Pioglitazone and glimepiride
Generic Name: pioglitazone and glimepiride (PYE-oh-GLI-ta-zone & glye-MEP-ir-ide)
Brand Name: Duetact
Thiazolidinedione antidiabetics such as pioglitazone and glimepiride may cause or worsen heart failure in some patients. Tell your doctor if you have a history of heart failure. Pioglitazone and glimepiride should not be used to treat patients who have heart failure with symptoms, or who have moderate to severe heart failure. You will be monitored for signs of heart failure when you start pioglitazone and glimepiride and when your dose increases. Contact your doctor at once if you develop symptoms of heart failure (eg, swelling of the hands, ankles, legs or feet; shortness of breath; sudden, unexplained weight gain). Your doctor may need to stop your medicine or change your dose.
Pioglitazone and glimepiride is used for:
Treating type 2 diabetes in certain patients. It is used along with diet and exercise.
Pioglitazone and glimepiride is a thiazolidinedione and sulfonylurea antidiabetic combination. It lowers blood sugar by making the cells of the body more sensitive to the action of insulin. It also causes the pancreas to release insulin, which helps to lower blood sugar.
Do NOT use pioglitazone and glimepiride if:
- you are allergic to any ingredient in pioglitazone and glimepiride
- you have heart failure with symptoms, or moderate to severe heart failure
- you have bladder cancer, high blood acid levels associated with diabetes (diabetic ketoacidosis), or type 1 diabetes
Contact your doctor or health care provider right away if any of these apply to you.
Before using pioglitazone and glimepiride:
Some medical conditions may interact with pioglitazone and glimepiride. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you have had a severe allergic reaction (eg, severe rash, hives, breathing difficulties, dizziness) to any other sulfonamide medicine such as sulfamethoxazole
- if you have a history of heart problems (eg, heart attack, heart failure), high blood acid levels or diabetic ketoacidosis, liver problems or abnormal liver function tests, stroke, syndrome of inappropriate secretion of antidiuretic hormone (SIADH), low blood sodium levels, bladder cancer, bone fracture, low calcium intake, or weak bones (eg osteoporosis)
- if you have kidney problems, anemia, adrenal gland or pituitary gland problems, eye or vision problems (eg, macular edema), stomach or bowel problems (eg, blockage, paralysis), glucose-6-phosphate dehydrogenase (G6PD) deficiency, fluid retention or swelling problems (edema), vomiting, poor health or nutrition, a fever, an infection, diarrhea, moderate to severe burns, or brain or nervous system problems, or if you have had a recent injury
- if you will be having surgery
- if you take medicines for high blood pressure, high cholesterol, or heart failure, or for prevention of heart disease or a stroke
- if you have a history of liver problems, including jaundice (yellowing of the skin or eyes), during therapy with a similar medicine called troglitazone
Some MEDICINES MAY INTERACT with pioglitazone and glimepiride. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Beta-blockers (eg, propranolol), clonidine, or reserpine because blood sugar may be increased or decreased. They may also hide certain signs of low blood sugar and make it more difficult to notice
- Anabolic steroids and androgens (eg, testosterone), angiotensin-converting enzyme (ACE) inhibitors (eg, enalapril), chloramphenicol, clarithromycin, cyclophosphamide, disopyramide, fibrates (eg, fenofibrate), fluconazole, fluoxetine, guanethidine, H2 receptor antagonists (eg, famotidine), insulin or other medicines for diabetes (eg, metformin, pramlintide), miconazole, monoamine oxidase inhibitors (MAOIs) (eg, phenelzine), nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen), pentoxifylline, phenyramidol, probenecid, propoxyphene, quinolone antibiotics (eg, ciprofloxacin), salicylates (eg, aspirin), somatostatin analogues (eg, octreotide), sulfinpyrazone, sulfonamides (eg, sulfamethoxazole), or tetracyclines (eg, doxycycline) because the risk of low blood sugar may be increased
- Barbiturates (eg, phenobarbital), clozapine, corticosteroids (eg, prednisone), danazol, diazoxide, diuretics (eg, furosemide, hydrochlorothiazide), estrogens, glucagon, hormonal contraceptives (eg, birth control pills), isoniazid, laxatives (eg, bisacodyl), nicotinic acid, olanzapine, phenothiazines (eg, promethazine), phenytoin, protease inhibitors (eg, ritonavir), rifampin, somatropin, sympathomimetics (eg, albuterol, epinephrine), or thyroid supplements (eg, levothyroxine) because they may decrease pioglitazone and glimepiride's effectiveness, resulting in high blood sugar
- Gemfibrozil because blood sugar may be increased or decreased
- Anticoagulants (eg, warfarin) because their effectiveness may be decreased or the risk of their side effects may be increased by pioglitazone and glimepiride
This may not be a complete list of all interactions that may occur. Ask your health care provider if pioglitazone and glimepiride may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
How to use pioglitazone and glimepiride:
Use pioglitazone and glimepiride as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Pioglitazone and glimepiride comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get pioglitazone and glimepiride refilled.
- Take pioglitazone and glimepiride by mouth with breakfast or the first main meal of the day unless instructed otherwise by your doctor.
- If you also take colesevelam, do not take it within 4 hours after taking pioglitazone and glimepiride. Check with your doctor if you have questions.
- Continue to take pioglitazone and glimepiride even if you feel well. Do not miss any doses.
- Taking pioglitazone and glimepiride at the same time each day will help you remember to take it.
- If you miss a dose of pioglitazone and glimepiride, skip the missed dose and go back to your regular dosing schedule, unless your doctor directs you otherwise. Do not take 2 doses at once.
Ask your health care provider any questions you may have about how to use pioglitazone and glimepiride.
Important safety information:
- Tell your doctor or dentist that you take pioglitazone and glimepiride before you receive any medical or dental care, emergency care, or surgery.
- Pioglitazone and glimepiride may cause drowsiness, dizziness, blurred vision, or light-headedness. These effects may be worse if you take it with alcohol or certain medicines. Use pioglitazone and glimepiride with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
- Check with your doctor before you drink alcohol.
- Carry an ID card at all times that says you have diabetes.
- Proper diet and exercise are important in order to lose weight and keep it off. Follow the diet and exercise program given to you by your health care provider.
- Check your blood sugar levels as directed by your doctor. If they are often higher or lower than they should be and you take pioglitazone and glimepiride exactly as prescribed, tell your doctor.
- It may be harder to control your blood sugar during times of stress such as fever, infection, injury, or surgery. Talk with your doctor about how to control your blood sugar if any of these occur. Do not change the dose of your medicine without checking with your doctor.
- Pioglitazone and glimepiride may cause low blood sugar levels. Low blood sugar may make you anxious, sweaty, weak, dizzy, drowsy, or faint. It may also make your heart beat faster; make your vision change; give you a headache, chills, or tremors; or make you more hungry. It is a good idea to carry a reliable source of glucose (eg, tablets or gel) to treat low blood sugar. If this is not available, you should eat or drink a quick source of sugar like table sugar, honey, candy, orange juice, or non-diet soda. This will raise your blood sugar level quickly. Tell your doctor right away if this happens. To prevent low blood sugar, eat meals at the same time each day and do not skip meals.
- Risk of low blood sugar may be increased by severe or prolonged exercise, drinking alcohol, or skipping meals.
- Pioglitazone and glimepiride contains a sulfonylurea. It may increase the risk of death from heart disease. Talk with your doctor about the benefits and risks of this or other therapies to treat your condition.
- Pioglitazone and glimepiride may cause ovulation in women who have not reached menopause but do not ovulate. To avoid pregnancy, be sure to use effective birth control while using pioglitazone and glimepiride.
- Pioglitazone and glimepiride may be associated with an increased risk of bladder cancer. Tell your doctor right away if you notice symptoms that could be associated with bladder cancer (eg, a red color or blood in the urine, difficult or painful urination, an increased need to urinate). Discuss any questions or concerns with your doctor.
- An increased incidence of bone fracture has been reported in women who take pioglitazone and glimepiride. Tell your doctor right away if you experience any unusual bone pain, especially in the hand, foot, or upper arm.
- A severe skin reaction (Stevens-Johnson syndrome/toxic epidermal necrolysis) may happen. It can cause serious health problems that may not go away, and sometimes death. Get medical help right away if you have signs like red, swollen, blistered, or peeling skin (with or without fever); red or irritated eyes; or sores in your mouth, throat, nose, or eyes.
- Serious and sometimes fatal liver problems have happened with pioglitazone and glimepiride. Call your doctor right away if you have symptoms of liver problems (eg, dark urine, pale stools, persistent loss of appetite, right-sided stomach pain, unusual nausea or tiredness, yellowing of the skin or eyes).
- Have an eye exam as you have been told by your doctor.
- Lab tests may be performed while you use pioglitazone and glimepiride. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
- Use pioglitazone and glimepiride with caution in the ELDERLY; they may be more sensitive to its effects.
- Pioglitazone and glimepiride should not be used in CHILDREN; safety and effectiveness in children have not been confirmed.
- PREGNANCY and BREAST-FEEDING: If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using pioglitazone and glimepiride while you are pregnant. It is not known if this medicine is found in breast milk. Do not breast-feed while taking pioglitazone and glimepiride.
Possible side effects of pioglitazone and glimepiride:
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:
Seek medical attention right away if any of these SEVERE side effects occur:
Cold-like symptoms; diarrhea; headache; muscle pain; nausea; sinus pain; sore throat; weight gain.
Severe allergic reactions (rash; hives; itching; difficulty breathing or swallowing; tightness in the chest; swelling of the mouth, face, lips, throat, or tongue; unusual hoarseness); chest pain; confusion; fainting; fast or irregular heartbeat; menstrual changes; one-sided weakness; severe dizziness; swelling of the hands, ankles, or feet; symptoms of heart failure (eg, shortness of breath; sudden, unexplained weight gain); symptoms of low blood sugar (eg, anxiety, chills, dizziness or drowsiness, headache, increased hunger, increased sweating, tremors); unusual tiredness or weakness; vision or speech changes.
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.
If OVERDOSE is suspected:
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.Proper storage of pioglitazone and glimepiride:
Store pioglitazone and glimepiride in the original container at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store pioglitazone and glimepiride in the bathroom. Keep pioglitazone and glimepiride out of the reach of children and away from pets.
- If you have any questions about pioglitazone and glimepiride, please talk with your doctor, pharmacist, or other health care provider.
- Pioglitazone and glimepiride is to be used only by the patient for whom it is prescribed. Do not share it with other people.
- If your symptoms do not improve or if they become worse, check with your doctor.
- Check with your pharmacist about how to dispose of unused medicine.
This information should not be used to decide whether or not to take pioglitazone and glimepiride or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about pioglitazone and glimepiride. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to pioglitazone and glimepiride. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using pioglitazone and glimepiride.
Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.
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Other brands: Duetact