Pioglitazone Dosage

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Usual Adult Dose for:

Additional dosage information:

Usual Adult Dose for Diabetes Type 2

Monotherapy:
Initial dose: 15 mg to 30 mg orally once a day. Doses may be taken without regard to meals.
Maintenance dose: In patients who respond inadequately to the initial dose, it may be increased in increments up to 45 mg once daily.

Combination Therapy:
15 mg to 30 mg orally once a day in combination with metformin, a sulfonylurea or insulin. Doses may be taken without regard to meals.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Patients with mildly elevated serum transaminase levels (ALT 1 to 2.5 times the upper limit of normal), at baseline or during therapy, should be evaluated to determine the cause of the liver enzyme elevation. Initiation or continuation of therapy should proceed with caution and include more frequent liver enzyme monitoring. If jaundice is observed, drug therapy should be discontinued.

Pioglitazone therapy should not be initiated in patients exhibiting clinical evidence of active liver disease or with increased serum transaminase levels (ALT > 2.5 times the upper limit of normal).

If at any time liver enzymes increase to > 3 times the upper limit of normal, liver enzymes should be rechecked as soon as possible. If ALT levels remain > 3 times the upper limit of normal, or the patient is jaundiced, pioglitazone should be discontinued.

Dose Adjustments

For patients receiving pioglitazone as monotherapy, the dose may be increased to a maximum of 45 mg once daily. If the patient does not show adequate response, combination therapy with metformin, a sulfonylurea or insulin may be considered.

For patients receiving metformin, a sulfonylurea or insulin, the current dose of the first drug should be continued upon initiation of pioglitazone therapy. If the patient does not show adequate response, the dosage of pioglitazone may be increased to 30 mg per day. The dosage of pioglitazone should not exceed 45 mg per day as doses greater than this have not been studied.

Precautions

Safety and effectiveness have not been established in pediatric patients (less than 18 years of age).

Dialysis

Data not available

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