Diabetes may develop at any age unexpectedly. However, diabetes 2 is the disease of adults. Have you noticed that you have such symptoms as worse vision, constant fatigue, thirst, recurrence of infections? If you were diagnosed with diabetes of the 2d type, you are likely to be prescribed the course of treatment with Actos medication. Learn what it is and how to take it the right way to see the desired effect.
What Is Pioglitazone (Actos)?
Actos Pioglitazone is a medication that is used to treat diabetes of the 2d type. The main active substance of the drug is Pioglitazone. The medication shows the necessary effect in combination with special physical exercises and a healthy diet. The principle of action is the following: It is one of the most effective medicines for diabetes treatments as it helps the body keep blood sugar under control. The drug is prescribed to the patients diagnosed with diabetes type 2 only and can’t be taken by patients with type 1 diabetes.
Pioglitazone Uses
What is Pioglitazone medicine used for? These tablets are used to lower the level of blood sugar. It is used to reduce insulin resistance in patients with impaired glucose tolerance and type 2 diabetes. It’s the first-line drug for the detection of the disease in combination with lifestyle changes.
How does Actos Pioglitazone drug work? The drug helps prevent many serious consequences caused by diabetes 2 type, including the damage of the kidney, problems with the nervous system, sexual sphere, blurred vision, etc.
Before you start using the drug, you are recommended to consult your healthcare specialist. It’s necessary to follow the instructions when you use the medication. Check how you should use the drug:
- Meals don’t affect the work of the pills. So, you can take it either with meals, before you are going to have meals, or within some time after you’ve had some food.
- In most cases, the drug is taken once a day. The dosage should be prescribed by the doctor as it depends on the patient’s condition. The dosage may be increased or decreased after you have blood sugar tests. According to the results of the test, your pharmacist will prescribe the dosage that will be safe and effective for you individually.
- There is no best time for taking the medication – the main condition is to take the medication regularly and try to take it at the same time daily. The medication schedule is a key to success as it works more effectively when being taken at the same time. Try not to miss the dosage to achieve a good result.
- Tell your pharmacist if you take any other drugs for diabetes or other health conditions. It is very important for the doctor to know when giving you instructions regarding the use of this medication. You may need to stop using some drugs for the period when you take this medicine due to the rules of interactions. Not all substances can be combined successfully during the treatment without any side effects. You will avoid any unexpected adverse body reactions if you tell the doctor your medical history with all the drugs you have taken recently or are still taking at the moment.
Indications of Actos Medication
Type 2 diabetes mellitus (DM) is one of the most common non-communicable diseases in the world. According to WHO experts, by 2025 the number of patients with type 2 diabetes will increase to 333 million people. The UK Prospective Diabetes Study showed that cardiovascular diseases, primarily myocardial infarction and acute cerebrovascular accidents, are the leading cause of premature death in type 2 diabetes patients.
The key mechanism of the pathogenesis of type 2 diabetes is considered to be insulin resistance (IR), which leads not only to hyperglycemia but also provokes such risk factors for the development of cardiovascular diseases, such as arterial hypertension and dyslipidemia. In this regard, the creation and use in the therapy drugs that directly affect IR is a promising direction in the treatment of this serious disease.
Since 1996, in the treatment of patients with type 2 diabetes, a new class of drugs has been used, united by their mechanism of action into the group of thiazolidinediones or insulin sensitizers (ciglitazone, rosiglitazone, darglitazone, troglitazone, Pioglitazone, englitazone), the main action of which is aimed at increasing the sensitivity of peripheral tissues to insulin.
What is Actos? As has already been said, this diabetes medication is prescribed to patients with 2nd type of diabetes.
- For the monotherapy or as a part of the combination therapy with insulin, Metformin, and sulfonylurea derivatives.
- As an additional means of treatment along with the diet and physical exercises.
Monotherapy
In monotherapy for patients who can’t achieve good results with diabetes mellitus with the help of diet therapy and exercise, this drug should be taken at a dose of 15 mg or 30 mg once a day. In some cases, the dose can be gradually increased to 45 mg/day. With monotherapy, the maximum dose of the medication is 45 mg once per day.
Combination Therapy
When a combination therapy with sulfonylurea derivatives is prescribed, Actos is taken at a dose of 15 mg or 30 mg once a day. At the beginning of the treatment course, the dose of the sulfonylurea derivative can be left unchanged. If there is a development of hypoglycemia, the dose of the medication must be decreased. However, you shouldn’t decide it on your own. It is your doctor who can either increase or decrease the dose of this medication. It won’t show the desired effect if you take the dose you want.
In combination with Metformin, this drug is prescribed at a dose of 15 mg or 30 mg once a day. At the beginning of the treatment course, the dose of Metformin can be unchanged. The risk of developing hypoglycemia with this combination is insignificant, so patients are unlikely to experience the need for the dose adjustment of Metformin.
In combination with insulin, Actos is prescribed at a dose of 15 mg or 30 mg once a day. At the beginning of the treatment course the dose of insulin can be unchanged. With the development of hypoglycemia and a decrease in plasma glucose concentration to less than 100 mg/dL, the dose of insulin can be reduced by 10-25%. Further adjustment of the insulin dose should be carried out individually, depending on the level of glycemia. In combination therapy, the maximum dose of this medication can reach 30 mg per day.
Actos Dosage
The dosage of the medication is prescribed individually depending on the patient’s health condition and the results of blood sugar tests. Usually, the dosage is taken once per day. The intake of food doesn’t influence the effectiveness of the drug. Patients who suffer from renal insufficiency don’t need the adjustment of dosage.
An overdose during monotherapy is not accompanied by the occurrence of specific clinical symptoms. An overdose in combination with a sulfonylurea preparation may be accompanied by the development of symptoms of hypoglycemia. The treatment in case of overdose is the following: carrying out symptomatic therapy depending on clinical manifestations (for example, treatment of hypoglycemia). Take into account that there is no specific antidote.
Maintenance Dose
The maintenance dose of the drug is once per day orally, regardless of the food intake. Those patients who have heart failure shouldn’t take more than 15 mg per day. Those who don’t suffer from heart failure can take a dose from 15 mg to 30 mg. The dosage is prescribed individually depending on the type of course treatment chosen by your pharmacist.
Maximum Dose
The maximum dosage is 45 mg in case a patient has a monotherapy. In combination therapy, the maximum dosage is 30 mg per day. Take into account that you shouldn’t take the maximum dose just because you have missed one dose before or if you think that the drug doesn’t show the desired result. A competent healthcare specialist is the only person who can prescribe you the maximum possible dose.
Dosage Form
You can buy round white pills in the dosage of 15 mg, 30 mg, and 45 mg. On the one side of the pill, there is the brand name “Actos,” while on the other side, there is the dosage of the main active substance. Buy the dosage form that you have been prescribed by the doctor, or you can get the larger one and divide pills into parts.
Possible Side Effects
“Is it safe to take Actos tablets?” – is the most common question patients ask when they are prescribed a treatment course. Like any other drug, it may cause unwanted side effects. Some patients don’t report about serious side effects, while in rare cases, patients admit that they have experienced more severe adverse reactions. Check what side effects are common during the intake of Atos medication.
Headache
It is one of the most common side effects caused by this medicine. You shouldn’t worry if you have a headache from time to time, but if it is very severe and painkillers don’t help, inform your doctor about this side effect.
Muscle Pain
Don’t be surprised if you feel pain in muscles and weakness. It is a temporary side effect that won’t last for the whole course of treatment.
Cold Symptoms
Some patients report the presence of cold symptoms during the Atos treatment course. But there is no solid evidence that there is a connection between the intake of the drug and the cold that may appear because of many other factors.
Painful or Difficult Urination
Those who take this drug should know that it may have a negative effect on urination. If you feel pain when urinating or notice that the process of urination has become more difficult for you, inform your doctor about the emergency of this side effect. It’s important to control this side effect as, according to some studies, there is a connection between the intake of Atos and bladder cancer. This especially refers to the patients who had bladder cancer before or are prescribed Atos when having an active phase of bladder cancer.
Not all epidemiological studies have shown that there is a high probability of the development of cancer when taking this medicine. But you need to take the drug carefully, keeping in mind that this medication may trigger the worsening of urination and that it is associated with an increased risk of cancer. Some scientists think that it isn’t safe to take the drug while others consider Actos the best known anti-diabetic medication for those who are diagnosed with type 2 diabetes.
Rapid Weight Gain
It is a well-known fact that people who are diagnosed with diabetes suffer from weight gain, being less responsive to diets. There are several types of diabetes. Diabetes 2nd type appears when the person suffers from extra weight. Those who suffer from diabetes 2 should control what they eat and lead a more active lifestyle. In all clinical trials, taking Pioglitazone, like other TZD, was accompanied by an increase in body weight by 0.5-3.7 kg, especially in the first 6 months of treatment. Subsequently, the weight of the patients stabilized.
Of course, weight gain is a very undesirable side effect of any drug in the treatment of type 2 diabetes. The vast majority of patients are obese or overweight. However, it is important to emphasize that the intake of Pioglitazone is mainly accompanied by an increase in the volume of subcutaneous adipose tissue, while the amount of visceral fat decreases while taking TZD. Despite the increase in weight while taking this medicine, the risk of developing and/or progression of cardiovascular disease does not increase. It is important to note that the degree of weight gain is directly correlated with concomitant antihyperglycemic therapy, i.e., weight gain is higher in patients receiving a combination of TZD with insulin or sulfonylureas and lower in patients with Metformin.
What is Pioglitazone? It is the active substance of the medication that makes it so that the insulin works more active; extra calories transform into fat. It doesn’t mean that you will become too obese when taking the drug. However, the mechanism of work contributes to the faster weight gain in the patients with diabetes 2 type. That’s why you should keep to a healthy diet and follow the doctor’s recommendations about the foods you should include in your daily ration and which foods you should avoid consuming at least for the period of treatment.
Therapy with this drug is accompanied by a slight dose-dependent decrease in hemoglobin and hematocrit levels. This side effect is most likely due to hemodilution due to fluid retention. There is no toxic effect on the bone marrow when taking this medication.
All of the above-listed side effects aren’t obligatory for everyone. You may not experience any of them, but you should be aware of all the risks to inform your doctor and prevent the development of severe side effects.
Adverse events occurring in ≥2% of pioglitazone treated patients in triple therapy clinical trials
| Placebo (n> 154) | Pioglitazone (n>145) | |
| Weight increased | 1,3 | 26,2 |
| Hypoglycaemia | 7,1 | 24,1 |
| Bronchitis | 2,0 | 2,8 |
| Gastroenteritis | 1,3 | 2,1 |
| Influenza | 0,7 | 2,1 |
| Tooth abscess | 0,0 | 2,1 |
| Arthralgia | 2,0 | 4,8 |
| Back pain | 2,0 | 3,5 |
| Myalgia | 1,3 | 2,8 |
| Oedema peripheral | 3,3 | 3,5 |
| Asthenia | 2,0 | 4,1 |
| Malaise | 1,3 | 2,8 |
| Headache | 2,0 | 2,8 |
| Diarrhoea | 2,0 | 2,1 |
| Abdominal pain upper | 0,7 | 2,1 |
Warnings and Precautions
The drug mustn’t be taken by patients under 18. The medication can’t be prescribed to women in the period of pregnancy or lactation. There is no trusted information about the effect of the drug on the unborn baby. It is unknown whether the medication can enter the mother’s milk. That’s why it is recommended to stop the treatment course if it is possible, depending on the health condition of the patient, or stop breastfeeding when taking the drug.
Those patients who have serious liver diseases should take the medication carefully as well as those who have heart diseases, anemia, and other serious health conditions. Take into account that the drug has certain contraindications. Check them before you start the treatment course. Besides age restrictions, pregnancy, and breastfeeding, the producer of the drug warns that you mustn’t take Actos in case you have diabetes 1 type or the individual sensitivity to any of the drug’s ingredients that may lead to breathing difficulties. Make sure you don’t have any contraindications before you start taking the drug.
When you start using Pioglitazone, don’t forget that it shows positive effects only if you combine the course of treatment with physical exercises and the diet recommended by your physician. Remember that you need to follow the physical training regime and keep to diet not only at the beginning of the treatment course but also after it to maintain the effect for long. One more thing to keep in mind is that the intake of Atos may become the reason for fluid retention, regardless of whether you have a monotherapy or a combination therapy.
The level of hepatic enzymes should be investigated both before prescribing the drug and during therapy. Since Pioglitazone is metabolized in the liver and excreted from the body mainly in bile and feces, it is not as dangerous for people with kidney disease as Metformin. However, given the fluid retention associated with this drug intake, the producer of Actos doesn’t recommend prescribing it to individuals with chronic renal failure. Alcohol abuse during treatment can contribute to the development of episodes of hypoglycemia.
Remember about this fact, as fluid retention may worsen the condition of patients who suffer from heart diseases. That’s why it is essential to control your health condition regularly when you take this drug. Follow the instructions of the doctor and make all the necessary tests to make sure that you do everything the right way. One more warning you need to be aware of is that the drug decreases the level of phosphatase. These warnings will save your life if you keep them in mind when taking the drug.
| Contraindicated for Use |
|
In patients with hepatic impairment |
|
In patients with cardiac failure |
|
In patients under 18 |
|
In patients with known hypersensitivity to Pioglitazone |
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In patients during pregnancy and lactation |
What Other Drugs Will Affect Actos
Those patients who take this drug in combination with oral contraceptives admit that the efficiency of contraceptives decreases. It may stimulate ovulation and become the reason for unplanned pregnancy if you don’t use reliable contraceptives.
There are no changes in pharmacokinetics and pharmacodynamics with the simultaneous use of this drug with Glipizide, Digoxin, indirect anticoagulants, Metformin. In vitro, ketoconazole inhibits the metabolism of Pioglitazone. There are no data on the pharmacokinetic interaction of Actos with erythromycin, astemizole, calcium channel blockers, cisapride, corticosteroids, cyclosporine, lipid-lowering drugs (statins), tacrolimus, triazolam, trimetrexate, and itraconazole.
Drugs Similar to Actos (Pioglitazone)
Drugs similar to Actos (pioglitazone) belong to the class of thiazolidinediones (TZDs) and work by improving insulin sensitivity and reducing insulin resistance in peripheral tissues. One alternative is Avandia (rosiglitazone), which shares a similar mechanism of action with pioglitazone in enhancing insulin sensitivity and reducing hepatic glucose production. Another option is Duvie (troglitazone), although it’s important to note that troglitazone has been withdrawn from the market in many countries due to safety concerns. However, it is still used in some regions where it is available.
These medications provide alternatives to Actos for individuals requiring pharmacological interventions to improve insulin sensitivity and achieve glycemic control, particularly in managing type 2 diabetes mellitus. Although, it’s essential to consider individual patient factors such as cardiovascular risk, liver function, and potential side effects when selecting the most suitable medication from this class.
Storage and Handling
It is recommended to store the medication in the room with a temperature that doesn’t exceed 25°C. If you need to travel somewhere and take the drug with you, use a special container, keep it tight, and make sure that light doesn’t enter the container. It should be stored in the room with the normal level of moisture. You should protect it from excessive humidity. Store the medication following the recommendations of the producer; otherwise, it won’t work effectively.