Pioglitazone in triple therapy

The licence for Actos (pioglitazone) has been extended to include triple oral therapy in combination with metformin and a sulphonylurea in patients (particularly overweight patients) with insufficient glycaemic control despite dual oral therapy.

Previously, Actos was licensed only as monotherapy or as dual therapy in combination with either metformin or a sulphonylurea.

The recommended dose of pioglitazone is the same whether used in montherapy or dual or triple combination therapy. Treatment should be started at 15-30mg once daily increasing to 45mg once daily if necessary in combination with metformin and/or a sulphonylurea.

Common adverse effects associated with triple therapy include weight gain, increased creatine phosphokinase, arthralgia and hypoglycaemia.
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