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Pioglitazone contraindication in heart failure — GPhC CRA MCQ

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ModerateEndocrine TherapeuticsPioglitazone contraindication in heart failureGPhC CRA

A 65-year-old man with type 2 diabetes and heart failure presents with a prescription for pioglitazone 15 mg once daily. What is the most appropriate action?

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Correct answer: DContact the prescriber as pioglitazone is contraindicated in heart failure

Pioglitazone is contraindicated in patients with heart failure (or history of heart failure) as it causes fluid retention which can precipitate or worsen heart failure. The BNF clearly states this contraindication. The prescriber should be contacted to discuss an alternative antidiabetic agent. SGLT2 inhibitors would be a more appropriate choice in this patient as they have demonstrated cardiovascular and heart failure benefits.

Reference: BNF; NICE NG28 Type 2 Diabetes