Pioglitazone and Glimepiride (Oral)

Pioglitazone and Glimepiride is a combination medication that is used to help patients with type II diabetes make better use of insulin.

Overview

Pioglitazone and Glimepiride is a combination treatment for type II diabetes. It is not effective for use on patients with type I diabetes.

Pioglitazone and Glimepiride are prescribed in conjunction with diet and exercise to help the patient to control blood sugar levels. The medication will not work effectively unless the patient also follows a balanced and structured plan for diet and exercise.

Pioglitazone works to make the body more efficient at making use of insulin and Glimepiride is used to stimulate insulin release from inside the pancreas. In combination they work to more effectively turn the food that you eat into energy.

Pioglitazone and Glimepiride combination is a prescribed medication that is available as Duetact tablets. This treatment must be taken regularly in order to control blood sugar levels properly.

This is not a cure for type II diabetes. Instead Pioglitazone and Glimepiride will help the patient to control levels of sugar, and exercise and diet must be changed to reverse the high levels of blood sugar. Without taking these steps the patient will need to continue taking this medication indefinitely and will be exposed to more serious side effects as the period of use progresses.

Condition treated

  • Type II diabetes

Type Of Medicine

  • Pioglitazone - Thiazolidinedione
  • Glimepiride - Sulfonylureas

Side Effects

In addition to the desired effects of the Pioglitazone and Glimepiride combination, other unwanted side effects can also occur. Not all will occur in all patients, but when side effects do occur you may need to seek medical attention.

You should seek immediate medical attention if you experience any of the following side effects:

Occurring more commonly:

  • Anxiousness
  • Bladder pain
  • Bloody urine
  • Blurring of vision
  • Chills
  • Cloudy urine
  • Cold sweats
  • Coma
  • Confusion or disorientation
  • Depression
  • Difficulty, burning or pain experienced during urination
  • Headaches
  • Increased frequency of urge to urinate
  • Increased heartbeat
  • Increased hunger
  • Increased weight
  • Lower back pain
  • Nausea
  • Nightmares
  • Paleness of the skin
  • Seizures or convulsions
  • Shakiness
  • Side pain
  • Slurring of speech
  • Swollen feet or lower legs
  • Unusual tiredness
  • Unusual weakness

Occurring less commonly:

  • Accidental injury
  • Loss of appetite
  • Pain or swelling of the arms or legs without cause
  • Paleness of the skin
  • Stomach pain
  • Troubled breathing when exerting oneself
  • Unusual bleeding
  • Unusual bruising
  • Vomiting
  • Weight loss
  • Yellowing of the eyes
  • Yellowing of the skin

Other side effects can also occur that are usually mild and do not indicate wider medical conditions that may be developing. These side effects do not normally need to be treated but you can report them to your doctor if they are ongoing or bothersome. The following side effects would not normally require you to seek medical attention but may occur:

Occurring more commonly:

  • Body aches
  • Body pains
  • Coughing
  • Diarrhea
  • Difficulty with moving
  • Dryness of the throat
  • Ear congestion
  • Feverishness
  • Hoarseness
  • Joint pains
  • Loss of voice
  • Muscle aching
  • Muscle cramping
  • Muscle pains
  • Muscle stiffness
  • Runny nose
  • Sneezing
  • Soreness of the throat
  • Stuffy nose
  • Swelling of the joints
  • Tender or swollen glands in the neck
  • Tooth disorder
  • Trouble with swallowing
  • Voice changes

Occurring less commonly:

Other side effects that have not been listed herein could also occur. In such cases you should inform your doctor and seek advice. If you believe your immediate health to be at risk, however, then you should contact the emergency services.

Dosage

This medication must be taken as directed by your doctor in conjunction with diet and exercise plans provided. You should not use more of it, take it more often nor use it for a longer period of time than ordered. If this medication is not taken properly then it will not work effectively.

The diet that you eat is the most important element in controlling your blood sugar level and you must follow a balanced diet in order to control it. This medication will be ineffectual if you eat foods that give you large spikes in blood sugar levels. You will also need to do regular exercise to help your body process sugar more effectively so that it does not build up in your system. Regular light exercise will make this medication more effective.

Pioglitazone and Glimepiride will always be provided with a medication guide that you should read and ensure that you understand before you begin use of the treatment. If you have any questions then you should ask your doctor before beginning use.

You should take this medication when you consume your first meal of the day.

If you are also using Colesevelam medication then you should wait for at least 4 hours after taking Pioglitazone and Glimepiride before using it.

The dose prescribed will be different for each patient and will depend on your blood sugar level and wider health condition. You should not make any changes to your dosing unless directed to by a doctor and must be regular in your use of the treatment for best effect. The following information is a guideline only and changes to dosing should not be made based on this:

When treating patients who have previously been taking Glimepiride:

  • Adults should take an initial dose of Pioglitazone 30mg and Glimepiride 2mg or Pioglitazone 30mg and Glimepiride 4mg. The dose may be increased to a maximum of Pioglitazone 45mg and Glimepiride 8mg.

When treating patients who have previously been taking Pioglitazone:

  • Adults should begin with an initial dose of Pioglitazone 30mg and Glimepiride 2mg. This dose can be increased but should not exceed Pioglitazone 45mg and Glimepiride 8mg.

When treating patients who have previously been taking Pioglitazone and Glimepiride as separate tablets:

  • Adult patients should be given either Pioglitazone 30mg and Glimepiride 2mg or Pioglitazone 30mg and Glimepiride 4mg. The dose can be adjusted as required up to a maximum of Pioglitazone 45mg and Glimepiride 8mg.

When treating patients who are changing to Pioglitazone and Glimepiride from other diabetes medication:

  • Adults should use a starting dose of Pioglitazone 30mg and Glimepiride 2mg. The dose can be increased by the doctor as required up to a maximum of Pioglitazone 45mg and Glimepiride 8mg.

If you miss a dose of this medication then you should take it as soon as you are able to. If you are close to your next dose being due, however, then you should skip it entirely and return to your normal schedule of use. Never take a double dose of the medication.

Interactions

Pioglitazone and Glimepiride can interact with a range of medication in the body. You should inform your doctor of all medications that you are taking before you begin use.

The use of Pioglitazone and Glimepiride would not normally be recommended for use with the following treatments:

  • Voriconazole
  • Tosufloxacin
  • Tolvaptan
  • Thioctic Acid
  • Sparfloxacin
  • Rufloxacin
  • Prulifloxacin
  • Pixantrone
  • Piperaquine
  • Pefloxacin
  • Pazufloxacin
  • Pasireotide
  • Ofloxacin
  • Octreotide
  • Norfloxacin
  • Nifedipine
  • Nadifloxacin
  • Moxifloxacin
  • Miconazole
  • Metreleptin
  • Lomefloxacin
  • Lixisenatide
  • Levofloxacin
  • Lanreotide
  • Isoniazid
  • Insulin Lispro, Recombinant
  • Insulin Glulisine
  • Insulin Glargine, Recombinant
  • Insulin Detemir
  • Insulin Degludec
  • Insulin Bovine
  • Insulin Aspart, Recombinant
  • Insulin
  • Ifosfamide
  • Gemifloxacin
  • Gatifloxacin
  • Flumequine
  • Fleroxacin
  • Entacapone
  • Enoxacin
  • Dulaglutide
  • Disopyramide
  • Ciprofloxacin
  • Besifloxacin
  • Balofloxacin
  • Aspirin

The use of Pioglitazone and Glimepiride may cause an increased risk of certain side effects when you are also taking any of the following. Both medications may be prescribed together but the doctor will normally adjust the dose or frequency of use of one or both treatments:

  • Tranylcypromine
  • Topiramate
  • Timolol
  • Sotalol
  • Selegiline
  • Safinamide
  • Rifampin
  • Rasagiline
  • Psyllium
  • Propranolol
  • Procarbazine
  • Practolol
  • Pindolol
  • Phenelzine
  • Penbutolol
  • Oxprenolol
  • Nilotinib
  • Nialamide
  • Nebivolol
  • Nadolol
  • Moclobemide
  • Metoprolol
  • Metipranolol
  • Methylene Blue
  • Linezolid
  • Levobunolol
  • Labetalol
  • Ketoconazole
  • Isocarboxazid
  • Iproniazid
  • Guar Gum
  • Glucomannan
  • Gemfibrozil
  • Furazolidone
  • Fenugreek
  • Esmolol
  • Colesevelam
  • Celiprolol
  • Carvedilol
  • Carteolol
  • Bitter Melon
  • Bisoprolol
  • Betaxolol
  • Atorvastatin
  • Atenolol
  • Acebutolol
  • Abiraterone

Other medications not listed here may also interact with the use of Pioglitazone and Glimepiride. Patients should inform their doctor of all treatments they are taking.

Patients with the following medical conditions may also be unable to use this medication. You must inform your doctor of all medical conditions from which you suffer, especially in these cases:

  • Adrenal gland problem
  • Glucose 6-phosphate dehydrogenase deficiency
  • Kidney problems
  • Pituitary problems
  • Poor nourishment
  • Weakend condition
  • Active bladder cancer
  • Diabetic ketoacidosis
  • Severe heart failure
  • Severe liver disease
  • Sulfa drug allergy
  • Type I diabetes
  • Diabetic macular edema
  • Edema
  • Heart disease
  • Liver disease
  • Fever
  • Infection
  • Surgery
  • Trauma
  • Fragile bones

Warnings

Before beginning use of this treatment you should consider the risks in relation to the benefits with your doctor. Ensure that you have considered the following:

Allergies: Inform your doctor of all allergies from which you suffer. Allergies to sulfa medications in particular may prohibit use.

Pediatric and Geriatric: Safety and efficiency of use has not been established in children. There are no known limitations to the use of this treatment in elderly patients.

Pregnancy and Breastfeeding: There is a risk presented when pregnant and there is a known risk to pregnancy when suffering from diabetes. Discuss pregnancy, future pregnancy and breastfeeding with your doctor before beginning treatment.

The patient's risk of developing serious heart and liver conditions during the use of this medication will be greatly increased. Patients should learn the symptoms of these conditions and know how to react in order to get the help they need if these conditions should continue.

Patients taking this medication should strictly limit and ideally cease the consumption of alcohol. Consumption of alcohol can have significant impact on blood sugar levels and can put the patient at risk of serious complications. You should discuss this with your doctor.

Storage

Keep the medication in a closed container and out of the reach of children at all times. Keep the tablets away from moisture, direct light and heat. Dispose of any unused medication safely as directed by your healthcare professional.

Summary

Pioglitazone and Glimepiride is a combination treatment used in patients with type II diabetes. It interacts with the insulin in the body to make more effective use of it.

This treatment will only be effective when used regularly and in conjunction with a healthy diet and an exercise plan that will be provided to you by your doctor.

This medication will need to be taken indefinitely unless the patient can control their blood sugar levels through diet and exercise. Ensure that you follow all of the guidance given by your doctor to help you to improve your condition.