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

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Route

Oral

Rate of Administration

–

Comments

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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.

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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