Pioglitazone is indicated in the management of type-2 Diabetes Mellitus.

Diabetes

In patients who are not adequately controlled with diet and exercise, Pioglitazone monotherapy can be started at 15 mg or 30 mg once daily. If patients do not respond well to the initial dose of Pioglitazone, the dose can be gradually increased up to 45 mg once daily. Combination therapy should be considered for patients who do not respond adequately to monotherapy.

Side effects reported with the use of drugs include-

• upper respiratory tract infection
• headache
• weight gain
• atherosclerosis
• hypoglycemia

URTI (Upper Respiratory Tract Infection)

Headache

Weight Gain

Atherosclerosis

• Pioglitazone exerts its antihyperglycemic effect only in the presence of insulin.  Therefore, Pioglitazone should not be used in patients with type 1 diabetes or for the treatment of diabetic ketoacidosis.
• Patients receiving Pioglitazone in combination with insulin or oral hypoglycemic agents may be at risk for hypoglycemia, and a reduction in the dose of the concomitant agent may be necessary.
• In premenopausal anovulatory patients with insulin resistance, treatment with thiazolidinediones, including Pioglitazone, may result in resumption of ovulation.  As a consequence of their improved insulin sensitivity, these patients may be at risk for pregnancy if adequate contraception is not used.
• Pioglitazone may cause decreases in hemoglobin and hematocrit. 
• Pioglitazone should be used with caution in patients with edema.
• In preclinical studies, thiazolidinediones, including pioglitazone, cause plasma volume expansion and pre-load-induced cardiac hypertrophy.