Lit 15

Lit 1515mg

Type:10 Tablets

Generic Name:Pioglitazone

Manufacturer:The White Horse Pharmaceuticals Ltd.

Price:80.00

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Indication

Type 2 DM

Administration

May be taken with or without food.

Adult Dose

Oral Type 2 diabetes mellitus Adult: 15 mg once daily. Elderly: No dosage adjustment needed. Hepatic impairment: Moderate to severe: Avoid.

Renal Dose

Renal impairment: No dosage adjustment needed.

Contraindication

Hypersensitivity. Type 1 diabetes mellitus, symptomatic or history of heart failure, diabetic ketoacidosis, childn <18 yr. Lactation.

Mode of Action

Pioglitazone is as a potent and highly selective agonist for the peroxisome proliferator activated receptor-? (PPAR-?). Activation of these receptors promotes the production of gene products involved in lipid and glucose metabolism. It also improves insulin response to target cells w/o increasing the pancreatic secretion of insulin.

Precaution

I. Liver Enzyme must be monitored regularly II. History of heart failure and MI should be verified III. Incidence of bladder cancer should be verified IV. Not to be used for elderly patients V. Not to be used continuously more than one year VI. Use only by Specialist advice. Increased risk of hypoglycaemia when used with insulin or oral hypoglycaemics. Oedema, congestive heart failure, hepatic dysfunction, jaundice, anaemia. May cause ovulation in premenopausal, anovulatory women. Monitor liver function before and during treatment. Monitor glycaemic control. Pregnancy. Caution when oral contraceptives or hormonal replacement therapy is used in diabetics due to increased risk of arterial diseases. Stop treatment if ALT increases and remains >3 times above the upper limit of normal or if jaundice develops. Lactation: Not known if excreted in breast milk; discontinue drug or do not nurse

Side Effect

>10% Edema when used in combination with sulfonylurea or insulin (<27%),Hypoglycemia (<27%),Upper respiratory infection (13%) 1-10% Headache (9%),Heart failure (up to 8%),Sinusitis (6%),Fracture of bone (5%),Pharyngitis (5%),Myalgia (5%) Frequency Not Defined Aggravated diabetes,Diabetic macular edema,Hepatic failure (rare),Increased cholesterol,Decreased serum triglycerides,Hematocrit/hemoglobin,Bladder cancer,Decreased visual acuity,Dyspnea,Increased transaminases,Pharyngitis,Sinusitis,Weight gain

Interaction

Increased risk of oedema w/ insulin, metformin and sulfonylureas. Increased plasma levels w/ gemfibrozil and ketoconazole. Decreased plasma levels w/ rifampicin.

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