Actoplus Met: Dual-Action Control for Type 2 Diabetes
| Product dosage: 500mg | |||
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Synonyms
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Actoplus Met combines two proven antidiabetic agents, pioglitazone and metformin, into a single, convenient tablet. This medication is specifically formulated for the management of type 2 diabetes mellitus in adults, particularly when metformin alone has not provided adequate glycemic control. It works by addressing two key pathophysiological defects of the disease: insulin resistance and hepatic glucose overproduction. By improving the body’s sensitivity to insulin and reducing glucose production by the liver, it offers a comprehensive approach to lowering both fasting and postprandial blood glucose levels. This synergistic mechanism supports long-term glycemic goals as part of a total treatment plan involving diet and exercise.
Features
- Contains two active ingredients: pioglitazone hydrochloride and metformin hydrochloride
- Available in multiple fixed-dose combination strengths (e.g., pioglitazone/metformin: 15mg/500mg, 15mg/850mg)
- Oral tablet formulation for convenient once- or twice-daily dosing
- Designed to address both insulin resistance and excessive hepatic glucose production
- Not indicated for the treatment of type 1 diabetes or diabetic ketoacidosis
Benefits
- Provides dual-mechanism action targeting multiple physiological defects in type 2 diabetes
- Helps achieve and maintain target HbA1c levels through complementary pharmacological effects
- May reduce the need for multiple separate medications, potentially improving adherence
- Can be used as both initial combination therapy or as a second-line treatment
- Supports comprehensive glycemic control including fasting and postprandial glucose
- May offer potential cardiovascular considerations through pioglitazone component
Common use
Actoplus Met is prescribed for the management of type 2 diabetes mellitus in adults when treatment with both pioglitazone and metformin is appropriate. It is commonly used when metformin monotherapy has failed to achieve adequate glycemic control, or as initial combination therapy in patients with significantly elevated HbA1c levels. The medication is typically part of a comprehensive treatment approach that includes dietary modification, weight reduction where appropriate, and regular exercise. It may be used alone or in combination with other antidiabetic agents, including insulin, when needed to achieve optimal glycemic targets.
Dosage and direction
The dosage of Actoplus Met should be individualized based on the patient’s current regimen, effectiveness, and tolerability. The usual starting dose is based on the patient’s current doses of pioglitazone and metformin. Typically administered once or twice daily with meals to reduce gastrointestinal side effects associated with metformin. Dose titration should be gradual, generally not exceeding the maximum recommended daily dose of 45mg pioglitazone/2550mg metformin. Renal function must be assessed before initiation and regularly during treatment, as metformin is contraindicated in patients with estimated glomerular filtration rate below 30 mL/min/1.73m². Liver enzymes should be monitored before initiation and periodically thereafter.
Precautions
Regular monitoring of hepatic function is recommended; discontinue if jaundice occurs. Assess renal function before initiation and at least annually during treatment. Monitor for signs and symptoms of heart failure. May cause ovulation in premenopausal anovulatory women, increasing pregnancy risk. Regular hematological monitoring recommended due to potential impact on vitamin B12 levels. Lactic acidosis is a rare but serious complication requiring immediate medical attention if symptoms occur. Periodic eye examinations recommended due to potential macular edema risk. Monitor for bone fracture risk, particularly in female patients. Hypoglycemia may occur when used with other glucose-lowering agents.
Contraindications
Renal impairment with eGFR below 30 mL/min/1.73m². Acute or chronic metabolic acidosis, including diabetic ketoacidosis. History of hypersensitivity to pioglitazone, metformin, or any component of the formulation. Acute congestive heart failure requiring pharmacological therapy. Severe hepatic impairment. History of lactic acidosis. Acute conditions that may affect renal function or tissue oxygenation (sepsis, dehydration, extensive surgery). Excessive alcohol intake.
Possible side effects
Common side effects include gastrointestinal symptoms such as diarrhea, nausea, vomiting, abdominal discomfort, and flatulence. Other frequently reported effects include headache, weight gain, edema, and upper respiratory infection. Hypoglycemia may occur, particularly when combined with other antidiabetic agents. Less common but serious side effects include lactic acidosis, congestive heart failure, hepatic impairment, macular edema, bone fractures, and vitamin B12 deficiency. Allergic reactions including urticaria and angioedema may occur. Hemoglobin and hematocrit decreases have been observed due to hemodilution effects.
Drug interaction
Cationic drugs eliminated by renal tubular secretion may increase metformin exposure. Drugs affecting glycemic control may require dose adjustment (corticosteroids, diuretics, sympathomimetics). Calcium channel blockers may increase pioglitazone exposure. CYP2C8 inhibitors and inducers may affect pioglitazone metabolism. Alcohol potentiates metformin’s effect on lactate metabolism. Iodinated contrast materials require temporary discontinuation. May potentiate effects of oral anticoagulants. Certain antimicrobials may affect metformin pharmacokinetics.
Missed dose
If a dose is missed, it should be taken as soon as remembered unless it is almost time for the next scheduled dose. Do not double the dose to make up for a missed dose. Patients should be advised to maintain regular dosing schedule and contact their healthcare provider if multiple doses are missed or if unsure about proper dosing. Consistent timing helps maintain stable blood glucose levels throughout the day.
Overdose
Metformin overdose may result in lactic acidosis, a medical emergency characterized by elevated blood lactate levels, metabolic acidosis, hypothermia, hypotension, and resistant bradyarrhythmias. Pioglitazone overdose may potentiate hypoglycemia if combined with other antidiabetic agents. Symptoms of hypoglycemia include confusion, drowsiness, weakness, sweating, rapid heartbeat, and vision changes. Treatment involves immediate gastric lavage if recent ingestion, supportive measures, and correction of hypoglycemia with intravenous glucose. Hemodialysis may be beneficial for metformin removal in cases of lactic acidosis.
Storage
Store at controlled room temperature between 20°C to 25°C (68°F to 77°F). Keep container tightly closed and protect from moisture and light. Keep out of reach of children and pets. Do not store in bathroom medicine cabinet due to humidity fluctuations. Discard any medication that has expired or shows signs of deterioration. Do not flush medications down toilet or pour into drain unless instructed to do so.
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. Individual patient needs may vary. Always consult with a qualified healthcare professional before starting, changing, or stopping any medication. The complete prescribing information should be reviewed before administration. Patients should not make treatment decisions based solely on this information. Report any adverse effects to healthcare provider promptly.
Reviews
Clinical studies demonstrate Actoplus Met effectively reduces HbA1c by approximately 1.5-2.0% from baseline when used as combination therapy. Patients report improved glycemic control with convenient once-daily dosing in appropriate cases. Healthcare providers note the combination therapy approach often improves adherence compared to multiple separate medications. Some patients experience gastrointestinal side effects initially, which often diminish with continued use. The fixed-dose combination is generally well-tolerated when appropriately titrated and monitored. Long-term studies show sustained efficacy in maintaining glycemic control when used as part of comprehensive diabetes management.