Uses of Pgit: - Type 2 diabetes mellitus Type 2 DM Hypersensitivity. Type 1 diabetes mellitus, symptomatic or history of heart failure, diabetic ketoacidosis, childn <18 yr. Lactation.

Thiazolidinedione Group

Pioglitazone is a preparation of Pioglitazone which is a member of the newest class of oral antidiabetic agent called thiazolidinediones. It depends on the presence of Insulin for its mechanism of action. Pioglitazone decreases Insulin resistance in the periphery and in the liver, resulting in increased Insulin dependent glucose disposal and decreased hepatic glucose output. It also improves abnormality in lipid metabolism by activating peroxisome proliferator activated receptor gamma (PPAR-γ).

How to use Pioglitazone: Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Pioglitazone may be taken with or without food, but it is better to take it at a fixed time. 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.

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

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

Common - Weight gain - Blurred vision - Respiratory tract infection - Numbness - Bone fracture >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

Pregnancy: There are no adequate and well controlled studies in pregnant women. Pioglitazone should be used during pregnancy only if the potential benefit justifies the potential risk to the foetus.Lactation: It is not known whether Pioglitazone is secreted in human milk. As many drugs are excreted in human milk, it should not be administered to a lactating women.

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

Store at 25° C.

Thiazolidinedione Group

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.

Pregnancy: There are no adequate and well controlled studies in pregnant women. Pioglitazone should be used during pregnancy only if the potential benefit justifies the potential risk to the foetus.Lactation: It is not known whether Pioglitazone is secreted in human milk. As many drugs are excreted in human milk, it should not be administered to a lactating women.