trimpex and Actos Interactions

Interactions between trimpex(trimethoprim) and Actos (pioglitazone)

trimethoprim and pioglitazone (Moderate Drug-Drug)

MONITOR: Coadministration with inhibitors of CYP450 2C8 may increase the plasma concentrations of pioglitazone, which is primarily metabolized by the isoenzyme. In ten healthy volunteers, pretreatment with the potent CYP450 2C8 inhibitor gemfibrozil (600 mg twice daily) for two days prior to coadministration of gemfibrozil and pioglitazone (30 mg orally) resulted in pioglitazone systemic exposure (AUC) that was 226% of that observed without gemfibrozil.

MANAGEMENT: Given the potential for dose-related adverse events with pioglitazone, caution is advised during coadministration with CYP450 2C8 inhibitors. Close monitoring for the development of hypoglycemia and other adverse effects of pioglitazone such as fluid retention, heart failure, and pulmonary and peripheral edema is recommended. Patients should be advised to regularly monitor their blood sugar and counseled on how to recognize and treat hypoglycemia, which may include symptoms such as headache, dizziness, drowsiness, nervousness, confusion, tremor, hunger, weakness, perspiration, and palpitations. The physician should be notified if an interaction is suspected.