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DRUGS & SUPPLEMENTS
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Piouno
What are the side effects you encounter while taking this medicine? |
Piouno uses
Pharmacological action
Piouno 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, Piouno 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 Piouno 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 Piouno there is a decrease in triglycerides and increase HDL. The level of LDL and total cholesterol in these patients does not change.
Pharmacokinetics
After oral administration Piouno 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 Piouno M-III and M-IV also significantly associated with serum albumin is more than 98%.
Piouno is extensively metabolized in the liver by hydroxylation and oxidation. Metabolites M-II, M-IV (hydroxy derivatives of Piouno) and M-III (keto derivative of Piouno) exhibit pharmacological activity in models of type 2 diabetes in animals. Metabolites also partly converted into conjugates glucuronic or sulfuric acids.
The metabolism of Piouno in the liver occurs with the participation of isoenzymes CYP2C8 and CYP3A4.
T1/2 of unchanged Piouno is 3-7 hours, total Piouno (pioglitazone and active metabolites) is 16-24 hours. The clearance of Piouno is 5-7 L / h.
After oral administration about 15-30% of the dose of Piouno is found in urine. Kidneys displayed a negligible amount of Piouno, 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 Piouno and active metabolites in serum remained at a high level 24 h after a single daily dose.
Why is Piouno prescribed?
Type 2 diabetes.
Dosage and administration
Piouno 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.
Piouno side effects, adverse reactions
Metabolism: a possible development of hypoglycaemia.
Hematopoietic system: possible anemia, decreased hemoglobin and hematocrit.
Digestive system: rarely - increased ALT.
Piouno contraindications
Diabetes mellitus type 1 (insulin-dependent), diabetic ketoacidosis, pregnancy, lactation, hypersensitivity to Piouno.
Using during pregnancy and breastfeeding
Piouno is contraindicated during pregnancy and lactation. In patients with insulin resistance and anovulatory cycles in pre menopausal period the treatment with thiazolidinediones, including Piouno, can cause ovulation. This increases the risk of pregnancy if you do not use adequate contraception.
In experimental studies in animals showed that Piouno has no teratogenic effects and adverse effects on fertility.
Category of the fetus by FDA - C.
Special instructions
Piouno 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 Piouno should be discontinued.
Piouno 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 Piouno 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 Piouno 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 Piouno is not mutagenic.
The use of Piouno in children is not recommended.
Piouno 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 Piouno and oral contraceptives may decrease contraceptive efficacy.
Ketoconazole inhibits the metabolism of Piouno in the liver in vitro.
Sulfonamides derivatives, metformin and insulin potentiate (relatively) hypoglycemia.
Piouno in case of emergency / overdose
Treatment: symptomatic therapy.
Piouno pharmaceutical active ingredients containing related brand and generic drugs:
Piouno available forms, composition, doses:
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.