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DRUGS & SUPPLEMENTS
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Piostar is an oral hypoglycemic agent, series of thiazolidinedione derivatives. Powerful and selective agonist of gamma-receptors, peroxisome proliferator-activated. 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, Piostar 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 Piostar 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 Piostar 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 Piostar 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 Piostar M-III and M-IV also significantly associated with serum albumin is more than 98%.
Piostar is extensively metabolized in the liver by hydroxylation and oxidation. Metabolites M-II, M-IV (hydroxy derivatives of Piostar) and M-III (keto derivative of Piostar) exhibit pharmacological activity in models of type 2 diabetes in animals. Metabolites also partly converted into conjugates glucuronic or sulfuric acids.
The metabolism of Piostar in the liver occurs with the participation of isoenzymes CYP2C8 and CYP3A4.
T1/2 of unchanged Piostar is 3-7 hours, total Piostar (pioglitazone and active metabolites) is 16-24 hours. The clearance of Piostar is 5-7 L / h.
After oral administration about 15-30% of the dose of Piostar is found in urine. Kidneys displayed a negligible amount of Piostar, 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 Piostar and active metabolites in serum remained at a high level 24 h after a single daily dose.
Type 2 diabetes.
Piostar 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.
Metabolism: a possible development of hypoglycaemia.
Hematopoietic system: possible anemia, decreased hemoglobin and hematocrit.
Digestive system: rarely - increased ALT.
Diabetes mellitus type 1 (insulin-dependent), diabetic ketoacidosis, pregnancy, lactation, hypersensitivity to Piostar.
Piostar is contraindicated during pregnancy and lactation. In patients with insulin resistance and anovulatory cycles in pre menopausal period the treatment with thiazolidinediones, including Piostar, can cause ovulation. This increases the risk of pregnancy if you do not use adequate contraception.
In experimental studies in animals showed that Piostar has no teratogenic effects and adverse effects on fertility.
Category of the fetus by FDA - C.
Piostar 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 should define indicators of liver function tests. In the case of jaundice Piostar should be discontinued.
Piostar 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 Piostar 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 Piostar 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 Piostar is not mutagenic.
The use of Piostar in children is not recommended.
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 Piostar and oral contraceptives may decrease contraceptive efficacy.
Ketoconazole inhibits the metabolism of Piostar in the liver in vitro.
Sulfonamides derivatives, metformin and insulin potentiate (relatively) hypoglycemia.
Treatment: symptomatic therapy.
Depending on the reaction of the Piostar after taken, if you are feeling dizziness, drowsiness or any weakness as a reaction on your body, Then consider Piostar 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 Piostar 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.
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The information was verified by Dr. Rachana Salvi, MD Pharmacology