Pioglitazone

Pioglitazone is a thiazolidinedione antidiabetic medicine available in Bangladesh under many brand names. Below are its uses, dosage, side effects and precautions — and all brands with their current prices.

• Treatment of type 2 diabetes mellitus in adults, as an adjunct to diet and exercise.
• May be used alone or with other antidiabetic medicines when prescribed by a doctor.
• Not indicated for type 1 diabetes or diabetic ketoacidosis.

For adults, Pioglitazone is usually taken once daily, with or without food. The exact strength and any dose adjustment depend on blood glucose control, other diabetes medicines, and individual risks such as heart, liver, or fluid-retention problems. Follow the prescribing doctor's instructions and do not change the dose without medical advice.

• Common effects may include weight gain, swelling or fluid retention, headache, muscle pain, and upper respiratory tract symptoms.
• When used with insulin or sulfonylureas, low blood sugar may occur.
• Serious effects can include worsening heart failure, shortness of breath, rapid weight gain, significant swelling, liver problems, bone fractures, and possible bladder-related problems such as blood in urine or painful urination.
• Seek urgent medical help for chest pain, severe breathlessness, yellowing of the skin or eyes, dark urine, or signs of an allergic reaction.

Use Pioglitazone with caution in people with heart disease or heart failure risk, edema, liver disease, history of bladder cancer or unexplained blood in urine, osteoporosis or fracture risk, and in elderly patients. Liver function and diabetes control may need monitoring. Use this medicine only under the guidance of a registered doctor or pharmacist.

• Insulin and sulfonylureas: increased risk of hypoglycaemia and fluid retention; dose adjustment of other diabetes medicines may be needed.
• Gemfibrozil and other strong CYP2C8 inhibitors: may increase Pioglitazone levels and side effects.
• Rifampicin and other CYP2C8 inducers: may reduce Pioglitazone levels and effectiveness.
• Alcohol may worsen diabetes control and can increase concern for liver-related problems; discuss safe use with a clinician.

• Known hypersensitivity to pioglitazone or any tablet ingredient.
• Type 1 diabetes mellitus or diabetic ketoacidosis.
• Current or severe heart failure; initiation is not recommended in patients with symptomatic heart failure.
• Active liver disease or unexplained persistent liver enzyme elevation.
• Current bladder cancer, history of bladder cancer, or unexplained visible blood in the urine unless evaluated by a doctor.

Pioglitazone is generally not preferred during pregnancy unless a specialist decides the potential benefit outweighs the risk; insulin is commonly used when medication is needed for diabetes in pregnancy. It is not known whether it passes into human breast milk, so breastfeeding patients should use it only after medical advice.

Store tablets at room temperature, protected from excess heat, moisture, and direct light. Keep in the original packaging, out of reach of children, and do not use after the expiry date.