糖尿病患者使用第一种药物进行三年的治疗之后，大约50%的人都会产生耐药性而需要辅以其他药物。而这种产品通过两种作用机理治疗糖尿病：即直接作用于胰岛素抵抗和减少人体肝脏生成的葡萄糖。（pioglitazone吡格列酮）

ACTOPLUS MET XR 15mg/1000mg
Generic Name for ACTOPLUS MET XR 15mg/1000mg
Pioglitazone (as HCl) 15mg, metformin HCl extended-release 1000mg; tabs.

Legal Classification:
Rx

Pharmacological Class for ACTOPLUS MET XR 15mg/1000mg
Thiazolidinedione + biguanide.

Manufacturer of ACTOPLUS MET XR 15mg/1000mg
Takeda Pharmaceuticals America, Inc.
 

Indications for ACTOPLUS MET XR 15mg/1000mg
Adjunct to diet and exercise to improve glycemic control in type 2 diabetes in patients already on pioglitazone and metformin, or when response to pioglitazone or metformin alone is inadequate.

 

Adult dose for ACTOPLUS MET XR 15mg/1000mg
Swallow whole. Give once daily with the evening meal. Individualize. Previously on pioglitazone and/or metformin: switch on a mg/mg basis. Initially 15mg/1000mg or 30mg/1000mg once daily; may adjust after 8–12 weeks; max 45mg pioglitazone/2000mg metformin per day. Elderly, debilitated, malnourished: max doses not recommended.

Children's dosing for ACTOPLUS MET XR 15mg/1000mg
Not recommended.

 

Also:
ACTOPLUS MET 15mg/500mg
ACTOPLUS MET 15mg/850mg
ACTOPLUS MET XR 30mg/1000mg

 

Contraindications for ACTOPLUS MET XR 15mg/1000mg
NYHA Class III or IV heart failure. Renal disease or dysfunction. Metabolic acidosis, ketoacidosis. Concomitant intravascular iodinated contrast agents (suspend during and for 48 hours after use).

Warnings/Precautions for ACTOPLUS MET XR 15mg/1000mg
Not for treating type 1 diabetes. Symptomatic HF: not recommended. CHF: NYHA Class II: start at lowest approved dose and titrate carefully. Edema. May increase plasma volume (monitor for signs/symptoms of heart failure); discontinue if cardiac status deteriorates, or if lactic acidosis, shock, acute MI, sepsis, or hypoxemia occurs. Confirm normal renal function before starting and monitor (esp. in patients ≥80yrs). Avoid in hepatic disease. Do not start therapy in active liver disease or if ALT >2.5xULN. Monitor ALT at baseline, then periodically. If ALT 1–2.5xULN, follow-up and monitor closely; discontinue if ALT >3xULN persists or if jaundice occurs. Not for use in patients with history of troglitazone-associated jaundice. Suspend therapy if dehydration occurs or before surgery. Monitor blood (esp. serum Vit. B12 in susceptible patients). Stress. Elderly, debilitated, uncompensated strenuous exercise, malnourished or deficient caloric intake, adrenal or pituitary insufficiency, or alcohol intoxication: increased risk of hypoglycemia. Resumption of premenopausal ovulation in anovulatory patients may occur (may result in unintended pregnancy). Pregnancy (Cat.C; not recommended; consider using insulin instead). Nursing mothers: not recommended.

Interactions for ACTOPLUS MET XR 15mg/1000mg
See Contraindications. Potentiated by CYP2C8 inhibitors (eg, gemfibrozil). Antagonized by CYP2C8 inducers (eg, rifampin). Antagonizes oral contraceptives, midazolam. Monitor for heart failure with insulin. Avoid excessive alcohol intake (potentiates effects of metformin on lactate). Cationic drugs eliminated by renal tubular secretion, furosemide, nifedipine: may increase metformin levels. Increased risk of hyperglycemia with diuretics, steroids, phenothiazines, phenytoin, sympathomimetics, calcium channel blockers, niacin, thyroid products, estrogens, oral contraceptives, isoniazid. β-blockers may mask hypoglycemia.

Adverse Reactions for ACTOPLUS MET XR 15mg/1000mg
Upper respiratory tract infection, GI upset, edema, headache, urinary tract infection, dizziness, weight gain, lactic acidosis (rare, half the cases are fatal); also women: risk of fracture.

 

How is ACTOPLUS MET XR 15mg/1000mg supplied?
Tabs—60, 180; XR tabs—30, 60, 90