What is equivalent to Pioglitazone (Thiazolidinedione) 15 milligrams?

From the Guidelines

Performing 4 mg is equivalent to pioglitazone 15 mg is not supported by the provided evidence, however, Rosiglitazone 4 mg is the maximum approved daily dose and Pioglitazone 15 mg is one-third of its maximum approved daily dose of 45 mg. Based on the provided evidence from the study published in Diabetes Care in 2019 1, the maximum approved daily dose of Pioglitazone is 45 mg, and the maximum approved daily dose of Rosiglitazone is 8 mg.

• The study does not provide a direct comparison between the two medications in terms of equivalence.
• However, it does provide information on the maximum approved daily doses of different medications, including Pioglitazone and Rosiglitazone.
• To determine the equivalent dose, we need to consider the potency and efficacy of each medication, which is not directly provided in the study.
• However, considering the maximum approved daily doses, we can estimate that Pioglitazone 15 mg is one-third of its maximum approved daily dose, and Rosiglitazone 4 mg is half of its maximum approved daily dose.
• Therefore, Rosiglitazone 4 mg may not be equivalent to Pioglitazone 15 mg, and the actual equivalent dose may be different.
• It's essential to consult the prescribing information and clinical guidelines for specific guidance on switching between these medications.
• Additionally, factors such as individual patient response, renal function, and potential side effects should be considered when determining the equivalent dose.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Equivalent Performing to Pioglitazone 15 mg

There are no direct comparisons of performing to pioglitazone 15 mg in the provided studies. However, the studies provide information on the pharmacokinetics and pharmacodynamics of pioglitazone, which may be useful in understanding its effects.

Pharmacokinetics of Pioglitazone

• The pharmacokinetics of pioglitazone have been studied in various populations, including healthy volunteers and patients with type 2 diabetes 2, 3.
• Pioglitazone exposure has been shown to increase dose dependently, but less than dose proportionally during multiple dosing 3.
• The median peak pioglitazone concentration occurs at 2 hours, and the mean half-life is 8 to 9 hours for pioglitazone and 24 to 32 hours for its active metabolites (M-III and M-IV) 3.

Effects of Pioglitazone on Glucose and Lipid Metabolism

• Pioglitazone has been shown to improve glucose and lipid metabolism in patients with type 2 diabetes by activating the nuclear peroxisome proliferator-activated receptor-gamma (PPAR-gamma) 4, 5.
• The addition of pioglitazone to preexisting therapy with metformin, sulphonylurea, insulin, or voglibose has been shown to decrease HbA1c and fasting blood glucose levels significantly in patients with poorly controlled type 2 diabetes 4.
• Pioglitazone has also been associated with improvements in serum lipid profiles in randomized placebo-controlled clinical studies 4.

Comparison with Other Treatments

• Pioglitazone has been compared with metformin in terms of its effects on vascular endothelial function in patients with type 2 diabetes treated with sulfonylureas 6.
• The study found that pioglitazone significantly decreased fasting insulin, HbA(1C), and HOMA-IR, and increased flow-mediated dilation (FMD), while metformin induced a significant decrease in HbA(1C) and only a trend for increase in FMD 6.