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Rosiglitazone -v- Pioglitazone

S

squirrel1

Member
Good evening and hello to all of you.

I am a type 2 Diabetic and I have been on a regime of 4mg Rosiglitazone and 1g Metformin (avandamet tablets) twice daily for the past 5 years. Total daily intake 8mg Rosiglitazone & 2g Metformin. During this period my blood sugar has averaged around 5.4 (97) I measure my blood at least once daily (normally twice) and this allows me to correct occasional hickies (like rice or pasta for example which elevate my blood sugar quite quickly)

Recently my physican has changed my precription to 1g Metformin twice daily and 30mg Pioglitazone (Actos) once daily. I have been on this new regime for the past three weeks and the results (for me) seem totally unacceptable. Blood sugars around 7 (126) - 8 (144) ! It appears from what I have read that I should allow 4 weeks before making any decisions/evaluations and also that 30mg pioglitazone is the recommended maximum daily dose when taken in conjunction with Metformin.

Any information advice experiences with this change and help generally would be greatly appreciated! :)

Squirrel1
 
[quote="squirrel1]
Recently my physican has changed my precription to 1g Metformin twice daily and 30mg Pioglitazone (Actos) once daily. I have been on this new regime for the past three weeks and the results (for me) seem totally unacceptable. Blood sugars around 7 (126) - 8 (144) ! It appears from what I have read that I should allow 4 weeks before making any decisions/evaluations and also that 30mg pioglitazone is the recommended maximum daily dose when taken in conjunction with Metformin.
[end quote]


Hi Squirrel1.
First of all welcome to the forum.

A couple of questions for you.
1. Do you know why you were changed from Rosiglitazone to Pioglitazone if you were doing well ?
2. I see you are using mg/dl readings is this because your meter shows them like that ? If that is the case the conversion is not quite right so your readings are a little lower in mmol/l than you have quoted.

The maximum dose of Metformin if the normal type is 3g, Met SR/MR it is 2g. So you are not on a high dose of that.
The normal introductoryt dose of Pioglitazone is between 15 - 30mg daily increasing to a maximum of 45mg once daily. So again, you are not on the max dose.

There is no contra-indication between Metformin and Pioglitazone so the doseage of both can be increased. As with any drugs time is needed for things to settle down and see what happens in your system. I think a minimum of 4 weeks and then possibly an increase of meds may be called for. You could also help the numbers by tweaking your dietary intake of carbohydrates. Every little helps.
 
Well I am also on pioglitazone alongside metformin. I was originally on 1500mg of metformin slow release that got me under some control but started having other issues and my hba1c rose from 7.2(not great but an improvement on my previous 8.7) to 9.2 with no change in diet also saw an endocrinologist and neurologist as was having kidney and nerve problems. My endocrinologist initially suggested I was put onto 30mg of pioglitazone but when he saw my latest hba1c he asked for me to be raised to 45mg daily alongside the existing dose of metformin. I ddint want to increase metformin as it really doesnt agree with my stomach!

Not sure why you were changed but hasnt there been some concern over heart or liver problems with Rosilgliazone?
 
Thanks to you FordPrefect & cugila for your helpful comments.

My readings are taken in mmol/l - the conversion is mine (for clarity!) and I have used a factor of 18 as the multiplier. :?

The reason for the change in regime was to quote my GP Practice "to ensure we are compliant with the latest guidance both nationally & locally.....your medication is being altered from rosiglitazone 1g twice daily to pioglitazone 30mg one daily and metformin 500mg two twice daily. This medication is at least as effective as your old medication but may offer additional benefits or cost savings to the NHS"

In other words I guess to cut costs!

I will continue to monitor my situation closely.

Once again - thanks for your help

Regards
squirrel1 :D
 
Hi squirrel1
My readings are taken in mmol/l - the conversion is mine (for clarity!) and I have used a factor of 18 as the multiplier.
Click to expand...

The UK uses mmol/l for Bg readings. It is when people use US sites and quote numbers in mg/dl where we need to convert.
The actual conversion is as follows divide by 1.12 then either multiply OR divide by 18 to get the correct numbers. Confusing isn't it ? :(


Rosiglitazone 4mg 28 tabs = £24.14 nett 56 pack is £48.28 nett
Actos (Pioglitazone) 30mg 28 tabs = £33.54 nett
Data from the UK BNF.

So money as you say appears to be the deciding factor.
 
squirrel 1 have you put your case to your GP ? I feel really lucky now, that neither my GP nor practice nurse would ever make any adjustment to my meds without involving me. Bottom line,it's your body !
 
Thanks to all for your helpful replies. Sorry for the delay but I have been looking after my grandson over the past few weeks :D Still trying to get back to my previous "good readings", but with care things are beginning to improve. Interesting to read the dietician talking about carbs. I learnt most of what I know from reading Bernstein (1st) and then anything I could get my hands on.

Have never understood the "eat lots of carbs brigade", my son (a type 1) was given the same advice when he was diagnosed. If I followed that advice my figures would be statospheric!!

Thanks to all once again
 
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