Pioglitazone and Metformin

Hypoglycaemic excluding Insulin · Biguanide/Thiazolidinedione

Indications

Type II diabetes, particularly in overweight patients, inadequately controlled by maximal tolerated doses of metformin.

Dosage

Adults: 1 tab twice daily. Children: Not recommended.

Adverse Effects

Anaemia, visual disturbance, weight gain, arthralgia, headache, haematuria, erectile dysfunction, oedema.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Contraindications: Cardiac failure or history of cardiac failure, respiratory failure, recent MI, shock, hepatic impairment, acute alcohol intoxication, alcoholism, diabetic ketoacidosis, diabetic pre-coma, renal impairment, dehydration, severe infection. Precautions: Monitor renal function at least once per year in patients with normal renal function and at least 2-4 time per year in patients with raised creatinine levels and the elderly. Monitor for signs of fluid retention, including weight gain, or other signs of cardiac failure (discontinue if deteriorates). Monitor for risk factors for lactic acidosis. Monitor for signs of hepatic dysfunction and measure liver enzymes before treatment and periodically thereafter. Monitor for weight gain and anaemia. Withdraw 48 hours before elective surgery.…

Interactions

Insulin, gemfibrozil, rifampicin, NSAIDs, intravascular iodinated contrast media, alcohol, cimetidine, glucocorticosteroids, beta2-agonists, diuretics, ACE inhibitors.

Advice to Patient

Take with meals.

Pharmacokinetics

PIOGLITAZONE: Onset: Delayed. Absorption: Oral: Rapid. Metabolism: Hepatic. Bioavailability: > 80%. Half-life elimination: 3-7 hrs. Time to peak, plasma: 2 hrs. Excretion: Urine (15%-30%). Faeces (mainly). METFORMIN: Onset of action: Within days, max effects up to 2 wks. Metabolism: Not metabolized by the liver. Bioavailability: Absolute: Fasting: 50%-60%. Half-life elimination: Plasma: 4-9 hrs. Blood: Approx. 17.6 hrs. Time to peak, serum: Immediate release: 2-3 hrs. Extended release: 7 hrs. (Range: 4-8 hrs). Excretion: Urine.

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.