Pioglitazone + Glimepiride

Generic Name

Pioglitazone-Glimepiride

Other Names

• Duetact

Drug Class

• Antidiabetic combination

Chemical Formula

C19H23N3O3S.C24H34O5

Molecular Weight

473.58 g/mol (pioglitazone) + 490.59 g/mol (glimepiride)

Mechanism of Action

• Pioglitazone: Acts as an insulin sensitizer by binding to peroxisome proliferator-activated receptors (PPAR-gamma). Glimepiride: Stimulates insulin release from pancreatic beta cells.

Indications

• Treatment of type 2 diabetes mellitus

Common Dosage Forms

• Tablet

Typical Dosage

• 15 mg pioglitazone/2 mg glimepiride once daily, with potential for dose adjustment based on individual patient response

Pediatric Dosage

• Not established

Geriatric Dosage

• Caution in dosing due to increased likelihood of age-related renal function decline

Side Effects

• Hypoglycemia, weight gain, edema, upper respiratory tract infection, headache, diarrhea, myalgia

Contraindications

• Type 1 diabetes, diabetic ketoacidosis, severe renal impairment, heart failure

Pregnancy Category

• C (pioglitazone) / C (glimepiride)

Lactation Safety

• L3 (Limited data - Probably compatible)

Drug Interactions

• Insulin, rifampin, gemfibrozil

Overdose Symptoms

• Hypoglycemia, coma

Antidote for Overdose

• Glucose

Storage Conditions

• Store at room temperature away from moisture and heat

Pharmacokinetics

• Absorption: Well absorbed
• Distribution: Both drugs extensively distributed
• Metabolism: Liver metabolism
• Excretion: Renal excretion (pioglitazone) / Biliary excretion (glimepiride)

Precautions

• Monitor blood glucose regularly, assess liver function tests periodically

Warnings

• Risk of heart failure, macular edema, fractures, and bladder cancer

Others

• Combination therapy provides complementary mechanisms of action for better glycemic control.