Pioglitazone/metformin, sold under the brand name Actoplus Met among others, is a fixed-dose combination anti-diabetic medication used to improve glycemic control in adults with type 2 diabetes. It contains pioglitazone, a thiazolidinedione, and metformin, a biguanide. Mechanisms
Pioglitazone is a member of the thiazolidinedione class, it decreases insulin resistance in the periphery and in the liver resulting in increased insulin dependent glucose disposal and decreased hepatic glucose output. Metformin is a member of the biguanide class, improves glucose tolerance in patients with type 2 diabetes, lowering both basal and postprandial plasma glucose. Metformin decreases hepatic glucose production, decreases intestinal absorption of glucose and improves insulin sensitivity by increasing peripheral glucose uptake and utilization. Indication
Pioglitazone/metformin is indicated as an adjunct to diet and exercise:
To improve glycemic control in patients with type 2 diabetes, or
For patients who are already treated with a separate combination of pioglitazone and metformin,
For patients whose diabetes is not adequately controlled with metformin alone, or
For patients who have initially responded to pioglitazone alone and require additional glycemic control. Dosage and administration
Use in pregnancy and lactation
Pioglitazone/metformin should not be used during pregnancy unless the potential benefit justifies the potential risk to the fetus. There are no adequate and well-controlled studies in pregnant women with combination of pioglitazone and metformin or its individual components. It is not known whether pioglitazone and/or metformin are secreted in human milk. Because many drugs are excreted in human milk, pioglitazone/metformin should not be administered to a breastfeeding woman.
Latanoprostene bunod (trade name Vyzulta) is an ophthalmic drug approved in the United States in 2017 for the reduction of intraocular pressure in patients with open-angle glaucoma or ocular hypertension. It targets the trabecular meshwork directly. == References ==