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Generic Name: Pioglitazone hydrochloride
Product Name: Actos


Actos is an oral antidiabetic drug of the thiazolidinedione class, used to treat Type 2 diabetes mellitus inadequately controlled by diet. It acts mainly by decreasing insulin resistance, via improving sensitivity to insulin in muscle and adipose tissue.


Generally, the body will break down (digest) food into products it can absorb and use. One of those products is glucose, or sugar, the main source of energy for the body. Insulin is produced by the pancreas and is needed to let glucose into the body’s cells so it can be processed into energy. For people with Type 2 diabetes, the body is able to produce some insulin, but not enough. In addition, the cells have become resistant to the effects of insulin, which means that the body can’t respond to the insulin. This condition is called insulin resistance.

When tissue, such as muscle, becomes insulin resistant, the body loses its ability to utilize glucose effectively. In an attempt to use the glucose, the body responds by telling the pancreas to produce extra insulin (a condition known as hyperinsulinemia). The extra insulin tries to unlock the cells and force them to take the glucose from the bloodstream. The liver also becomes insulin resistant and responds by overproducing glucose. This contributes to high blood glucose (known as hyperglycemia). Eventually, the pancreas can no longer produce enough insulin to compensate for insulin resistance.

As a result, glucose levels rise in the blood. Actos effectively reduces insulin resistance, fasting insulin levels, and blood glucose. Actos, along with healthy eating and physical activity, works by helping the body use its naturally produced insulin, or administered insulin in type 2 diabetes, to help use glucose as a fuel and reduce the harmful buildup of glucose.

Dose advice

Actos should be taken once daily with or without food.

Monotherapy: The recommended dosage of Actos is 15 or 30 mg once daily, increasing after four weeks, if greater therapeutic effect is needed, to 45 mg once daily.

Combination therapy: The recommended dose of Actos is 30 mg once daily in combination with sulfonylureas, insulin or metformin. It may be possible to achieve metabolic control at a reduced dose of the sulfonylurea, insulin or metformin.

  • If there is a particular risk of hypoglycaemia, pioglitazone can be introduced at a dose of 15 mg.
  • For patients already on insulin, pioglitazone should be introduced at a dose of 15 mg once daily. Dosage can then be increased cautiously.

Maximum recommended dose: The dose should not exceed 45 mg/day since doses higher than 45 mg/day have not been studied in clinical trials.


Schedule 4

Common side effects

Uncommon side effects

  • Oedema (swelling of extremeties, water retention)
  • Shortness of breath
  • Chest pain

For further information talk to your doctor.

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Posted On: 22 July, 2003
Modified On: 19 February, 2008


Created by: myVMC