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Piomin 500
Pacific Pharmaceuticals Ltd.
Generic: Metformin Hydrochloride + Pioglitazone
Safety Advices
বাংলা
English
UNSAFE
It is unsafe to consume alcohol with Piomin 500.
CONSULT YOUR DOCTOR
Piomin 500 may be unsafe to use during pregnancy. Although there are limited studies in humans, animal studies have shown harmful effects on the developing baby. Your doctor will weigh the benefits and any potential risks before prescribing it to you. Please consult your doctor.
SAFE IF PRESCRIBED
Piomin 500 is probably safe to use during breastfeeding. Limited human data suggests that the drug does not represent any significant risk to the baby.
CAUTION
Your ability to drive may be affected if your blood sugar is too low or too high. Do not drive if these symptoms occur.
CAUTION
Piomin 500 should be used with caution in patients with kidney disease. Dose adjustment of Piomin 500 may be needed. Please consult your doctor.
Use of Piomin 500 is, however, not recommended in patients with severe kidney disease. Regular monitoring of kidney function test is advisable while you are taking this medicine.
CAUTION
Piomin 500 should be used with caution in patients with liver disease. Dose adjustment of Piomin 500 may be needed. Please consult your doctor.
Piomin 500 is generally started with low dose in patients with mild to moderate liver disease and its use is not recommended in patients with severe liver disease.
Medicine Overview of Piomin 500mg+15mg Tablet
Introduction
Piomin 500 is a combination medicine that helps control blood sugar levels. This medicine is used together with diet and exercise to improve blood sugar control in adults with type 2 diabetes mellitus. It helps in proper utilisation of insulin, thereby lowering the blood sugar level. Piomin 500 should be taken in the dose and duration as advised by your doctor. It must be taken with food to avoid stomach upset. If you miss a dose, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to...
... Show moreUses of Piomin 500
- Type 2 diabetes mellitus
Side effects of Piomin 500
Common
- Nausea
- Loss of appetite
- Taste change
- Stomach pain
- Diarrhea
- Edema (swelling)
- Weight gain
- Respiratory tract infection
- Bone fracture
- Blurred vision
How to use Piomin 500
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Piomin 500 is to be taken with food.
How Piomin 500 works
Piomin 500 is a combination of two antidiabetic medicines: Pioglitazone and metformin. Pioglitazone is a thiazolidinedione which works by increasing the body's sensitivity to insulin. Metformin is a biguanide which decreases the production and absorption of sugar in your body and allows better use of existing insulin. Together, they provide better control of blood sugar.
Quick Tips
- Take it as per the dose and duration prescribed by your doctor.
- Monitor your blood sugar level regularly while you are taking this medicine.
- It can cause hypoglycemia (low blood sugar level) when used with other antidiabetic medicines, alcohol or if you delay or miss a meal.
- Always carry some sugary food or fruit juice with you in case you experience hypoglycemic symptoms such as cold sweats, cool pale skin, tremor, and anxiety.
- Your doctor may check your liver function regularly. Inform your doctor if you develop symptoms such as abdominal pain, loss of appetite, or yellowing of the eyes or skin (jaundice).
- Inform your doctor if you notice weight gain, shortness of breath, irregular heartbeat, or any abnormal swelling.
Brief Description
Indication
Type 2 DM
Adult Dose
Oral
Type 2 diabetes mellitus
Adult: Tab contains pioglitazone 15 mg and metformin 500 mg or 850 mg:
Initially, 15 mg/500 mg bid or 15 mg/850 mg once daily.
Patients inadequately controlled on metformin monotherapy: Initially, 15 mg/500 mg bid or 15 mg/850 mg 1-2 times daily, depending on current metformin dose.
Patients inadequately controlled on pioglitazone monotherapy: Initially, 15 mg/500 mg bid or 15 mg/850 mg once daily.
Max: Pioglitazone 45 mg and metformin 2,550 mg daily.
Hepatic impairment: Contraindicated.
Child Dose
Safety and efficacy not established
Renal Dose
Renal impairment
Obtain eGFR before starting metformin
eGFR <30 mL/min/1.73 m²: Contraindicated
eGFR 30-45 mL/min/1.73 m²: Not recommended to initiate treatment
Monitor eGFR at least annually or more often for those at risk for renal impairment (eg, elderly)
If eGFR falls below 45mL/min/1.73 m² while taking metformin, risks and benefits of continuing therapy should be evaluated
If eGFR falls below 30 mL/min/1.73 m²: while taking metformin, discontinue the drug
Contraindication
Renal disease or renal dysfunction (e.g. as suggested by serum creatinine levels >1.5 mg/dl in male, >1.4 mg/dl in females or abnormal creatinine clearance), which may also result from conditions such as cardiovascular collapse (shock), acute myocardial infarction and septicemia.Current or history of cardiac failure, active or history of bladder cancer,
Known hypersensitivity to Pioglitazone, Metformin or any other component of this combination.
Acute or chronic metabolic acidosis including diabetic ketoacidosis with or without coma.
Mode of Action
Pioglitazone is as a potent and highly selective agonist for the peroxisome proliferator activated receptor-gamma. Activation of these receptors promotes the production of gene products involved in lipid and glucose metabolism. It also improves insulin response to target cells witho increasing the pancreatic secretion of insulin.
Metformin decreases hepatic gluconeogenesis, decreases intestinal absorption of glucose and improves insulin sensitivity (increases peripheral glucose uptake and utilisation).
Precaution
Patient w/ oedema, anaemia. Premenopausal, anovulatory women. Pregnancy. Patient Counselling This drug may cause visual disturbance, if affected, do not drive or operate machinery. Monitoring Parameters Monitor HbA1c, serum glucose; signs and symptoms of oedema or heart failure, bladder cancer; liver enzymes, haematologic parameters, renal function; vit B12 and folate if anaemia is present. Routine ophth examination.
Lactation: not known if crosses into breast milk, avoid using in nursing women
Side Effect
>10%
Lower limb edema (2.9-11.3%),Upper respiratory infection (12-16)
1-10%
Weight gain (2.9-6.7%),Diarrhea (4.8-5.8%),Nausea (3.6-5.8%),Urinary tract infection (5.3-5.8%),Dizziness (4.8-5.4%),Headache (4.6-5.3%),Sinusitis (4.4-5%),Edema (3%)
Interaction
Additive effect w/ sulfonylureas. Thiazide diuretics, corticosteroids, phenothiazines, OC, sympathomimetics, niacin, Ca channel blockers and isoniazid may exacerbate loss of glycaemic control. ACE inhibitors may reduce fasting blood glucose concentrations. May increase serum level w/ cimetidine.
Potentially Fatal: Concurrent use w/ iodinated contrast agents may increase the risk of metformin-induced lactic acidosis.
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