Pioglitazone + Metformin

(pye oh gli' ta zone) (met for' min)

PCI  :Contraindicated in pregnancy

LCI  :Contraindicated in lactation

Molecule Info

|See TERMINOLOGY & ABBREVIATIONS |

Indication(s) & Dosage

Type 2 diabetes mellitus, Adult: Starting dose should be based on patient's current dosage regimen of pioglitazone and/or metformin. For patients who are inadequately controlled on metformin monotherapy: Usual starting dose: pioglitazone/metformin: 15mg/500mg or 15mg/850mg 1-2 times daily, adjust dose gradually based on therapeutic response. For patients who are on pioglitazone monotherapy but require additional glycaemic control: Usual starting dose: pioglitazone/metformin: 15mg/500mg twice daily or 15mg/850mg once daily, adjust dose gradually based on therapeutic response. Daily max: pioglitazone/metformin: 45mg/2250mg.

Administration

Should be taken with food.

Contraindications

Hypersensitivity; diabetic coma, diabetic ketoacidosis; severe renal or hepatic impairment; recent MI, CHF; type 1 DM; severe infection; acute or chronic metabolic acidosis with or without coma; stress, trauma; severe impairment of thyroid function; dehydration, acute or chronic alcoholism; children <18 yr, pregnancy, lactation.

Special Precautions

Elderly. Monitor renal function regularly. Patients receiving pioglitazone in combination with insulin or oral hypoglycaemic agents may be at risk of hypoglycaemia. Oedema, congestive heart failure; hepatic dysfunction; jaundice. Premenopausal, anovulatory women, anaemia. Monitor liver function.

Adverse Drug Reaction(s)

Pioglitazone: Pharyngitis, oedema, headache, upper resp tract infection, sinusitis, anaemia; GI disturbances, wt gain, visual disturbances, dizziness, arthralgia, haematuria, impotence. Metformin: Anorexia, nausea, vomiting, diarrhoea, wt loss, flatulence, occasional metallic taste; weakness; hypoglycaemia; rash, malabsorption of vit B12. Potentially Fatal: Lactic acidosis in presence of renal failure and alcoholism.

Drug Interactions

Pioglitazone: Ketoconazole inhibits the metabolism of pioglitazone . Increased hypoglycaemic effect with alcohol. Metformin: Additive effect with sulphonylureas. Antagonistic effects with diuretics, corticosteroids, phenothiazines, thyroid products, oestrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, Ca channel blockers and isoniazid. Potentially Fatal: Pioglitazone: admin of a thiazolidinedione with OC reduces the plasma concentrations of the hormones which may result in the loss of contraceptive effectivity. Metformin: Lactic acidosis with alcohol and potentiation of hypoglycaemic effect. Cimetidine and furosemide may increase plasma-metformin levels. Drugs eliminated via renal tubular secretion may increase metformin levels.

Pregnancy Category (FDA)

Category C: Either studies in animals have revealed adverse effects on the foetus  and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.

Storage

Oral: Store at 25°C.

Pharmacology

Pioglitazone is as a potent and highly selective agonist for the peroxisome proliferator activated receptor-gamma. Activation of these receptors promotes the production of gene products involved in lipid and glucose metabolism. It also improves insulin response to target cells witho increasing the pancreatic secretion of insulin. Metformin decreases hepatic gluconeogenesis, decreases intestinal absorption of glucose and improves insulin sensitivity.

ATC Classification

A10BG03 - pioglitazone; Belongs to the class of thiazolidinediones. Used in the treatment of diabetes. A10BA02 - metformin; Belongs to the class of biguanides. Used in the treatment of diabetes.

Brand/Product Info


Total Products : 16                
Brand Name Manufacturer/Marketer Composition Dosage Form Pack Size & Price
ACTOMEG 500 Unimed & Unihealth Manufacturers Ltd. Pioglitazone hydrochloride 15mg+ Metformin hydrochloride 500mg Film Coated Tablet 20's: 180.00 MRP
ACTOMEG 850 Unimed & Unihealth Manufacturers Ltd. Pioglitazone hydrochloride 15mg+ Metformin hydrochloride 850mg Film Coated Tablet 20's: 200.00 MRP
CODIAGLIT 500 Beximco Pharmaceuticals Ltd Metformin Hydrochloride 500mg + Pioglitazone 15mg Tablet 30's: 300.00 MRP
CODIAGLIT 850 Beximco Pharmaceuticals Ltd Metformin Hydrochloride 500mg + Pioglitazone 15mg Tablet 30's: 345.00 MRP
Compimet 500 Incepta Pharmaceuticals Limited Metformin Hydrochloride 500mg + Pioglitazone 15mg Tablet 10x3's :MRP 300 Tk
Compimet 850 Incepta Pharmaceuticals Limited Metformin Hydrochloride 850mg + Pioglitazone 15mg Tablet 10x3's :MRP 330 Tk
GLITAMIN 500 The White Horse Pharma Pioglitazone hydrochloride 15mg+ Metformin hydrochloride 500mg Film Coated Tablet 30's: 270.00 MRP
GLITAMIN 850 The White Horse Pharma Pioglitazone hydrochloride 15mg+ Metformin hydrochloride 850mg Film Coated Tablet 30's: 300.00 MRP
PIOL-M 500 Opsonin Pharma Limited Pioglitazone hydrochloride 15mg+ Metformin hydrochloride 500mg Film Coated Tablet 20's: 180.00 MRP
PIOL-M 850 Opsonin Pharma Limited Pioglitazone hydrochloride 15mg+ Metformin hydrochloride 850mg Film Coated Tablet 20's: 200.00 MRP
PIOMET 500 Silva Pharmaceuticals Limited Pioglitazone hydrochloride 15mg+ Metformin hydrochloride 500mg Film Coated Tablet 30's: 271.01 MRP
PIOMET 850 Silva Pharmaceuticals Limited Pioglitazone hydrochloride 15mg+ Metformin hydrochloride 850mg Film Coated Tablet 30's: 301.14 MRP
PIOMIN 500 Pacific Pharmaceuticals Ltd. Pioglitazone hydrochloride 15mg+ Metformin hydrochloride 500mg Film Coated Tablet 30's: 300.00 MRP
PIOMIN 850 Pacific Pharmaceuticals Ltd. Pioglitazone hydrochloride 15mg+ Metformin hydrochloride 850mg Film Coated Tablet 30's: 345.00 MRP
POLITOR 500 ACI Ltd. Pioglitazone hydrochloride 15mg+ Metformin hydrochloride 500mg Film Coated Tablet 30's: 270.90 MRP
POLITOR 850 ACI Ltd. Pioglitazone hydrochloride 15mg+ Metformin hydrochloride 850mg Film Coated Tablet 30's: 301.20 MRP