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glimepiride and pioglitazone

A10BD06

Forms & Strengths

Tablet: 2 mg glimepiride / 30 mg pioglitazone
Tablet: 4 mg glimepiride / 30 mg pioglitazone

Adult Dosing

Initial dose based on previous therapy; typical starting dose is 1 tablet (2 mg/30 mg or 4 mg/30 mg) once daily with the first main meal
Max daily dose: 8 mg glimepiride / 45 mg pioglitazone

Pediatric Dosing

Safety and efficacy not established in pediatric patients (< 18 years)

Indications

Adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus when treatment with both glimepiride and pioglitazone is appropriate

Mechanism of Action

Glimepiride: Sulfonylurea that stimulates insulin secretion from pancreatic beta cells and reduces glucose output from the liver
Pioglitazone: Thiazolidinedione that acts as an agonist for peroxisome proliferator-activated receptor-gamma (PPAR-g), improving sensitivity to insulin in muscle and adipose tissue and decreasing hepatic glucose production

Contraindications

Hypersensitivity to glimepiride, pioglitazone, or any component
Type 1 diabetes mellitus or diabetic ketoacidosis
New York Heart Association (NYHA) Class III or IV heart failure
Active bladder cancer or history of bladder cancer

Adverse Reactions

Hypoglycemia
Weight gain
Edema and fluid retention
Upper respiratory tract infection
Headache
Sinusitis
Myalgia
Bone fracture

Drug Interactions

CYP2C8 inhibitors (e.g., gemfibrozil) significantly increase pioglitazone exposure
CYP2C8 inducers (e.g., rifampin) decrease pioglitazone concentrations
CYP2C9 inducers or inhibitors may alter glimepiride metabolism
Drugs that cause hypoglycemia (e.g., insulin, GLP-1 receptor agonists) increase risk of severe hypoglycemia
Thiazide diuretics and other medications that produce hyperglycemia may attenuate glycemic control

Curated Content: Needs Vetting Before Put to Clinical Use