pioglitazone and Cardizem Interactions

Interactions between pioglitazone and Cardizem (diltiazem)

diltiazem and pioglitazone (Moderate Drug-Drug)

MONITOR: Pioglitazone is metabolized by CYP450 3A4 microsomal enzymes in the liver. The clinician should be aware of the potential for an interaction when pioglitazone is used in combination with another medication that inhibits and is also metabolized by CYP450 3A4.

MANAGEMENT: Monitoring for clinical and laboratory evidence of altered safety and efficacy of both drugs if pioglitazone is added to or removed from the patients medication regimen is recommended. Patients should be advised to regularly monitor their blood sugar, counseled on how to recognize and treat hypoglycemia (e.g., headache, dizziness, drowsiness, nausea, tremor, hunger, weakness, or palpitations) and to notify their physician if it occurs.