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Pioglitazone Hydrochloride and Metformin Hydrochloride Tablets

This product is suitable for use on the basis of diet control and exercise in patients with type 2 diabetes who are currently treated with a combination of pioglitazone hydrochloride and metformin hydrochloride or patients with type 2 diabetes who have poor blood sugar control after treatment with metformin hydrochloride alone. Important limitations of use: Pioglitazone exerts its hypoglycemic effects only in the presence of endogenous insulin. This product is not intended to treat type 1 diabetes or diabetic ketoacidosis as it is not effective in these conditions. Patients with liver disease must use this product with caution.

Recommended dose: The treatment of type 2 diabetes should be individualized based on effectiveness and tolerability, and should not exceed the maximum recommended daily dose of pioglitazone 45 mg and metformin hydrochloride 2550 mg. Metformin doses above 2000 mg are better tolerated when administered in three divided doses per day. Select the starting dose of this product based on the patient’s current pioglitazone and/or metformin dosage. When initiating this product or increasing the dose, patients should be closely monitored for adverse reactions related to fluid retention, such as weight gain, edema, and signs or symptoms of congestive heart failure. Liver function tests (eg, serum alanine and aspartate aminotransferase, alkaline phosphatase, and total bilirubin) should be performed before starting use of this product. Patients without liver disease do not need to undergo routine periodic liver function tests during treatment with this product. Patients with abnormal liver function tests before or during use of this product should have corresponding measures taken by a professional physician. The daily dose of this product can be taken in divided doses. Taking it with food can reduce the gastrointestinal side effects related to metformin hydrochloride. The initial dosage for patients with poor blood glucose control using metformin alone is based on the usual starting dose of pioglitazone, which is 15 to 30 mg/day. Starting with this product, 15 mg/500 mg (1 tablet) can be used, 1 to 2 times a day, based on the evaluation of treatment response. As a result, the dose is gradually increased. For those who have been converted from combined treatment of pioglitazone hydrochloride and metformin hydrochloride to this product, the starting dose will be based on the original dosage of metformin tablets and pioglitazone tablets. They can start taking this product from 15 mg/500 mg (1 tablet) of this product. This product should be taken with meals to reduce the gastrointestinal adverse reactions caused by metformin. Patients with kidney disease should assess their kidney function before starting to take this product and monitor it regularly after taking the drug. This product is contraindicated in patients with eGFR lower than 45mL/min/1.73m. When using this product with gemfibrozil or other strong CYP2C8 inhibitors, the recommended maximum dose is one tablet per day. Discontinuation of iodinated contrast agent imaging: For patients with eGFR between 45 and 60 mL/min/1.73m; patients with a history of liver disease, alcoholism, or heart failure; or patients who will receive intra-arterial injection of iodinated contrast agent, they must Stop using this product during an iodine contrast agent imaging examination or before starting the examination. Forty-eight hours after imaging, eGFR should be re-evaluated and if renal function is stable, the drug can be restarted. The same medicines produced by different manufacturers may have inconsistent instructions. If you find any inconsistency in the instructions before taking the medicine, please consult your doctor or pharmacist in time.

Adverse reactions:
The side effects of this product mainly come from the side effects of pioglitazone and metformin, and mild or moderate edema, diarrhea and other symptoms may occur. Adverse reactions of metformin hydrochloride: diarrhea, nausea, vomiting, bloating, fatigue, indigestion, abdominal discomfort and headache. Other rare symptoms include abnormal stool, hypoglycemia, myalgia, dizziness, dizziness, nail abnormalities, rash, increased sweating, abnormal taste, chest discomfort, chills, flu symptoms, hot flashes, palpitations, weight loss, etc. Metformin can reduce vitamin B12 absorption but rarely causes anemia. Lactic acidosis caused by this product is rare within the therapeutic dose range. Adverse reactions of pioglitazone hydrochloride: A few patients develop edema after taking this product. When combined with insulin, the probability of patients developing edema and anemia increases. This product can cause increased plasma volume and cardiac hypertrophy caused by increased preload, inducing heart failure. There is a risk of hypoglycemia when combined with other antidiabetic drugs. Can cause abnormal liver function (mild to moderate elevation of transaminases, reversible). Can cause blood lipids to increase.

Drug contraindications:
Contraindicated for renal impairment, lactation, pregnancy, allergy to this product.


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