Piolit
Generic Name
Pioglitazone
Manufacturer
Leading Pharmaceutical Company
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| piolit 15 mg tablet | ৳ 8.02 | N/A |
Description
Overview of the medicine
Pioglitazone is an oral antidiabetic drug used to improve glycemic control in adults with type 2 diabetes mellitus as an adjunct to diet and exercise.
Uses & Indications
Dosage
Adults
Initial dose 15 mg or 30 mg once daily. Maximum recommended dose is 45 mg once daily. Dose adjustments should be based on glycemic response.
Elderly
No specific dose adjustment generally needed, but careful monitoring for adverse effects, especially fluid retention.
Renal_impairment
No dose adjustment required for patients with renal impairment.
How to Take
Administer orally, once daily, with or without food. Tablets should be swallowed whole with water.
Mechanism of Action
Pioglitazone is a thiazolidinedione that acts as an agonist for peroxisome proliferator-activated receptor gamma (PPARγ) in adipose tissue, skeletal muscle, and the liver. This action increases insulin sensitivity, leading to improved glucose uptake and utilization in peripheral tissues and reduced hepatic glucose output.
Pharmacokinetics
Onset
Gradual onset, effects usually seen within 2-3 weeks, maximal effect in 2-3 months.
Excretion
Primarily excreted via bile into the feces (55%) and urine (45%).
Half life
Parent drug: 3-7 hours; active metabolites: 16-24 hours.
Absorption
Rapidly absorbed, peak plasma concentrations reached within 2 hours. Absolute bioavailability is over 80%.
Metabolism
Extensively metabolized in the liver by cytochrome P450 enzymes (primarily CYP2C8 and CYP3A4) to active and inactive metabolites.
Side Effects
Contraindications
- Known hypersensitivity to pioglitazone or any component of the formulation.
- Heart failure (NYHA Class III or IV).
- Active bladder cancer or a history of bladder cancer.
- Diabetic ketoacidosis.
Drug Interactions
Rifampicin
Potent CYP2C8 inducer; co-administration may decrease pioglitazone plasma concentrations. Consider increasing pioglitazone dose or alternative therapy.
Gemfibrozil
Potent CYP2C8 inhibitor; co-administration may significantly increase pioglitazone plasma concentrations. Consider reducing pioglitazone dose.
Oral contraceptives
May reduce the effectiveness of oral contraceptives. Patients should use additional or alternative methods of contraception.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
Overdose may lead to hypoglycemia (if used with insulin or sulfonylurea) and fluid retention. Treatment is symptomatic and supportive. Gastric lavage and activated charcoal may be considered if recent ingestion.
Pregnancy & Lactation
Pregnancy Category C. Not recommended during pregnancy unless the potential benefit justifies the potential risk to the fetus. Avoid during breastfeeding as it is unknown if pioglitazone is excreted in human milk.
Side Effects
Contraindications
- Known hypersensitivity to pioglitazone or any component of the formulation.
- Heart failure (NYHA Class III or IV).
- Active bladder cancer or a history of bladder cancer.
- Diabetic ketoacidosis.
Drug Interactions
Rifampicin
Potent CYP2C8 inducer; co-administration may decrease pioglitazone plasma concentrations. Consider increasing pioglitazone dose or alternative therapy.
Gemfibrozil
Potent CYP2C8 inhibitor; co-administration may significantly increase pioglitazone plasma concentrations. Consider reducing pioglitazone dose.
Oral contraceptives
May reduce the effectiveness of oral contraceptives. Patients should use additional or alternative methods of contraception.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
Overdose may lead to hypoglycemia (if used with insulin or sulfonylurea) and fluid retention. Treatment is symptomatic and supportive. Gastric lavage and activated charcoal may be considered if recent ingestion.
Pregnancy & Lactation
Pregnancy Category C. Not recommended during pregnancy unless the potential benefit justifies the potential risk to the fetus. Avoid during breastfeeding as it is unknown if pioglitazone is excreted in human milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24-36 months from the date of manufacture.
Availability
Pharmacies, Hospitals
Approval Status
Approved
Patent Status
Patent expired in many countries
Clinical Trials
Extensive clinical trials have demonstrated pioglitazone's efficacy in improving glycemic control and insulin sensitivity in patients with type 2 diabetes. Studies have also explored its cardiovascular safety profile, noting a black box warning for heart failure.
Lab Monitoring
- Liver function tests (ALT) should be performed prior to initiation and periodically thereafter.
- Monitor for signs and symptoms of heart failure regularly.
- Baseline and periodic hemoglobin/hematocrit.
Doctor Notes
- Careful patient selection is crucial, especially regarding pre-existing cardiovascular risk factors and history of bladder cancer.
- Monitor patients for signs and symptoms of fluid retention and heart failure, particularly during initiation or dose escalation.
- Assess liver function tests (ALT) before initiating therapy and periodically thereafter. Discontinue if ALT > 3x ULN.
- Consider bone fracture risk, especially in women, and advise on bone health strategies.
Patient Guidelines
- Take Piolit exactly as prescribed by your doctor.
- Monitor your blood sugar levels regularly as advised by your healthcare provider.
- Report any unusual rapid weight gain, swelling, or shortness of breath to your doctor immediately, as these could be signs of heart failure.
- Inform your doctor about any history of bladder cancer or liver problems.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue your regular dosing schedule. Do not double the dose to make up for a missed one.
Driving Precautions
Pioglitazone may cause blurred vision or dizziness. Patients should be cautious when driving or operating machinery until they know how the medicine affects them.
Lifestyle Advice
- Maintain a balanced diet, engage in regular physical activity, and strive for a healthy weight to help manage your diabetes effectively.
- Avoid smoking and limit alcohol intake.
Alternative Medicines in Bangladesh
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.