Piouno - kufotokoza mankhwala, malangizo, ntchito, ndemanga

Mapiritsi 15 mg, 30 mg

Piritsi limodzi lili

ntchito yogwira - pioglitazone hydrochloride 16.53 mg (wofanana ndi pioglitazone 15.00 mg) pa mulingo wa 15 mg, kapena 33.06 mg (30.00 mg) pa mlingo wa 30 mg,

zokopa: lactose monohydrate, calcium carmellose, hydroxypropyl cellulose, magnesium stearate.

Mapiritsi ndi oyera kapena pafupifupi oyera, ozungulira okhala ndi biconvex pamtunda (kwa mulingo wa 15 mg), mapiritsi ndi oyera kapena pafupifupi oyera, ozungulira, osindikizidwa ndi cinsalu ndi logo ndi mawonekedwe a mtanda (kwa mulingo wa 30 mg).

Mankhwala

Pharmacokinetics

Kuzungulira kwa pioglitazone ndi metabolites yogwira mu seramu yamagazi amakhalabe pamalo okwera maola 24 pambuyo pa tsiku limodzi. Equilibrium serum mozungulira pioglitazone ndi pioglitazone yathunthu (pioglitazone + yogwira metabolites) imafikiridwa mkati mwa masiku 7. Kukonzanso mobwerezabwereza sikumabweretsa kuchuluka kwa mankhwala kapena ma metabolites. The kuchuluka ndende mu seramu (Cmax), dera pansi pa pamapindikira (AUC) ndi osachepera ndende mu magazi seramu (Cmin) ya pioglitazone ndi okwanira pioglitazone kuchuluka malinga ndi Mlingo wa 15 mg ndi 30 mg patsiku.

Pambuyo pakamwa, pioglitazone imatengedwa mwachangu kuchokera m'mimba, yomwe imatsimikiziridwa mu seramu ya magazi pambuyo pa mphindi 30, ndipo nderezo limafika patatha maola awiri. Kuyamwa kwa mankhwala palokha popanda kudya. Mtheradi bioavailability woposa 80%.

Kuchulukitsa komwe kumagawa mankhwalawa m'thupi ndi 0.25 l / kg. Pioglitazone ndi metabolites ake yogwira amagwirizana kwambiri ndi mapuloteni a plasma (> 99%).

Kupenda Pioglitazone imatengedwa kwambiri ndi hydroxylation ndi oxidation, ndipo ma metabolites amasinthidwanso pang'ono kukhala glucuronide kapena sulfate conjugates. Ma metabolites M-II ndi M-IV (hydroxy derivatives of pioglitazone) ndi M-III (keto derivatives of pioglitazone) ali ndi zochitika zamankhwala.

Kuphatikiza pa pioglitazone, M-III ndi M-IV ndi mitundu yayikulu yokhudzana ndi mankhwala omwe amadziwika mu seramu yaumunthu atagwiritsidwa ntchito mobwerezabwereza. Amadziwika kuti isoforms zambiri za cytochrome P450 zimathandizira kagayidwe ka pioglitazone. Kagayidwe kake kamaphatikizapo cytochrome P450 isoforms monga CYP2C8,, mochepa, CYP3A4, ndikuwonjezera gawo la isoforms ena ambiri, kuphatikiza ndi extrahepatic CYP1A1.

Pambuyo pakukonzekera pakamwa, pafupifupi 45% ya mlingo wa pioglitazone umapezeka mkodzo, 55% mu ndowe. Kupereka kwa pioglitazone kudzera mu impso sikunyalanyaza, makamaka mu mawonekedwe a metabolites ndi ma conjugates. Hafu ya moyo wa pioglitazone ndi maola 5-6, pioglitazone yonse (pioglitazone + yogwira metabolites) ndi maola 16-23.

Magulu apadera a odwala

Hafu ya moyo wa pioglitazone kuchokera ku seramu yamagazi imakhalabe yosasinthika mwa odwala omwe ali ndi zolimbitsa thupi (creatinine chilolezo 30-60 ml / min) komanso ovuta (creatinine chilolezo 4 ml / min). Palibe chidziwitso pakugwiritsa ntchito mankhwalawa pochiza odwala omwe akupanga dialysis, chifukwa chake pioglisant sayenera kugwiritsidwa ntchito pochiza gulu ili la odwala.

Kulephera kwa chiwindiPioglisant imaphatikizidwa kwa odwala omwe ali ndi vuto la chiwindi.

Kufotokozera kwamachitidwe a pharmacological

Mosankha bwino kumapangitsa kuti zida za nyukiliya za gamma ziyambitsidwe ndi peroxisome proliferator (gamma PPAR). Imasintha kusintha kwa majini omwe amakhudzidwa ndi insulin ndipo amathandizira kuyang'anira kuchuluka kwa glucose ndi lipid metabolism mu adipose, minofu ya minofu ndi chiwindi. Simalimbikitsa kukula kwa insulin, komabe, imagwira ntchito pokhapokha ngati insulin yopanga ntchito ya kapamba ikasungidwa. Kuchepetsa kukana kwa insulin kwa zotumphukira ndi chiwindi, kumawonjezera kudya kwa glucose wodalira insulini, kumachepetsa kutulutsa kwa chiwindi kuchokera ku chiwindi, kumachepetsa kuchuluka kwa shuga, insulini ndi glycosylated hemoglobin m'magazi. Odwala omwe ali ndi vuto la lipid metabolism, amachepetsa triglycerides ndikuwonjezera HDL osasintha LDL ndi cholesterol yonse.

M'maphunziro oyesera, ilibe zowononga thupi komanso mutagenic. Akamapereka makoswe achimuna ndi aamuna mpaka 40 mg / kg / tsiku, pioglitazone (mpaka 9 peresenti kuposa MPDC, yowerengeredwa pa 1 m2 ya thupi), palibe zotsatira zakuwonekera.

Zizindikiro zogwiritsidwa ntchito

Type 2 matenda a shuga:
- pa monotherapy odwala omwe ali ndi mafuta onenepa kwambiri osagwiritsa ntchito zakudya zolimbitsa thupi komanso masewera olimbitsa thupi osalolera kuti metformin kapena kukhalapo kwa contraindication chifukwa chake,
- monga gawo la mankhwala:

1. Metformin odwala omwe ali ndi kunenepa kwambiri chifukwa chosakonzekera kuwongolera kwakumaso kwa maziko a metformin monotherapy,
2. Ndi mankhwala a sulfonylurea okhawo mwa odwala omwe metformin imapangidwa, chifukwa chosagwiritsa ntchito mokwanira glycemic motsutsana ndi maziko a monotherapy omwe amachokera ku sulfonylurea.
3. Ndi insulin chifukwa chosakwanira kuwongolera glycemic pa mankhwala ndi insulin odwala omwe metformin imatsutsana.

Mankhwala

Thiazolidinedione hypoglycemic wothandizira pakamwa.

Pioglitazone imathandizira ma gamma receptors mu nyukiliya, omwe amathandizira ndi peroxisome proliferator (PPARγ). Imasintha kusintha kwa majini omwe amakhudzidwa ndi insulin ndipo amayendetsa gawo la kayendetsedwe kamagazi a glucose and lipid metabolism mu adipose, minofu ya minofu ndi chiwindi. Mosiyana ndi kukonzekera kochokera ku sulfonylureas, pioglitazone simalimbikitsa kutulutsa insulin, koma imagwira ntchito pokhapokha ngati insulini yopanga inshuwaransi ya kapamba ikasungidwa. Pioglitazone amachepetsa kukana kwa insulini mu chiwopsezo cha zotumphukira ndi chiwindi, kumawonjezera kumwa kwa glucose wodalira insulin ndikuchepetsa kutulutsa shuga mu chiwindi, kumachepetsa kuchuluka kwa shuga, insulin ndi glycosylated hemoglobin. Pochita mankhwala a pioglitazone, kuchuluka kwa ma triglycerides ndi mafuta aulere am'madzi am'magazi amachepetsa, ndipo kuchuluka kwa lipoproteins kwapamwamba kumakulanso.

Kwa odwala omwe ali ndi matenda a shuga a 2, kuwongolera kwa glucose m'magazi kumakhala bwino pamimba yopanda kanthu ndikatha kudya.

Pharmacokinetics

Pioglitazone imatengedwa mwachangu, Cmax ya pioglitazone m'magazi am'magazi nthawi zambiri imafika patangotha ​​maola awiri kuchokera pakamwa. Pazigawo zingapo zamankhwala othandizira, kutsika kwa plasma kumawonjezeka motalika ndi kuchuluka kwa mlingo. Ndi makonzedwe obwereza obwereza, pioglitazone ndi metabolites ake samachitika. Kudya sizimakhudza mayamwidwe. Bioavailability ndi woposa 80%.

Vd ndi 0,25 l / kg yolemetsa thupi ndipo imakwaniritsidwa masiku 4-7 atayamba chithandizo. Kumangiriza kwa mapuloteni a plasma a pioglitazone ndi oposa 99%, ma metabolites ake - oposa 98%.

Pioglitazone imapangidwa ndi hydroxylation ndi oxidation. Makamaka njirayi imagwira nawo ntchito ya cytochrome P450 isoenzymes (CYP2C8 ndi CYP3A4), komanso, mpaka pang'ono, enaenzenzymes. Atatu mwa 6 omwe atchulidwa metabolites (M) amawonetsa zochitika zamankhwala (M-II, M-III, M-IV). Popeza zochitika za pharmacological, ndende ndi kuchuluka kwa zomanga mapuloteni a plasma, pioglitazone ndi metabolite M-III mofananamo ndizomwe zimachitika, zomwe zimagwiritsidwa ntchito pa metabolite M-IV pantchito yonse ya mankhwalawa imakhala yayikulu kuposa katatu poyerekeza ndi gawo la pioglitazone, komanso zochitika za metabolite M-II ndizochepa kwambiri .

Kafukufuku wa in vitro awonetsa kuti pioglitazone siimaletsa isoenzymes ya CYP1A, CYP2C8 / 9, CYP3A4.

Amapukusidwa makamaka m'matumbo, komanso impso (15-30%) mu mawonekedwe a metabolites ndi ma conjugates. T1 / 2 ya pioglitazone yosasinthika yamagazi a plasma pafupifupi 3-7 maola, ndi kwa onse ogwira metabolites maola 16-24.

Kuchulukana kwa pioglitazone ndi metabolites yogwira m'madzi a m'magazi kumakhalabe pamtunda wokwanira kwa maola 24 pambuyo pa kumwa kwa tsiku limodzi.

Pharmacokinetics mu milandu yapadera yamankhwala

Odwala okalamba komanso / kapena vuto la impso, kusintha kwa mankhwalawa sikofunikira.

Poyerekeza ndi kumbuyo kwa ntchito ya chiwindi chovuta, magawo a pioglitazone yaulere ndi apamwamba.

Gwiritsani ntchito ntchito yolakwika yaimpso

Kwa odwala omwe ali ndi vuto la impso (kulengedwa kwa creatinine kuposa 4 ml / min), kusintha kwa mlingo sikofunikira. Palibe chidziwitso pakugwiritsa ntchito pioglitazone mwa odwala omwe amalandila hemodialysis. Chifukwa chake, pioglitazone sayenera kugwiritsidwa ntchito pagululi la odwala.

- kulephera kwa impso (CC ochepera 4 ml / min).

Contraindication

- lembani matenda ashuga 1
- matenda ashuga ketoacidosis,
- kulephera kwa mtima, kuphatikiza mbiri (gulu la I-IV malinga ndi gulu la NYHA),
- Kulephera kwa chiwindi (kuchuluka kwa chiwindi michere kuchulukitsa nthawi 2,5 kuposa malire abwinobwino),
- Kulephera kwa impso (CC ochepera 4 ml / min),
- kuchepa kwa lactase, tsankho lactose, malabsorption wa glucose-galactose,
- mimba
- nthawi yoyambira,
- ana osaposa zaka 18 (maphunziro azachipatala za chitetezo ndi kugwiritsa ntchito kwa pioglitazone mwa ana sanachitike),
- Hypersensitivity kuti pnoglitazone kapena zigawo zina za mankhwala.

Ndi kusamala - edematous syndrome, kuchepa magazi.

Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere. Kugwiritsa ntchito ndi chitetezo cha pioglitazone mwa amayi apakati sizinaphunzire, chifukwa chake, zimaphatikizidwa kuti mugwiritse ntchito mankhwalawa panthawi yapakati. Pioglitazone yawonetsedwa kuti ikukula pang'onopang'ono pa fetal. Sizikudziwika ngati pioglitazone yaponyedwa mkaka wa m'mawere, chifukwa chake, mankhwalawa sayenera kumwedwa ndi akazi panthawi yotseka. Ngati ndi kotheka, kuikidwa kwa mankhwalawa panthawi yoyamwa, kuyamwitsa kuyenera kuyimitsidwa.

Zotsatira zoyipa

Kuchokera ku ziwalo zam'maganizo: nthawi zambiri - kuwonongeka kwa mawonekedwe.

Kuchokera kupuma dongosolo: Nthawi zambiri - chapamwamba kupuma thirakiti matenda, pafupipafupi - sinusitis.

Kuchokera kumbali ya kagayidwe: kawirikawiri - kuchuluka kwa thupi.

Kuchokera kwamatsenga amanjenje: pafupipafupi - hypesthesia, pafupipafupi - kusowa tulo.

Kuphatikiza kwa pioglitazone ndi metformin

Kuchokera ku ziwalo za hemopoietic: Nthawi zambiri - magazi m'thupi.

Kuchokera ku ziwalo zam'maganizo: nthawi zambiri - kuwonongeka kwa mawonekedwe.

Kuchokera m'mimba yogaya chakudya: pafupipafupi - flatulence.

Kuchokera kumbali ya kagayidwe: kawirikawiri - kuchuluka kwa thupi.

Kuchokera ku minculoskeletal system: nthawi zambiri - arthralgia.

Kuchokera ku dongosolo lamanjenje: Nthawi zambiri - mutu.

Kuchokera ku genitourinary system: nthawi zambiri - hematuria, erectile kukanika.

Kuphatikiza kwa pioglitazone ndi sulfonylureas

Kuchokera pazinthu zam'maganizo: mosalekeza - vertigo, kuwonongeka kwa mawonekedwe.

Kuchokera pamimba yogaya: nthawi zambiri - flatulence.

Zina: pafupipafupi - kutopa.

Kuchokera kumbali ya kagayidwe: kawirikawiri - kuchuluka kwa thupi, kuchepa - ntchito yowonjezera ya lactate dehydrogenase, kuchuluka kwa chidwi, hypoglycemia.

Kuchokera ku dongosolo lamanjenje: Nthawi zambiri - chizungulire, mosapweteka - mutu.

Kuchokera ku genitourinary system: mokwanira - glucosuria, proteinuria.

Kuchokera pakhungu: pafupipafupi - thukuta limakula.

Kuphatikiza kwa pioglntazone ndi metformin ndi sulfonylureas

Kuchokera kumbali ya kagayidwe: kawirikawiri - hypoglycemia, nthawi zambiri - kuchuluka kwa thupi, zochulukitsa za creatine phosphokinase (CPK).

Kuchokera ku minculoskeletal system: nthawi zambiri - arthralgia.

Kuphatikiza kwa pioglitazone ndi insulin

Kuchokera kumbali ya kagayidwe: kawirikawiri - hypoglycemia.

Kuchokera ku minculoskeletal system: Nthawi zambiri - kupweteka kumbuyo, arthralgia.

Kuchokera pakapumidwe dongosolo: nthawi zambiri - kupuma movutikira, bronchitis.

Kuchokera pamtima: Nthawi zambiri - kulephera kwa mtima.

Zina: nthawi zambiri - edema.

Mbali ya ziwalo zam'maganizo: pafupipafupi sizidziwika - kutupa kwa macula, fupa la mafupa.

Kugwiritsa ntchito pioglitazone nthawi yayitali kwa chaka chimodzi chazandalama mu 6-9% ya milandu, odwala ali ndi edema, ofatsa kapena odziletsa, ndipo nthawi zambiri safuna kusiya ntchito.

Zosokoneza zowoneka zimachitika makamaka kumayambiriro kwa zamankhwala ndipo zimagwirizanitsidwa ndi kusintha kwa plasma glucose, monga ena othandizira ena a hypoglycemic.

Mlingo ndi makonzedwe

Mu nthawi 1 / mosasamala za kudya.

Mlingo woyambira ndi 15 kapena 30 mg 1 nthawi / Mulingo wambiri watsiku ndi tsiku wa monotherapy ndi 45 mg, palimodzi ndi 30 mg.

Popanga pioglitazone limodzi ndi metformin, makonzedwe a metformin amatha kupitilizidwa pa mlingo womwewo.

Kuphatikiza ndi mankhwala a sulfonylurea: kumayambiriro kwa chithandizo, makonzedwe awo akhoza kupitilizidwa chimodzimodzi. Pankhani ya hypoglycemia, mankhwala a sulfonylurea ofunikira amatsitsidwa.

Kuphatikiza ndi insulin: mlingo woyambirira wa pioglitazone ndi 15-30 mg /, mlingo wa insulin amakhalabe womwewo kapena amatsika ndi 10-25% pamene hypoglycemia imachitika.

Kwa odwala okalamba, kusintha kwa mankhwalawa sikofunikira.

Kwa odwala omwe ali ndi vuto la impso (kulengedwa kwa creatinine kuposa 4 ml / min), kusintha kwa mlingo sikofunikira. Palibe chidziwitso pakugwiritsa ntchito pioglitazone mwa odwala omwe amalandila hemodialysis. Chifukwa chake, pioglitazone sayenera kugwiritsidwa ntchito pagululi la odwala.

Pioglitazone sayenera kugwiritsidwa ntchito kwa odwala omwe ali ndi vuto la chiwindi.

Palibe chidziwitso pakugwiritsa ntchito pioglitazone kwa odwala osakwana zaka 18, choncho kugwiritsa ntchito pioglitazone mu gulu lino sikulimbikitsidwa.

Kuchita ndi mankhwala ena

Mukamagwiritsa ntchito pioglitazone limodzi ndi mankhwala ena amkamwa a hypoglycemic, kukula kwa hypoglycemia ndikotheka. Pankhaniyi, kuchepetsa mankhwalawa kwa mankhwala ena amkamwa a hypoglycemic angafunike.

Potengera maziko ophatikizika a pioglitazone omwe ali ndi insulin, kukulitsa kwa kulephera kwa mtima ndikotheka.

Pioglitazone sichikhudza pharmacokinetics ndi pharmacodynamics ya glipizide, digoxin, warfarin, metformin.

Gemfibrozil imakulitsa mtengo wa AUC wa pioglitazone katatu.

Rifampicin imathandizira kagayidwe ka pioglitazone ndi 54%.

Mu vitro ketoconazole linalake ndipo tikulephera kagayidwe ka pioglitazone.

Malangizo apadera a kuvomerezedwa

Pochiza matenda amishuga amtundu wa 2 shuga, kuphatikiza pa pioglitazone, tikulimbikitsidwa kutsatira zakudya ndi masewera olimbitsa thupi kuti mukhalebe ndi mphamvu yothandizirana ndi mankhwala, komanso pokhudzana ndi kuchuluka kwa thupi.

Pogwiritsa ntchito pioglitazone, kusungunuka kwa madzi ndi kuchuluka kwa kuchuluka kwa plasma ndizotheka, zomwe zingayambitse kukulitsa kapena kukulira kwa kulephera kwa mtima, chifukwa chake, ngati mkhalidwe wamtima wamagazi ukuwonjezeka, pioglitazone iyenera kusiyidwa.

Odwala omwe ali ndi chiopsezo chimodzi chokwanira chodwala matenda a mtima osakhazikika (CHF) ayenera kuyamba kulandira chithandizo chamankhwala ochepa ndikuwonjezera pang'onopang'ono. Ndikofunikira kuzindikira panthawi yoyambirira zizindikiro zakulephera kwa mtima, kuwonda (kungawonetse kukula kwa kulephera kwa mtima) kapena kukula kwa edema, makamaka kwa odwala omwe ataya mtima. Pankhani ya chitukuko cha CHF, mankhwalawo amathetsedwa.

Pioglitazone ikhoza kuyambitsa vuto la chiwindi. Asanalandire chithandizo komanso nthawi yamankhwala, ntchito ya chiwindi imayenera kufufuzidwa. Ngati ntchito ya ALT ipitilira 2,5 kuchulukitsa kwachilendo, kapena pamaso pa zizindikiro zina zakulephera kwa chiwindi, kugwiritsa ntchito pioglitazone kumatsutsana.Ngati, m'maphunziro awiri otsatizana, ntchito ya ALT ipitilira malirewo pafupipafupi katatu kapena wodwala akayamba jaundice, chithandizo ndi pioglitazone chimayimitsidwa nthawi yomweyo. Ngati wodwala ali ndi zizindikiro zosonyeza kuti chiwindi chimagwira ntchito mosakhazikika, kusanza, kupweteka kwam'mimba, kufooka, matenda am'mimba, mkodzo wakuda), ntchito ya michere ya chiwindi iyenera kufufuzidwa mwachangu.

Pioglitazone ikhoza kuyambitsa kuchepa kwa hemoglobin kapena hematocrit ndi 4% ndi 4.1%, motsatana, komwe kungakhale chifukwa cha hemodilution (chifukwa chosunga madzimadzi).

Pioglitazone imawonjezera chidwi cha insulin, zomwe zimawonjezera chiopsezo cha hypoglycemia mwa odwala omwe amalandila mankhwala osakanikirana okhala ndi sulfonylurea kapena insulin. Pangafunikire kuchepetsa kuchepetsedwa kwa chomaliza.

Pioglitazone ikhoza kuyambitsa kapena kukulitsa edema ya macular, yomwe ingayambitse kuchepa kwa zowoneka bwino.

Pioglitazone imatha kuchulukitsa azimayi.

Odwala omwe ali ndi polycystic ovary syndrome, kuchuluka kwa insulin kungayambitse kuyambiranso kwa ovulation komanso kutenga pakati. Odwala omwe ali ndi polycystic ovary syndrome omwe safuna kukhala ndi pakati ayenera kugwiritsa ntchito njira zodalirika zakulera. Mimba ikachitika, chithandizo chikuyenera kuyimitsidwa nthawi yomweyo.

Kukopa pa kuyendetsa magalimoto ndi kayendedwe kazinthu

Poganizira zovuta za mankhwalawa, chisamaliro chimayenera kuthandizidwa poyendetsa magalimoto ndikugwiritsa ntchito njira zomwe zimafunikira chidwi.

Momwe mungagwiritsire ntchito: Mlingo ndi njira ya chithandizo

Tengani pakamwa kamodzi pa tsiku, mosasamala za kudya.

Mlingo woyambitsa ndi 15 kapena 30 mg kamodzi tsiku lililonse. Mlingo wambiri watsiku ndi tsiku wa monotherapy ndi 45 mg, ndi mankhwala osakanikirana - 30 mg.

Mukamapereka mankhwala a piouno limodzi ndi metformin, makonzedwe a metformin amatha kupitilizidwa pa mlingo womwewo.

Kuphatikiza ndi mankhwala a sulfonylurea: kumayambiriro kwa chithandizo, makonzedwe awo akhoza kupitilizidwa chimodzimodzi. Pankhani ya hypoglycemia, mankhwala a sulfonylurea ofunikira amatsitsidwa.

Kuphatikiza ndi insulin: Mlingo woyamba wa pioglitazone ndi 15-30 mg patsiku, mlingo wa insulin umakhalabe womwewo kapena umatsika ndi 10-25% pomwe hypoglycemia imachitika.

Kwa odwala okalamba, kusintha kwa mankhwalawa sikofunikira.

Kwa odwala omwe ali ndi vuto la impso (kulengedwa kwa creatinine kuposa 4 ml / min), kusintha kwa mlingo sikofunikira. Palibe chidziwitso pakugwiritsa ntchito pioglitazone mwa odwala omwe amalandila hemodialysis. Chifukwa chake, pioglitazone sayenera kugwiritsidwa ntchito pagululi la odwala.

Pioglitazone sayenera kugwiritsidwa ntchito kwa odwala omwe ali ndi vuto la chiwindi.

Palibe chidziwitso pakugwiritsa ntchito pioglitazone kwa odwala osakwana zaka 18, kugwiritsa ntchito pioglitazone mu gulu lino sikulimbikitsidwa.

Zotsatira za pharmacological

Gawo logwira ntchito la Piouno ndi pioglitazone, wothandizira wa hypoglycemic wa mndandanda wa thiazolidinedione woperekera pakamwa.

Pioglitazone imathandizira ma gamma receptors mu nyukiliya, yodziyimira ndi peroxisome proliferator (PPAR gamma). Imasintha kusintha kwa majini omwe amakhudzidwa ndi insulin ndipo amayendetsa gawo la kayendetsedwe kamagazi a glucose and lipid metabolism mu adipose, minofu ya minofu ndi chiwindi. Mosiyana ndi kukonzekera kochokera ku sulfonylureas, pioglitazone simalimbikitsa kutulutsa insulin, koma imagwira ntchito pokhapokha ngati insulini yopanga inshuwaransi ya kapamba ikasungidwa. Pioglitazone amachepetsa kukana kwa insulini mu chiwopsezo cha zotumphukira ndi chiwindi, kumawonjezera kumwa kwa glucose wodalira insulin ndikuchepetsa kutulutsa shuga mu chiwindi, kumachepetsa kuchuluka kwa shuga, insulin ndi glycosylated hemoglobin. Pochita mankhwala a pioglitazone, kuchuluka kwa ma triglycerides ndi mafuta aulere am'madzi am'magazi amachepetsa, ndipo kuchuluka kwa lipoproteins kwapamwamba kumakulanso.

Kwa odwala omwe ali ndi matenda a shuga a 2, kuwongolera kwa glucose m'magazi kumakhala bwino pamimba yopanda kanthu ndikatha kudya.

Kuchita

Mukamagwiritsa ntchito pioglitazone limodzi ndi mankhwala ena amkamwa a hypoglycemic, kukula kwa hypoglycemia ndikotheka. Pankhaniyi, kuchepetsa mankhwalawa kwa mankhwala ena amkamwa a hypoglycemic angafunike.

Potengera maziko ophatikizika a pioglitazone omwe ali ndi insulin, kukulitsa kwa kulephera kwa mtima ndikotheka.

Gemfibrozil imakulitsa mtengo wa AUC wa pioglitazone katatu.

Mu vitro ketoconazole linalake ndipo tikulephera kagayidwe ka pioglitazone.