Pioglitazone

It is a thiazolidinedione antidiabetic agent that depends on the presence of insulin for its mechanism of action. It decreases insulin resistance in the periphery and in the liver resulting in increased insulin-dependent glucose disposal and decreased hepatic glucose output.

Indications

It is an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes. It is indicated for monotherapy and in combination with a sulfonylurea, metformin, or insulin when diet and exercise plus the single agent does not result in adequate glycemic control.

Dosage

In patient not adequately controlled with diet and exercise may be initiated at 15mg or 30mg once daily. For patients who respond inadequately to the initial dose of it, the dose can be increased in increments upto 45mg once daily.In combination with a sulfonylurea may be initiated at 15mg or 30mg once daily. In combination with metformin may be initiated at 15mg or 30mg once daily. In combination with insulin may be initiated at 15 mg or 30mg once daily

Contra-Indications

Hypersensitivity.

Special Precautions

In patients with type 1 diabetes or for the treatment of diabetic ketocidosis. Patients receiving it in combination with insulin or oral hypoglycemic agents may be at risk for hypoglycemia, therapy may result in ovulation in some premenopausal anovulatory women. In patient with edema.

Side Effects

Headache, upper respiratory tract infection, myalgia, sinusitis and pharyngitis.

Drug Interactions

Oral Contraceptives.