What is the purpose of Actos (Pioglitazone)?

From the Guidelines

Actos (pioglitazone) is a medication primarily used to treat type 2 diabetes by improving insulin sensitivity, and its use is supported by the most recent and highest quality study 1.

Key Points

• Actos belongs to a class of drugs called thiazolidinediones (TZDs) and works by helping the body use insulin more effectively to lower blood sugar levels.
• The typical dosage ranges from 15 to 45 mg taken once daily, with or without food.
• Actos doesn't replace the need for lifestyle modifications like healthy eating and exercise but works alongside these measures.
• The medication specifically targets insulin resistance by activating peroxisome proliferator-activated receptor-gamma (PPAR-gamma), which increases the body's sensitivity to insulin in muscle, fat, and liver tissues.
• Patients should be aware that Actos may take several weeks to reach its full effect and requires regular blood sugar monitoring.
• Common side effects include weight gain, fluid retention, and potential increased risk of heart failure, so regular medical follow-up is essential while taking this medication.
• According to the most recent study 1, pioglitazone improves glucose and lipid metabolism and reverses steatohepatitis in people with prediabetes, type 2 diabetes, or even without diabetes.
• A meta-analysis 1 showed that pioglitazone significantly improved steatosis and inflammation, but not fibrosis, and was associated with a significant reduction in the primary outcome of death, myocardial infarction, or stroke.

Important Considerations

• Pioglitazone may be beneficial for patients with nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) 1.
• The medication should be used with caution in patients with or at risk for congestive heart failure and has been associated with fractures and weight gain 1.
• Regular monitoring of liver function and cardiovascular risk factors is essential while taking Actos.

From the FDA Drug Label

ACTOS (pioglitazone hydrochloride) is an oral antidiabetic agent that acts primarily by decreasing insulin resistance. ACTOS is used in the management of type 2 diabetes mellitus (also known as non-insulin-dependent diabetes mellitus [NIDDM] or adult-onset diabetes)

The purpose of Actos is to manage type 2 diabetes mellitus by decreasing insulin resistance.

• It improves glycemic control while reducing circulating insulin levels.
• The main mechanism of action is to increase insulin-dependent glucose disposal and decrease hepatic glucose output 2.
• Actos is a thiazolidinedione antidiabetic agent that depends on the presence of insulin for its mechanism of action 2.

From the Research

Actos Purpose

The purpose of Actos (pioglitazone) is to increase hepatic and peripheral insulin sensitivity, thereby inhibiting hepatic gluconeogenesis and increasing peripheral and splanchnic glucose uptake in patients with type 2 diabetes mellitus 3, 4.

Mechanism of Action

• Pioglitazone improves glycemic control primarily by increasing peripheral insulin sensitivity in patients with type 2 diabetes 5.
• It also exhibits a variety of favorable pleiotropic effects, including anti-inflammatory, antioxidant, vasoprotective, antihypertensive, and hypolipidemic actions 6.
• The thiazolidinediones, a class of agents that includes pioglitazone, favorably influence insulin sensitivity and possibly also pancreatic beta-cell function 7.

Therapeutic Uses

• Pioglitazone is used as monotherapy or in combination with metformin, repaglinide, insulin, or a sulfonylurea to induce improvements in glycemic control and serum lipid profiles in patients with type 2 diabetes mellitus 3, 4.
• It is also effective in reducing some measures of cardiovascular risk and arteriosclerosis 3, 4.
• Pioglitazone can be administered in combination with metformin, sulfonylureas, exenatide, dipeptidyl peptidase 4 (DPP-4) inhibitors, or insulin to improve glycemic control with an extremely low incidence of hypoglycemia 6.