From the Guidelines
Thiazolidinediones available in the United States include pioglitazone (brand name Actos) and rosiglitazone (brand name Avandia). These medications are oral antidiabetic agents used to treat type 2 diabetes by improving insulin sensitivity in peripheral tissues, as noted in the study by 1. They work by activating peroxisome proliferator-activated receptor gamma (PPAR-γ), which increases glucose uptake in muscle and fat cells while reducing glucose production in the liver. Some key points to consider when prescribing thiazolidinediones include:
- They may cause fluid retention, weight gain, and potentially increase the risk of heart failure in susceptible individuals, as highlighted in the study by 1.
- They typically take several weeks to reach maximum effectiveness and are often used in combination with other antidiabetic medications when monotherapy with metformin is insufficient.
- Regular monitoring of liver function is recommended, especially during the initial months of therapy, due to the potential risk of liver toxicity, as seen with troglitazone (Rezulin) which was withdrawn from the market due to this concern.
- Contraindications for TZDs include heart failure (New York Heart Association heart function classification class II and above), active liver disease, transaminase elevations exceeding 2.5 times the upper limit of normal, and severe osteoporosis and fractures, as stated in the study by 1.
- The most recent guidelines, such as those outlined in the study by 1, provide a comprehensive overview of the management of diabetes, cardiorenal, and metabolic diseases, including the use of thiazolidinediones.
From the FDA Drug Label
ACTOS The FDA drug label does not answer the question.
From the Research
Thiazolidinedione Brand Names
- The brand names of thiazolidinediones mentioned in the studies are:
Thiazolidinediones Uses
- Thiazolidinediones are used for the treatment of type 2 diabetes mellitus (T2DM) 2, 3, 4, 5, 6
- They act by improving insulin sensitivity in adipose tissue, liver, and skeletal muscle 2
- Pioglitazone is also licensed for use in combination with insulin 2
Thiazolidinediones Side Effects
- The main side effects of thiazolidinediones include weight gain, oedema, and mild dilutional anaemia 2
- They can cause fluid retention, thereby increasing the risk of heart failure 5, 6
- Thiazolidinediones are contraindicated in patients with moderate to severe liver dysfunction, New York Heart Association III-IV cardiac status, pregnancy, lactation, and in children 2