Therapeutic indications
Pioglitazone is indicated as a second or third line treatment for type 2 diabetes mellitus, as described below:
how monotherapy
– in adult patients (especially overweight patients), with insufficient control of diet and exercise, for whom metformin is not suitable due to contraindications or intolerance.
how dual oral therapy in combination with
– metformin in adult patients (especially overweight patients) with insufficient glycemic control despite the maximum tolerated dose of metformin monotherapy.
– sulfonylurea derivatives, only in adult patients who are intolerant to metformin or for whom metformin is contraindicated, with insufficient glycemic control, despite the maximum tolerated dose of sulfonylurea monotherapy.
how triple oral therapy in combination with
– metformin and sulfonylureas in adult patients (especially overweight patients) with inadequate glycemic control despite dual oral therapy.
Pioglitazone is also indicated in combination with insulin in adult patients with type 2 diabetes mellitus and poor insulin glycemic control for whom metformin is not suitable due to contraindications or intolerance (see section “Contraindications”).
After initiation of pioglitazone therapy, patients should be assessed after 3–6 months to assess the adequacy of the response to treatment (for example, a decrease in HbA1c< span>). In patients who do not respond adequately, pioglitazone should be discontinued. Given the potential risks of long-term therapy, prescribers should confirm that benefits from pioglitazone are continuing at subsequent routine examinations.
