NYHA (class III-IV) heart failure patients. Hypoglycemia. Concomitant use w/ insulin formulations or sulfonylurea drugs. Adrenal insufficiency or pituitary gland dysfunction; debilitating condition, malnourishment, starvation, irregular or lack of dietary intake; intense muscular exercise; excessive alcohol intake. Patients w/ history of bowel obstruction or abdominal surgery. Acute or history of pancreatitis. Discontinue if hypersensitivity reactions are suspected. Change in clinical status of patients w/ previously controlled type 2 diabetes; evaluate promptly for evidence of ketoacidosis or lactic acidosis. Periodic monitoring of liver function; discontinue if jaundice is observed. May affect ability to drive & use machines. Severe hepatic impairment. Elderly. Teneligliptin: Patients prone to QT prolongation (patients w/ heart disease eg, CHF, having hypokalemia, w/ or w/ history of arrhythmia eg, bradycardia). Concomitant use w/ drugs known to cause QT prolongation eg, class IA or III antiarrhythmic drugs. Pioglitazone: Fluid retention & cardiac failure. Discontinue therapy if any deterioration in cardiac status occurs. Assess risk factors for bladder cancer (including age, smoking history, exposure to some occupational or chemotherapy agents eg, cyclophosphamide or prior radiation treatment in the pelvic region) & investigate any macroscopic hematuria before initiating treatment. Wt gain. New-onset or worsening diabetic macular edema w/ decreased visual acuity. Polycystic ovarian syndrome. Bone fractures in women. Concomitant use w/ cytochrome P4502C8 inhibitors (eg, gemfibrozil) or inducers (eg, rifampicin).
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