Pioglitazone

Administration

• Type: Diabetes medication
• Dosage Forms: 15 mg, 30 mg, 45 mg
• Routes of Administration: PO
• Common Trade Names: Actos

Adult Dosing

• 15-45 mg PO qd
• Max: 45 mg/day

Pediatric Dosing

• >15-30 mg PO qd
• Start with 15 mg PO qd
• Max: 45 mg/day
• Give with metformin

Special Populations

• Pregnancy Rating: C
• Lactation risk: No recommended

• Renal Dosing: no adjustment
• Hepatic Dosing: no adjustment

Contraindications

• Allergy to class/drug
• Pediatric patients <15 yo
• Type 1 diabetes
• DKA
• Active bladder cancer
• CHF (symptomatic; NYHA Class III-IV)

Caution

• CHF (NYHA Class I-II)
• CHF Risk
• Edema
• Hepatic impairment
• Bladder cancer history
• Premenopausal anovulatory patients

Adverse Reactions

Serious

• CHF
• Hepatotoxicity
• Diabetic macular edema
• Bladder cancer risk
• Fractures (females)

Common

• URI
• Headache
• Myalgia
• Weight gain
• Edema
• Fluid retention
• Flatulence
• Anemia
• Ovulation induction

Pharmacology

• Half-life: 3-7 hrs; 16-24 hrs (metabolites)
• Metabolism: Liver (CYP450)
• Excretion: Urine; bile

Mechanism of Action

• Increases insulin sensitivity

See Also

• Diabetes medication

References

• Pioglitazone [monograph]. Epocrates Version. 20.2 [iPhone]. Epocrates, Inc, San Francisco, CA. Available from https://online.epocrates.com/. Accessed March 3, 2020.
• Actos. Food and Drug Administration Web site.* https://www.accessdata.fda.gov/drugsatfda_docs/label/1999/21073lbl.pdf. Accessed March 3, 2020.