mg/500mg

Form: tablet

Dosing interval: Once a day.

Maximum Dose: It is suggested to not to exceed 45mg/2550mg per day.

Dialyzable:Metformin: Yes

Maintainance dose

The dose recommendation for pioglitazone alone therapy is to start with 15-30mg per day with metformin. If metformin alone therapy: start with 1000-1700mg per day with pioglitazone.

Hepatic Adjustment

Study shows that: 1) If ALT (alanine transferase) levels are lesser than 2.5 x Upper limit number, the medicine needs to be used with caution. 2) If ALT (alanine transferase) levels are greater or equal to 2.5 x Upper limit number, Do not use the medicine. 3) If f ALT (alanine transferase) levels are greater than 3 x Upper limit number or patient is reported with jaundice; Discontinuation of medicine is recommended.

Renal Adjustment

In patients with eGFR (glomerular filteration rate) less than 30ml/min/1.73m2; the medicine is contraindicated. However, in patients eGFR (glomerular filteration rate) approximately 30-45ml/min/1.73m2; the drug is not suggested to be used for therapeutic indication.

  • pregnant

    Pregnancy

    Can be used but doctor consultation is important before use, as human and animal research is insufficient or animals showed defects and human research hasn?t been conducted.

  • mother

    Lactation

    Studies suggested the use of this combination therapy should not be used by nursing mothers as many adverse effects were reported in animal studies which weighs out the potential risk for lactating mothers. Choice should be made upon either to stop the use of medication or stop nursing.

ContraIndication
Cautions

BLACK BOX WARNING: Pioglitazone and Rosiglitazone are known to cause an exaggeration of cardiovascular cases. Studies recommend to conduct Liver enzyme tests before initiating therapy, with eGFR (estimated Glomerular filteration rate) less than 30ml/min/1.73m2 monitor with extreme care. Elderly patients of age greater than 80 years requires special monitoring when on metformin=pioglitazone therapy. Monitor levels of vitamin B12 and glucose levels when initiating the therapy. Unexpected ovulation may occur in premenopausal women is also reported when taking this combinational therapy. Study also reported an evidence of fluid retention in patients using insulin in combination. Lactic acidosis evidences have also been reported.

Pharmacokinetics

Disclaimer

Dawaai's intention is to make sure that it's consumers get information that is accurate, reviewed by an expert and error-free. However, the information mentioned here should not be used as a replacement for the advice of a qualified physician. The information given here is for informational purposes only, which may not cover all possible precautions, side effects, contraindications or drug interactions. Consult your doctor and discuss your queries related to any medicine or disease.

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