Adjunct to diet & exercise to improve glycemic control in adults w/ type 2 DM who are already treated w/ a pioglitazone & metformin, or who have inadequate glycemic control on a pioglitazone alone or metformin alone.
Dosage/Direction for Use
Initially 1 tab once or twice daily. Max: 3 tab daily.
Contraindications
Hypersensitivity. Cardiac failure or history of cardiac failure (NYHA stages I-IV); resp failure, recent MI, shock; acute alcohol intoxication, alcoholism; diabetic ketoacidosis or pre-coma; acute conditions w/ the potential to alter renal function eg, dehydration, severe infection, shock, intravascular administration of iodinated contrast agents; current or history of bladder cancer. Renal & hepatic impairment. Pregnancy & lactation. Ped patients.
Special Precautions
Patients w/ type 1 diabetes or diabetic ketoacidosis, patients receiving insulin or other anti hypoglycemic agents, patients w/ symptomatic heart failure, edema, perimenopause, PCOS. Observe signs & symptoms of cardiac failure, wt gain or edema in patients w/ reduced cardiac reserve. Lactic acidosis may occur. Monitor renal & hepatic function. Childn. Elderly.
Nifedipine may increase metformin absorption. Competing for common renal tubular transport systems w/ cationic drugs. Loss of glycemic control when in concomitant w/ thiazides & other diuretics, corticosteroids, phenothiazines, thyroid prep, estrogen, OC, phenytoin, nicotinic acid, sympathomimetics, Ca-channel blockers & INH.
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