Actos use with insulin

The licence for Actos (pioglitazone) has been extended to include combination treatment with insulin - this use was previously contraindicated.

Pioglitazone can be used in combination with insulin in type II diabetes inadequately controlled by insulin when metformin is inappropriate because of intolerance or contraindications.

The recommended pioglitazone dose is 15–30mg once daily, increasing to 45mg once daily if necessary. Insulin should be continued at the patients' current dose but reduced if hypoglycaemia occurs.

Cardiac failure has been reported when pioglitazone is used in combination with insulin or in patients with a history of cardiac failure. Also, both insulin and pioglitazone are associated with fluid retention so concomitant administration may increase the risk of oedema. It is recommended that patients should be monitored for signs and symptoms of heart failure, weight gain and oedema when pioglitazone is used in combination with insulin. Pioglitazone should be discontinued if any deterioration in cardiac status occurs.

Pioglitazone is also licensed for the treatment of type II diabetes either as monotherapy, dual therapy with metformin or sulphonylurea or triple therapy with metformin and sulphonylurea.

Further information: Takeda 01628 537900

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