Pidus

Indications

Pioglitazone is used to control blood sugar in adults with type 2 diabetes, together with diet and exercise. It can be used alone or with other diabetes medicines such as Metformin, sulfonylureas or, in some cases, insulin.

How It Works

It belongs to the thiazolidinedione group. It makes the body's muscle, fat and liver cells respond better to insulin (it reduces insulin resistance), so more sugar moves out of the blood and the liver makes less sugar.

Dosage and Administration

Adults: usually 15 mg or 30 mg once a day, with or without food. The doctor may increase it slowly to a maximum of 45 mg once a day. It can take a few weeks to show its full effect. Not for children.

Interactions

With insulin it increases the risk of fluid build-up and heart failure. With sulfonylureas (such as Gliclazide) or insulin, blood sugar can go too low, so their dose may need lowering. Gemfibrozil raises Pioglitazone levels and Rifampicin lowers them. Tell your doctor about all medicines you take.

Contraindications

• Heart failure now or in the past.
• Bladder cancer now or in the past, or unexplained blood in the urine.
• Liver disease.
• Diabetic ketoacidosis or type 1 diabetes.
• Allergy to Pioglitazone.

Side Effects

Common: weight gain, swelling of the ankles or legs, upper respiratory infections, headache, and mild anaemia. It can increase the risk of bone fractures, mainly in women, and rarely causes swelling at the back of the eye that blurs vision.

Get urgent medical help if you have shortness of breath, rapid weight gain or quickly worsening swelling (possible heart failure); blood in the urine, pain on passing urine or a sudden urge to pass urine; yellow skin or eyes, dark urine, or persistent nausea and stomach pain; or signs of low blood sugar such as shaking, sweating and confusion that do not improve after taking sugar.

Pregnancy and Lactation

Not used in pregnancy; insulin is usually preferred, so tell your doctor if you plan a pregnancy or become pregnant. Not recommended while breastfeeding.

Precautions and Warnings

Your doctor will check liver tests before and during treatment, and your weight and swelling. Have regular eye checks. It may restart ovulation in some women who were not ovulating, so use contraception if pregnancy is not wanted. Keep to your diet and exercise plan and check your blood sugar as advised.

Overdose

Taken alone it rarely causes very low blood sugar, but with other diabetes medicines it can. If a large amount is taken, seek medical help and treat low sugar with glucose or a sweet drink.

Therapeutic Class

Oral antidiabetic (thiazolidinedione).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.