metformin + pioglitazone hydrochloride at a glance
Medicine class
A fixed combination of two oral glucose-lowering medicines: a biguanide and a thiazolidinedione.
Main use
Type 2 diabetes that remains insufficiently controlled with metformin alone.
Taking the tablet
Swallow with water; taking it with or just after food may reduce stomach and bowel effects.
Important checks
Kidney function, liver function, glucose control, weight and possible fluid retention require review.
What is metformin + pioglitazone hydrochloride used for?
The selected product is licensed for:
Second-line treatment of type 2 diabetes in adults, particularly adults who are overweight, when adequate glucose control has not been achieved with maximum tolerated metformin treatment.
How does metformin + pioglitazone hydrochloride work?
The two ingredients lower blood glucose through complementary actions. Metformin mainly reduces glucose production by the liver and improves glucose uptake, while pioglitazone activates PPAR-gamma receptors to make fat, muscle and liver tissue more responsive to insulin.
metformin + pioglitazone hydrochloride preparations and strengths
Tablet
Route: Oral
Strengths: 15 mg + 850 mg
How to take metformin + pioglitazone hydrochloride
Follow the directions on the dispensing label and do not alter treatment without discussing it with the prescriber.
Swallow the film-coated tablet with a glass of water.
Take it with or just after food to reduce gastrointestinal symptoms.
Continue any agreed diabetes diet and monitoring plan.
Tell the healthcare team before surgery or an examination using injected iodinated contrast, because treatment may need to be temporarily withheld.
metformin + pioglitazone hydrochloride side effects
Common or expected effects
- Nausea, vomiting, diarrhoea, abdominal pain or loss of appetite, especially when treatment starts
- Weight gain or fluid-related swelling
- Headache or altered sensation
- Temporary visual disturbance
- Reduced vitamin B12 levels or deficiency
- Bone fractures
- Upper respiratory infection
Get urgent medical advice
- Lactic acidosis: severe tiredness, vomiting, abdominal pain, muscle cramps, feeling cold, slow heartbeat or difficulty breathing
- Heart failure or fluid retention: new or worsening breathlessness, rapid weight gain or swelling
- Severe allergic reaction, including facial or throat swelling and breathing difficulty
- Liver injury: jaundice, dark urine, marked fatigue, nausea or abdominal pain
- Visible blood in the urine, painful urination or urinary urgency
- New or worsening loss of visual acuity, which may indicate macular oedema
metformin + pioglitazone hydrochloride in pregnancy
The fixed metformin–pioglitazone product should not be used during pregnancy because adequate human pregnancy data for pioglitazone are lacking. Anyone planning pregnancy, who may be pregnant or who becomes pregnant should contact their diabetes team promptly so treatment can be reviewed. This differs from metformin used without pioglitazone, which can be used in pregnancy when clinically appropriate.
metformin + pioglitazone hydrochloride while breastfeeding
The fixed combination is contraindicated during breastfeeding because infant exposure and safety for pioglitazone are uncertain. Metformin alone is generally compatible with breastfeeding, so the prescriber should select an appropriate alternative.
metformin + pioglitazone hydrochloride interactions
Check with a pharmacist or prescriber before starting, stopping or regularly using other medicines.
Iodinated contrast agents
The combination must be withheld around intravascular contrast procedures and restarted only after renal function has been reassessed as stable.
Alcohol
Excessive or acute alcohol intake increases the risk of metformin-associated lactic acidosis, especially with fasting, malnutrition or liver impairment.
NSAIDs, ACE inhibitors, angiotensin-II receptor blockers and diuretics
These may impair kidney function and increase metformin accumulation, so renal function may require closer monitoring.
Common questions about metformin + pioglitazone hydrochloride
Answers are fully visible for fast scanning and source review.
Why is metformin + pioglitazone hydrochloride prescribed?
It is used for adults with type 2 diabetes when metformin alone has not provided sufficient blood-glucose control and treatment with both mechanisms is considered appropriate.
Can metformin + pioglitazone hydrochloride cause low blood sugar?
The combination does not usually cause hypoglycaemia by itself, but the risk can rise when it is used with insulin or medicines such as sulfonylureas.
Does metformin + pioglitazone hydrochloride cause weight gain?
Pioglitazone can cause weight gain through increased fat or fluid retention. Rapid weight gain accompanied by swelling or breathlessness needs prompt assessment.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.