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Pioglitazone in low resource areas

By Sandeep Saluja | 06 Jun, 2015

The glitazones were at the centre stage of controversy sometime back.Pioglitazone was withdrawn in India and then came back.Despite all controversies,it is a relatively inexpensive and effective drug.In my own practice,it is generally second line therapy with the first position being taken by metformin.Many would put sulphonylureas on the second spot but my own bias stems from the fact that pioglitazone whether alone or in combination with metformin without sulphonylureas does not carry a risk of hypoglycemia and this is particularly important where frequent monitoring is difficult.
I may mention a recent relevant review on the drug
http://informahealthcare.com/doi/abs/10.1586/17446651.2015.1054809

I am keen to know the views of esteemed members on the position of this drug in remote and low resource areas.

Replies

 

Venkateswara rao Kalluri Replied at 7:28 AM, 6 Jun 2015

In our practice too Pioglitazone has been using has third line of drug after Metformin and sulphonylureas, but mostly in combination with metformin, i never seen one case reporting hypoglycemia until now.

Sandeep Saluja Replied at 7:50 AM, 6 Jun 2015

Thanks Venkateswara!Why would you not prefer to have it second line?Fear of cancer?Possibility of edema?

Venkateswara rao Kalluri Replied at 10:47 PM, 6 Jun 2015

Yes, the Pioglitazone is know for its fluid retention and peripheral edema, though we didnt come across these side effects in any patients but we dnt prescribe in CHF patients.

Mubarakali Janmohamed Replied at 10:24 PM, 7 Jun 2015

Glitazones help by reducing insulin resistance, just like
Metformin. Hence can be used as an adjunct or add-on
therapy but not as second line. This is what most guide-
lines tell us and in practice, this is what most of us do.

This Community is Archived.

This community is no longer active as of December 2018. Thanks to those who posted here and made this information available to others visiting the site.