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    Information about Pioglitazone

    Pioglitazone uses

    Pioglitazone is used in the treatment of type 2 diabetes. It is used in addition to diet and exercise to improve blood sugar control in adults with type 2 diabetes.

    How pioglitazone works

    Pioglitazone is an anti-diabetic medication. It works by increasing the body's sensitivity to insulin, a natural substance that helps control blood sugar levels.

    Common side effects of pioglitazone

    Weight gain, Blurred vision, Respiratory tract infection, Numbness, Bone fracture

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    Expert advice for Pioglitazone

    • Pioglitazone helps to control blood sugar level and avoids long-term complications.
    • You should continue to exercise regularly, eat a healthy diet, and take your other diabetes medicines along with Pioglitazone.
    • Full effect may be visible after several weeks of starting Pioglitazone.
    • Weight gain, headache, and swelling due to fluid build-up may occur.
    • Notify your doctor if you experience shortness of breath, heart problems, or any abnormal swelling.
    • May not be suitable for patients with a history of heart failure or bladder cancer.

    Frequently asked questions for Pioglitazone


    Q. Is Pioglitazone a blood thinner?

    No. Pioglitazone is an anti-diabetic medication. Blood thinners are the medicine that prevents the formation of a harmful blood clot. These include medicines like Aspirin, Heparin and Warfarin.

    Q. Is Pioglitazone a diuretic?

    No. Pioglitazone is not a diuretic. It is used in the treatment of Diabetes Mellitus. Diuretics are those medicine which increases urination.

    Q. Can Pioglitazone used in Hepatitis B infection?

    Some studies have shown that Pioglitazone may be helpful in preventing Hepatitis B Virus-associated Hepatocellular Cancer (Liver Cancer). However, these findings are still very preliminary and clear role has not been established.

    Q. Can Pioglitazone used in Hepatitis C infection?

    Pioglitazone has been shown to inhibit Liver Cancer (HCC) recurrence in overweight Hepatitis C Virus-infected diabetic patients. It also improved insulin resistance (a state where the body is resistant to the effects and functions of the insulin hormone) in them.

    Q. Can Pioglitazone used along with Vitamin D?

    Studies indicate that Vitamin-D combined with Pioglitazone may be more effective in improving Bone Mineral Density and Bone Metabolism than Vitamin-D or Pioglitazone alone in the treatment of Diabetes Mellitus patients with kidney dysfunction (Diabetic Nephropathy).

    Q. Can Pioglitazone be used along with sitagliptin?

    Combination therapy with Sitagliptin and Pioglitazone leads to a substantial and sustained improvement in glycemic (blood sugar) control compared to the treatment with Pioglitazone alone. This is useful for patients who cannot tolerate Metformin or Sulfonylureas.

    Q. Is there any role of Pioglitazone in Alzheimer disease?

    Recent evidence suggests that Pioglitazone may be beneficial in Alzheimer's disease (AD), decreasing the cognitive decline early in the disease process. However, larger studies are now in progress to establish the same.

    Q. Can Pioglitazone and repaglinide combined in diabetes treatment?

    For patients who previously failed oral antidiabetic therapy, the combination of Repaglinide and Pioglitazone have acceptable safety, with greater reductions of glycemic parameters (blood sugar levels) than using either agent alone.

    Q. Does Pioglitazone cause urinary bladder tumour?

    Large population studies indicate that Pioglitazone is associated with an increased risk of bladder cancer. The absence of an association of bladder cancer with the other drug of the same class, Rosiglitazone, suggests that the increased risk is drug specific and not a class effect.

    Q. Are Pioglitazone and rosiglitazone same?

    Pioglitazone & Rosiglitazone both belong to a class of antidiabetics called Thiazolidinediones. Rosiglitazone has been removed from the market because using this drug was associated with increased risk of cardiovascular events like heart attack and stroke. This is not seen with Pioglitazone.

    Q. Can Pioglitazone be used along with glimepiride in diabetes?

    Pioglitazone when added to Glimepiride in Patients with Diabetes Mellitus, has been found to significantly reduce plasma lipid levels and significant improvement in blood pressure control related to a reduction in the insulin resistance.

    Q. Is Pioglitazone a steroid?

    No. Pioglitazone is not a steroid. It is an anti-diabetic medication which belongs to the class of thiazolidinediones.

    Q. How to use Pioglitazone?

    Pioglitazone is an anti-diabetes drug used along with a proper diet and exercise program to control high blood sugar in patients with type 2 diabetes. Pioglitazone acts as an insulin sensitizer and decreases the extent of insulin resistance in the body too.

    Q. How safe is Pioglitazone?

    Pioglitazone cardiovascular safety profile compares favourably with that of Rosiglitazone. Pioglitazone has been found to be associated with bladder tumours but causality assessment has not been proved yet.

    Q. How does Pioglitazone cause oedema?

    Pioglitazone increases the permeability of fluid in tiny blood vessels called capillaries. This results in easier movement of fluids across the membrane and their consequent accumulation, resulting in oedema (puffiness). Also, Pioglitazone causes increased sodium and water reabsorption from the kidney that contributes to the oedema.

    Q. How does Pioglitazone cause bladder cancer?

    The mechanism behind the link between Pioglitazone use and bladder cancer is still unknown. Studies have suggested that use of Pioglitazone for more than one year results in increased risk of development of tumour of the urinary bladder.

    Q. How does Pioglitazone cause heart failure?

    Pioglitazone can cause fluid retention and edema. Consequently, there is a lot of fluid in the body (fluid overload). As a result, it may precipitate heart failure (which worsens with fluid overload in those at risk).

    Q. How Pioglitazone protects against atherosclerosis?

    Studies in animals have concluded that Pioglitazone improves the elasticity of the aortic wall ( the aorta is a large blood vessel that arises from the heart and supplies oxygenated blood to the rest of the body). This may be a mechanism by which it protects against atherosclerosis, but more studies are needed to confirm this.

    Q. Can Pioglitazone be used with insulin?

    The addition of Pioglitazone reduces daily insulin dosages, but study findings have not been consistent. Improvement of lipid profiles has also been weak with this combination therapy. Long-term studies are needed before any conclusions can be reached. Combination therapy should be primarily used for patients who achieve an insufficient reduction in blood sugar with insulin alone.

    Q. Which is not safe in heart failure, Pioglitazone or rosiglitazone?

    Pioglitazone & Rosiglitazone both belong to a class of antidiabetics called Thiazolidinediones. Rosiglitazone has been removed from the market because using this drug was associated with increased risk of cardiovascular events like heart attack and stroke. Pioglitazone can cause heart failure too, but the risk is less that that with Rosiglitazone. Both the medicines should be avoided in heart failure.

    Q. What are the alternatives to Pioglitazone?

    Fortunately, there are many alternatives to Pioglitazone- Metformin, Acarbose, Sitagliptin, Exenatide, Insulin or combination therapies of these medicines can be used.

    Q. Can Pioglitazone used for dementia?

    Findings indicate that Pioglitazone treatment is associated with a reduced dementia risk in Diabetes mellitus patients. Prospective studies are needed to evaluate a possible neuroprotective effect in these patients in an ageing population.

    Q. Can Pioglitazone used for infertility?

    Pioglitazone may be of use in infertile patients with polycystic ovary syndrome (PCOS) who are resistant to conventional ovulation induction such as by drugs like Clomiphene, Dexamethasone, or Metformin.

    Q. Can Pioglitazone used for psoriasis?

    The use of Pioglitazone for plaque psoriasis treatment is controversial. Some studies revealed no effect of Pioglitazone 30 mg daily neither on the clinical response of moderate-to-severe psoriasis whereas others demonstrate that it could be considered as an efficacious and safe agent for the treatment of plaque psoriasis.

    Q. Can Pioglitazone used for autism?

    In a research study in a small number of autistic children, daily treatment with 30 or 60 mg Pioglitazone for 3–4 months induced apparent clinical improvement. Pioglitazone should be considered for further testing of therapeutic potential in autistic patients but as of now, autism is not an approved indication for Pioglitazone use.

    Q. Can Pioglitazone be used in depression?

    Pioglitazone, either alone or as add-on therapy to conventional treatments, could clinically benefit patients of major depression according to a study.

    Q. Can Pioglitazone used for weight loss?

    A recent study shows that although Pioglitazone causes a significant decrease in blood sugar, HbA1C and lipid levels, it is associated with weight gain, which would limit its utility. It has not been shown to cause weight loss.

    Q. Can Pioglitazone be used to treat fatty liver?

    Pioglitazone has also been used to treat non-alcoholic steatohepatitis (fatty liver), but this use is presently considered experimental.

    Q. Can Pioglitazone be used for secondary stroke prevention?

    Pioglitazone reduces recurrent stroke and major vascular events in stroke patients with insulin resistance, prediabetes, and diabetes mellitus. However, its use as a preventive therapy requires more research.

    Content on this page was last updated on 04 January, 2018, by Dr. Varun Gupta (MD Pharmacology)