Pioglitazone: Uses, Dosage, Side Effects & Brands | MedexInfo
Pioglitazone
Rx Only
Generic NamePioglitazone
Therapeutic ClassThiazolidinedione / Antidiabetic
Common Dose15–30 mg once daily
Max / 24h45 mg
PregnancyCategory C
Indications ▼
Type 2 Diabetes Mellitus as monotherapy when diet and exercise alone are insufficient
Combination therapy with other oral antidiabetic agents or insulin
Improvement of insulin sensitivity in peripheral tissues
Mechanism & Pharmacokinetics ▼
Mechanism: Activates peroxisome proliferator-activated receptor gamma (PPAR-γ), enhancing insulin sensitivity in adipose tissue, muscle, and liver; reduces hepatic glucose output.
Pharmacokinetics: Well absorbed orally, bioavailability ~80%. Extensively metabolized in liver via CYP2C8 and CYP3A4. Half-life 3–7 hours (active metabolites 16–24 h). Excreted mainly in urine as metabolites.
Dosage & Administration ▼
| Patient Category | Recommended Dose | Max / 24h |
|---|---|---|
| Adults | 15–30 mg orally once daily; may increase to 45 mg/day based on response | 45 mg |
| Elderly | Start at 15 mg/day; monitor liver function and fluid retention | 45 mg |
| Hepatic Impairment | Use with caution; avoid in severe hepatic disease | As above |
| Renal Impairment | No dose adjustment usually required; monitor for edema | 45 mg |
Note: Take with or without food. Monitor blood glucose, liver function tests, and signs of fluid retention. Discontinue if hepatic dysfunction occurs.
Side Effects ▼
Common: Edema, weight gain, headache, upper respiratory infection
Occasional: Fatigue, myalgia, anemia
Serious: Heart failure exacerbation, hepatotoxicity, fracture risk in women, bladder cancer (long-term risk)
Contraindications ▼
Hypersensitivity to pioglitazone or other thiazolidinediones
NYHA Class III/IV heart failure
Active liver disease or ALT >2.5x upper limit of normal
Type 1 diabetes or diabetic ketoacidosis
Drug Interaction ▼
CYP2C8 inhibitors (e.g., gemfibrozil): may increase pioglitazone levels
CYP2C8 inducers (e.g., rifampicin): may reduce efficacy
Insulin or other antidiabetics: increased risk of hypoglycemia and fluid retention
Oral contraceptives: generally no significant interaction
Pregnancy & Lactation ▼
Category C; use only if clearly needed
Excretion in breast milk unknown; weigh benefits vs risks
Clinical / Research Summary ▼
Effectively lowers HbA1c by 0.5–1.5% as monotherapy or combination therapy.
Improves insulin sensitivity and lipid profile.
Long-term use may increase risk of heart failure and bone fractures in women; regular monitoring recommended.
Patient Counseling Points ▼
Take once daily at the same time each day, with or without food.
Monitor for weight gain, swelling, or shortness of breath; report promptly.
Do not start insulin or adjust dose without physician guidance while on pioglitazone.
Storage & Handling ▼
Store at 20–25°C, protect from moisture and light
Keep out of reach of children
Brand Names (Bangladesh & Global) ▼
Bangladesh:
Medical Disclaimer: This information is for educational purposes only and should not replace professional medical advice. Always consult a qualified healthcare provider.
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