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pioglitazone hydrochloride
Actos

Pregnancy Risk Category C

How supplied
Tablets:
15 mg, 30 mg, 45 mg

Action
Lowers blood glucose levels by decreasing insulin resistance. Improves sensitivity of insulin in muscle and adipose tissue.

Indication & dosage
Adjunct to diet and exercise to improve glycemic control in patients with type 2 non-insulin-dependent diabetes mellitus; or when diet, exercise, and either a sulfonylurea, metformin, or insulin doesn't result in adequate glycemic control--

Adults:
initially, 15 or 30 mg P.O. once daily. For patients who respond inadequately to initial dose, dosage may be increased in increments; maximum dose is 45 mg/day. If used in combination therapy, maximum dose shouldn't exceed 30 mg/day.

Adverse reactions
CNS:
headache.
CV:
edema.
EENT:
sinusitis, pharyngitis.
Hematologic:
anemia.
Metabolic:
hypoglycemia with combination therapy, aggravated diabetes mellitus, weight gain.
Musculoskeletal:
myalgia.
Respiratory:
upper respiratory tract infection.
Other:
tooth disorder, decreased triglyceride levels, increased high-density lipoprotein cholesterol levels.

Interactions
Drug-drug.
Ketoconazole: may inhibit metabolism of pioglitazone. Monitor patient's blood glucose levels more frequently.
Oral contraceptives:
may reduce plasma levels of oral contraceptives, resulting in less effective contraception. Advise patients taking drug and oral contraceptives to consider additional birth control measures.

Effects on diagnostic tests
None reported.

Contraindications
Contraindicated in patients with hypersensitivity to drug or its components and in those with type 1 insulin-dependent diabetes mellitus, clinical evidence of active liver disease, serum ALT level greater than 21/2 times the upper limit of normal, or New York Heart Association class III or IV heart failure; also contraindicated in patients who experienced jaundice while taking troglitazone and in the treatment of diabetic ketoacidosis.

Nursing considerations

Patient teaching

*Liquid contains alcohol. **May contain tartrazine.  †Canada  ‡Australia  §U.K.  OTCOver the counter
Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE-THREATENING

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