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Pianorm-M uses

Pianorm-M consists of Metformin, Pioglitazone.


Pianorm-M (Metformin) is a biguanide antihyperglycemic agent used for treating non-insulin-dependent diabetes mellitus (NIDDM). It improves glycemic control by decreasing hepatic glucose production, decreasing glucose absorption and increasing insulin-mediated glucose uptake. Pianorm-M (Metformin) is the only oral antihyperglycemic agent that is not associated with weight gain. Pianorm-M (Metformin) may induce weight loss and is the drug of choice for obese NIDDM patients. When used alone, Pianorm-M (Metformin) does not cause hypoglycemia; however, it may potentiate the hypoglycemic effects of sulfonylureas and insulin. Its main side effects are dyspepsia, nausea and diarrhea. Dose titration and/or use of smaller divided doses may decrease side effects. Pianorm-M (Metformin) should be avoided in those with severely compromised renal function (creatinine clearance < 30 ml/min), acute/decompensated heart failure, severe liver disease and for 48 hours after the use of iodinated contrast dyes due to the risk of lactic acidosis. Lower doses should be used in the elderly and those with decreased renal function. Pianorm-M (Metformin) decreases fasting plasma glucose, postprandial blood glucose and glycosolated hemoglobin (HbA1c) levels, which are reflective of the last 8-10 weeks of glucose control. Pianorm-M (Metformin) may also have a positive effect on lipid levels.

Indication: For use as an adjunct to diet and exercise in adult patients (18 years and older) with NIDDM. May also be used for the management of metabolic and reproductive abnormalities associated with polycystic ovary syndrome (PCOS).

Pianorm-M (Metformin) is an oral antihyperglycemic agent that improves glucose tolerance in patients with NIDDM, lowering both basal and postprandial plasma glucose. Pianorm-M (Metformin) is not chemically or pharmacologically related to any other class of oral antihyperglycemic agents. Unlike sulfonylureas, Pianorm-M (Metformin) does not produce hypoglycemia in either patients with NIDDM or healthy subjects and does not cause hyperinsulinemia. Pianorm-M (Metformin) does not affect insulin secretion.


Pharmacological action

Pianorm-M is an oral hypoglycemic agent, series of thiazolidinedione derivatives. Powerful and selective agonist of gamma-receptors, peroxisome proliferator-activated (PPAR-gamma). PPAR-gamma receptors are found in adipose and muscle tissues and liver. Activation of nuclear receptor PPAR-gamma modulates the transcription of several genes that are sensitive to insulin, involved in controlling glucose and lipid metabolism. This medicine reduces insulin resistance in peripheral tissues and liver, as a result of this is increased flow of glucose and insulin reduced glucose production in the liver. Unlike sulfonylureas, Pianorm-M (Pioglitazone) does not stimulate insulin secretion by beta cells of the pancreas.

In diabetes mellitus type 2 (insulin-dependent) decrease in insulin resistance under the action of Pianorm-M (Pioglitazone) reduces blood glucose levels, reduce insulin levels in plasma and hemoglobin A1c (glycated hemoglobin, HbA1c).

In diabetes mellitus type 2 (insulin-dependent) with lipid disorders during treatment with Pianorm-M (Pioglitazone) there is a decrease in triglycerides and increase HDL. The level of LDL and total cholesterol in these patients does not change.


After oral administration Pianorm-M (Pioglitazone) is found in fasting plasma after 30 minutes. Cmax in plasma is reached after 2 hours. At ingestion there was a slight increase of Cmax to 3-4 hours, but the extent of absorption was not changed.

Protein binding of human serum, mainly to albumin greater than 99%; binding to other serum proteins less pronounced. The metabolites of Pianorm-M (Pioglitazone) M-III and M-IV also significantly associated with serum albumin is more than 98%.

Pianorm-M (Pioglitazone) is extensively metabolized in the liver by hydroxylation and oxidation. Metabolites M-II, M-IV (hydroxy derivatives of Pianorm-M (Pioglitazone)) and M-III (keto derivative of Pianorm-M (Pioglitazone)) exhibit pharmacological activity in models of type 2 diabetes in animals. Metabolites also partly converted into conjugates glucuronic or sulfuric acids.

The metabolism of Pianorm-M (Pioglitazone) in the liver occurs with the participation of isoenzymes CYP2C8 and CYP3A4.

T1/2 of unchanged Pianorm-M (Pioglitazone) is 3-7 hours, total Pianorm-M (Pioglitazone) (pioglitazone and active metabolites) is 16-24 hours. The clearance of Pianorm-M (Pioglitazone) is 5-7 L / h.

After oral administration about 15-30% of the dose of Pianorm-M (Pioglitazone) is found in urine. Kidneys displayed a negligible amount of Pianorm-M (Pioglitazone), mainly in the form of metabolites and their conjugates.

It is believed that the ingestion of large doses is excreted in bile as unchanged and as metabolites and excreted in the feces.

The concentrations of Pianorm-M (Pioglitazone) and active metabolites in serum remained at a high level 24 h after a single daily dose.


Why is Pianorm-M prescribed?

Type 2 diabetes (insulin independent).

Dosage and administration

Pianorm-M is taken orally in dose 30 mg 1 time / day. The duration of treatment is determined individually.

The maximum dose in combination therapy is 30 mg / day.

Pianorm-M (Pioglitazone) side effects, adverse reactions

Metabolism: a possible development of hypoglycaemia (mild to severe).

Hematopoietic system: possible anemia, decreased hemoglobin and hematocrit.

Digestive system: rarely - increased ALT.

Pianorm-M contraindications

Diabetes mellitus type 1 (insulin-dependent), diabetic ketoacidosis, pregnancy, lactation, hypersensitivity to Pianorm-M (Pioglitazone).

Using during pregnancy and breastfeeding

Pianorm-M is contraindicated during pregnancy and lactation. In patients with insulin resistance and anovulatory cycles in pre menopausal period the treatment with thiazolidinediones, including Pianorm-M (Pioglitazone), can cause ovulation. This increases the risk of pregnancy if you do not use adequate contraception.

In experimental studies in animals showed that Pianorm-M (Pioglitazone) has no teratogenic effects and adverse effects on fertility.

Category of the fetus by FDA - C.

Special instructions

Pianorm-M (Pioglitazone) should not be used in the presence of clinical presentations of liver disease in the active phase or an increase in ALT is 2.5 times above ULN.

During treatment for suspected development of liver dysfunction (nausea, vomiting, abdominal pain, fatigue, lack of appetite, dark urine) should define indicators of liver function tests. In the case of jaundice Pianorm-M (Pioglitazone) should be discontinued.

Pianorm-M (Pioglitazone) should be used with caution in patients with edema.

Anemia, decreased hemoglobin and hematocrit decrease may be associated with increased plasma volume and do not show any clinically significant hematological effects.

If necessary to usee Pianorm-M (Pioglitazone) simultaneously with ketoconazole should be more regular follow-up blood glucose levels.

There have been rare cases of a temporary increase in the activity level of CPK during treatment with this drug, which had no clinical consequences. The relationship of these reactions from taking Pianorm-M (Pioglitazone) is unknown.

The average values of bilirubin, AST, ALT, ALP and GGT decreased in the survey at the end of treatment by this medicine compared with those of before treatment.

Before treatment and during the first year of treatment (every 2 months) and then periodically monitor the activity of ALT should be.

Experimental studies have shown that Pianorm-M (Pioglitazone) is not mutagenic.

The use of Pianorm-M (Pioglitazone) in children is not recommended.

Pianorm-M drug interactions

In another thiazolidinedione derivative simultaneously observed with oral contraceptives decrease the concentration of ethinyl estradiol and norethindrone in plasma by approximately 30%. Therefore, while the use of Pianorm-M (Pioglitazone) and oral contraceptives may decrease contraceptive efficacy.

Ketoconazole inhibits the metabolism of Pianorm-M (Pioglitazone) in the liver in vitro.

Sulfonamides derivatives, metformin and insulin potentiate (relatively) hypoglycemia.

Pianorm-M in case of emergency / overdose

Treatment: symptomatic therapy.


Pianorm-M pharmaceutical active ingredients containing related brand and generic drugs:

infoActive ingredient is the part of the drug or medicine which is biologically active. This portion of the drug is responsible for the main action of the drug which is intended to cure or reduce the symptom or disease. The other portions of the drug which are inactive are called excipients; there role is to act as vehicle or binder. In contrast to active ingredient, the inactive ingredient's role is not significant in the cure or treatment of the disease. There can be one or more active ingredients in a drug.

Pianorm-M available forms, composition, doses:

infoForm of the medicine is the form in which the medicine is marketed in the market, for example, a medicine X can be in the form of capsule or the form of chewable tablet or the form of tablet. Sometimes same medicine can be available as injection form. Each medicine cannot be in all forms but can be marketed in 1, 2, or 3 forms which the pharmaceutical company decided based on various background research results.
Composition is the list of ingredients which combinedly form a medicine. Both active ingredients and inactive ingredients form the composition. The active ingredient gives the desired therapeutic effect whereas the inactive ingredient helps in making the medicine stable.
Doses are various strengths of the medicine like 10mg, 20mg, 30mg and so on. Each medicine comes in various doses which is decided by the manufacturer, that is, pharmaceutical company. The dose is decided on the severity of the symptom or disease.

Pianorm-M destination | category:

infoDestination is defined as the organism to which the drug or medicine is targeted. For most of the drugs what we discuss, human is the drug destination.
Drug category can be defined as major classification of the drug. For example, an antihistaminic or an antipyretic or anti anginal or pain killer, anti-inflammatory or so.

Pianorm-M Anatomical Therapeutic Chemical codes:

infoA medicine is classified depending on the organ or system it acts [Anatomical], based on what result it gives on what disease, symptom [Therapeutical], based on chemical composition [Chemical]. It is called as ATC code. The code is based on Active ingredients of the medicine. A medicine can have different codes as sometimes it acts on different organs for different indications. Same way, different brands with same active ingredients and same indications can have same ATC code.

Pianorm-M pharmaceutical companies:

infoPharmaceutical companies are drug manufacturing companies that help in complete development of the drug from the background research to formation, clinical trials, release of the drug into the market and marketing of the drug.
Researchers are the persons who are responsible for the scientific research and is responsible for all the background clinical trials that resulted in the development of the drug.



  1. "Pioglitazone". https://pubchem.ncbi.nlm.nih.gov/co... (accessed August 28, 2018).
  2. "metformin". https://pubchem.ncbi.nlm.nih.gov/co... (accessed August 28, 2018).
  3. "Pioglitazone". http://www.drugbank.ca/drugs/DB0113... (accessed August 28, 2018).

Frequently asked Questions

Can i drive or operate heavy machine after consuming Pianorm-M?

Depending on the reaction of the Pianorm-M after taken, if you are feeling dizziness, drowsiness or any weakness as a reaction on your body, Then consider Pianorm-M not safe to drive or operate heavy machine after consumption. Meaning that, do not drive or operate heavy duty machines after taking the capsule if the capsule has a strange reaction on your body like dizziness, drowsiness. As prescribed by a pharmacist, it is dangerous to take alcohol while taking medicines as it exposed patients to drowsiness and health risk. Please take note of such effect most especially when taking Primosa capsule. It's advisable to consult your doctor on time for a proper recommendation and medical consultations.

Is Pianorm-M addictive or habit forming?

Medicines are not designed with the mind of creating an addiction or abuse on the health of the users. Addictive Medicine is categorically called Controlled substances by the government. For instance, Schedule H or X in India and schedule II-V in the US are controlled substances.

Please consult the medicine instruction manual on how to use and ensure it is not a controlled substance.In conclusion, self medication is a killer to your health. Consult your doctor for a proper prescription, recommendation, and guidiance.



sDrugs.com conducted a study on Pianorm-M, and the result of the survey is set out below. It is noteworthy that the product of the survey is based on the perception and impressions of the visitors of the website as well as the views of Pianorm-M consumers. We, as a result of this, advice that you do not base your therapeutic or medical decisions on this result, but rather consult your certified medical experts for their recommendations.

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The information was verified by Dr. Arunabha Ray, MD Pharmacology

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