Piomet
Generic Name
Pioglitazone
Manufacturer
General Pharmaceutical Company (example)
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| piomet 15 mg tablet | ৳ 10.03 | ৳ 100.33 |
Description
Overview of the medicine
Pioglitazone is an oral antidiabetic drug used to treat type 2 diabetes mellitus. It improves glycemic control by increasing insulin sensitivity in peripheral tissues and the liver.
Uses & Indications
Dosage
Adults
Initial dose is 15 mg or 30 mg once daily. The dose can be increased up to a maximum of 45 mg once daily based on glycemic response and tolerability.
Elderly
No specific dose adjustment is generally required for elderly patients, but initiate therapy at the lowest dose and titrate cautiously.
Renal_impairment
No dose adjustment is needed for patients with renal impairment. However, monitor for fluid retention.
How to Take
Take orally once daily, with or without food. Swallow the tablet whole with water.
Mechanism of Action
Pioglitazone is a potent and highly selective agonist for peroxisome proliferator-activated receptor-gamma (PPAR-gamma) found in adipose tissue, skeletal muscle, and the liver. Activation of PPAR-gamma receptors modulates the transcription of insulin-responsive genes involved in glucose and lipid metabolism, leading to reduced insulin resistance.
Pharmacokinetics
Onset
Glycemic control improves gradually over several weeks of therapy, with full effect observed after 2-3 months.
Excretion
Approximately 15-30% excreted in urine, and the remainder (55-80%) eliminated in feces, primarily as metabolites.
Half life
Pioglitazone: Approximately 3-7 hours. Active metabolites (M-III and M-IV): 16-24 hours.
Absorption
Well absorbed after oral administration; bioavailability is approximately 83%. Peak plasma concentrations are reached within 1-2 hours.
Metabolism
Extensively metabolized in the liver by cytochrome P450 isoenzymes CYP2C8 and CYP3A4 to active and inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to pioglitazone or any component of the tablet.
- Diabetic ketoacidosis.
- Moderate to severe heart failure (NYHA Class III or IV).
- Active bladder cancer or history of bladder cancer.
- Unexplained macroscopic hematuria.
- Severe hepatic impairment.
Drug Interactions
Midazolam
Pioglitazone may decrease midazolam exposure. This interaction may be clinically relevant if midazolam is coadministered intravenously.
Rifampicin
Coadministration with rifampicin (a strong CYP2C8/3A4 inducer) significantly decreases pioglitazone exposure. Consider increasing the dose of pioglitazone.
Gemfibrozil
Coadministration with gemfibrozil (a strong CYP2C8 inhibitor) significantly increases pioglitazone exposure. A dose reduction of pioglitazone may be necessary.
Oral Contraceptives
Pioglitazone may decrease the effectiveness of oral contraceptives. Advise patients to use an additional method of contraception.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
In case of an overdose, symptomatic and supportive measures should be taken. Gastric lavage and activated charcoal may be considered if appropriate. Pioglitazone is not removed by hemodialysis.
Pregnancy & Lactation
Pregnancy Category C. Not recommended during pregnancy unless the potential benefit justifies the potential risk to the fetus. It is unknown if pioglitazone is excreted in human milk; avoid during breastfeeding.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
2 to 3 years from the date of manufacture, depending on the manufacturer. Check product packaging for specific dates.
Availability
Available in pharmacies
Approval Status
Approved by major regulatory bodies (e.g., FDA, DGDA)
Patent Status
Generic available
Clinical Trials
Pioglitazone has undergone extensive clinical trials demonstrating its efficacy in improving glycemic control in patients with type 2 diabetes mellitus, both as monotherapy and in combination with other agents. Trials have also investigated its effects on cardiovascular outcomes, with mixed results.
Lab Monitoring
- Liver function tests (LFTs) should be performed before initiating therapy and periodically thereafter.
- HbA1c levels to monitor glycemic control.
- Renal function tests if indicated.
- Monitor for signs and symptoms of heart failure.
Doctor Notes
- Assess cardiac status and risk factors for heart failure before initiation and regularly during therapy.
- Monitor liver function tests (LFTs) before and periodically during treatment.
- Counsel patients on the importance of reporting any signs of fluid retention or hematuria.
- Consider alternative therapies in patients with a history of bladder cancer.
Patient Guidelines
- Follow diet and exercise recommendations provided by your doctor.
- Monitor blood glucose levels regularly as instructed.
- Report any signs of unusual weight gain, swelling, or shortness of breath immediately.
- Be aware of the risk of bone fractures and discuss with your doctor if you have concerns.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Pioglitazone may cause visual disturbances or dizziness, which could impair your ability to drive or operate machinery. Exercise caution.
Lifestyle Advice
- Maintain a healthy, balanced diet appropriate for diabetes.
- Engage in regular physical activity as advised.
- Avoid smoking and limit alcohol consumption.
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.