Pioglitazone

CLINICAL USE

Treatment of type 2 diabetes mellitus

DOSE IN NORMAL RENAL FUNCTION

15–45 mg daily

PHARMACOKINETICS

Molecular weight :392.9 (as hydrochloride)

%Protein binding :>99

%Excreted unchanged in urine : <1

Volume of distribution (L/kg) :0.25

half-life – normal/ESRD (hrs) :5–6 (active metabolites: 16–23)/Unchanged

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Unlikely to be dialysed. Dose as in normal renal function and monitor carefully

HD :Unlikely to be dialysed. Dose as in normal renal function and monitor carefully

HDF/high flux :Unknown dialysability. Dose as in normal renal function and monitor carefully

CAV/VVHD :Unknown dialysability. Dose as in normal renal function and monitor carefully

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

None known

ADMINISTRATION

Reconstition

–

Route

Oral

Rate of Administration

–

Comments

–

OTHER INFORMATION

Liver function tests should be measured prior to initiation of therapy and then every 2 months for the first 12 months, and thereafter at regular intervalsPioglitazone should not be used in patients with heart failure or history of heart failure; incidence of heart failure is increased when pioglitazone is combined with insulin. Patients should be closely monitored for signs of heart failure.

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