Generic Actos Pioglitazone

Generic Actos. 

Active ingredient: pioglitazone

Generic Actos is a good alternative to a brand medication used for diabetes type 2 treatment. Generic Actos contains the same active ingredient Pioglitazone HCL as brand medication has. It means that generic version of Pioglitazone works the same as brand Actos; indications, contraindications, actos side effects, drug interactions are similar as well. Generic medication may differ in commercial name, form and shape of tablets, excipients.

Pioglitazone belongs to a group of medications called selective agonists of PPAR-gamma. The medication helps to control sugar blood levels. It lowers insulin resistance of peripheral tissues in the liver, decrease blood concentration of glucose, insulin levels and glycated hemoglobin in the plasma. Generic Actos is used to treat insulin-dependent diabetes mellitus (II type).

Therapeutic action

Generic Actos is an anti-diabetic oral hypoglycemic drug. Action mechanism is associated with selective stimulation of the nuclear gamma-activated receptors proliferatorom peroxisome (PPAR-gamma agonist peroxisome proliferator-activated receptor-gamma). PPAR-gamma receptors are found in fat and muscle tissue and in the liver.
Activation of nuclear PPAR-gamma modulates the transcription of genes sensitive to insulin which participate in controlling of glucose and lipids metabolism in the liver, fat and muscle tissues.

Pioglitazone lowers insulin resistance of peripheral tissues and liver, resulting in increased utilization of Insulin-dependent glucose and decreased release of glucose out of the liver. Actos medication does not stimulate insulin secretion by beta-cells of the pancreas, however, it is only active synthesis of insulin.

Generic Actos decreases the blood concentration of glucose, insulin levels and hemoglobin A1 (glycated hemoglobin) in patients with diabetes type 2. In monotherapy or in combination with sulfonylurea medications (metformine) or insulin Actos improves sugar blood levels. In addition, Pioglitazone reduces triglycerides blood levels in patients with diabetes type 2 with lipid disorders. The medication does not affect cholesterol and LDL blood levels.

After oral administration Pioglitazone is found in blood plasma after 30 minutes. Cmax is achieved in 2 hours. If actos tablets are taken during meal Cmax is achieved in 3-4 hours. Over 99% of pioglitazone and over 98% of its metabolites bind to serum proteins (mostly albumin). The average volume of distribution is 0.63 L / kg. Pioglitazone is extensively metabolized in the liver with the participation of cytochrome P450 isoenzymes - CYP2C8 and CYP3A4. In vitro pioglitazone did not inhibit the activity of P450. The concentrations of pioglitazone and its active metabolite remain at a high level for 24 hours after receiving a single recommended daily dose. Nearly 15-30% of the dose is found in urine, mostly in the form of metabolites and their conjugates. Nearly 70-85% of the dose is eliminated with feces.

Indication

Generic Actos is prescribed for the treatment of non insulin dependent diabetes (type 2) as monotherapy or in combination with other diabetes medicines or insulin in case when diet and physical exercises are insufficient to achieve the desired blood levels of glucose.

Administration

The dose of Pioglitazone is indicated individually by a health care provider. Actos is usually taken once daily with or without food. Maximal daily dose is 45mg. You should take the medication exactly as prescribed by your doctor. Do not take generic Actos without your doctor's approval. Pioglitazone tablets are taken orally swallowing with sufficient amount of water. Do not crash or split the tablets unless it is prescribed by your physician.

Overdose

Seek immediate medication attention if you took too much of Pioglitazone dosage. The symptoms of overdose may include: hypoglycemia, coma, fainting, increased heart rate, seizures, sweating, headache, confusion, weakness, tremor, irritability and others. In case of actos overdose symptomatic treatment is required.

Contraindications

Generic Actos is contraindicated in:

• Hypersensitivity to any of the drug ingredients
• Insulin dependent diabetes type 1
• Diabetic ketoacidosis;
• Liver disease in the acute phase;
• If the level of alanine aminotransferase (ALT, ALT) above normal by 2.5 times or more;
• Pregnancy and breastfeeding.

Generic Actos should be used with caution in: 

• edema
• swelling
• moderate increase in liver enzymes
• patients under 18 years of age

The use of generic Actos during pregnancy and breastfeeding

Generic Actos is contraindicated in pregnancy. There were no conducted adequate controlled studies which could determine the safety profile of Pioglitazone for use during pregnancy. In patients with anovulatory cycle in premenopause period the use of Actos may cause ovulation. As a result Pioglitazone may increase the risk of pregnancy. Since high sugar blood levels may significantly increase the risk of congenital anomalies, as well as increased incidence of pathology in the neonatal period and the increase in mortality during pregnancy the use of insulin is required. It is not known whether pioglitazone can pass through breast milk. However, the use of Actos during breastfeeding should be avoided or strictly monitored by a health care provider.

Side effects

• As every medication Pioglitazone may cause side effects. Generic Actos may cause the following side effects:
• Hypoglycemia (as monotherapy, in combination with a sulfonylurea derivative - 2% with insulin - 8-15%)
• Edema (monotherapy - 4.8%, in combination with insulin - 15.3%).
• Anemia (1-1.6%), decreased hemoglobin and hematocrit (2-4%).
• Increased alanine aminotransferase / alanine aminotransferase (more than 3 times - 0.25%), creatine clearance in blood plasma.
• Respiratory tract infections
• Sore throat
• Headache
• Sinus infection
• Myalgia
• Weight gain
• Symptoms of high blood sugar levels
• Symptoms of low blood sugar levels
• Liver dysfunction
• Shortness of breath
• Vision disorders
• Local allergic reactions

Generic Actos special cautions and warning

The treatment of diabetes mellitus type II should be undertaken in conjunction with diet and exercise. This is important not only in the beginning of treatment with Actos, but also throughout the entire course of therapy.

Efficacy of treatment is preferable to value the level of glycated hemoglobin (Hb A1c), which is the most appropriate indicator of glycemic control in a long period of time. Glycosylated hemoglobin reflects blood glucose levels over the past 2-3 months. Therefore the duration of treatment with Pioglitazone should be not less than 3 months. During the treatment ALT levels should be monitored, especially at the beginning of therapy.

Drug interaction
Make sure to inform your doctor if you take any medical preparations, including herbals , vitamins, minerals and food supplement. Generic Actos (pioglitazone) may interact with the following medicines:

• Antiviral drug Atazanavir. Atazanavir may increase the blood levels of  pioglitazone in the blood
• Cholesterol medication Lipitor (atorvastatin). Actos may lower the effect of Lipitor making it less effective
• Seizure medications can increase blood levels of Actos
• Cholesterol medication Gemfibrozil may increase blood levels of the medication
• Midazolam may lower the blood levels of Actos
• Calcium channel blocker Nifedipine. Actos may make Nifedipine (Adalat) less effective
• Oral contraceptives. Clinical trials showed that Actos may make oral contraceptives less effective and thus can increase the risk of pregnancy
• Tuberculosis treatment drugs Rifampin and Rifampenine can decrease Pioglitazone blood levels
• Antiviral drug Ritonavir can increase blood level of generic Actos and thus can increase the risk of Actos side effects

Storage
Keep the medication out of reach of children. Store at room temperature in protected from light place. Do not store the medication in the bathroom.