Piozone Dosage/Direction for Use

Include nutritional counseling, weight reduction (as needed), and exercise in the management of type 2 diabetes.
Individualize antidiabetic therapy based on glycemic control and patient’s response to treatment.
Patients should be carefully monitored for adverse reactions related to fluid retention and signs of congestive heart failure after initiation of pioglitazone or with dose increase. (see Warnings and Precautions).
Liver enzymes should be checked prior to initiation of pioglitazone therapy (see Warnings and Precautions).
As adverse events eg, edema and weight gain appear to be dose-related, the smallest effective dose should be used.
During treatment initiation and dose titration, fasting plasma glucose should be used to determine the therapeutic response to pioglitazone HCl and identify the minimum effective dose. Thereafter, glycosylated hemoglobin (HbA1c) should be measured at intervals of approximately 3 months.
Monotherapy: Patients without Congestive Heart Failure: Starting Dose: 15 mg or 30 mg once daily, with or without meals.
Patients with NYHA Class I or II Heart Failure: Starting Dose: 15 mg once daily.
Dosage may be titrated in increments of 15 mg up to a maximum of 45 mg once daily based on glycemic response as determined by HbA1c.
Combination Therapy with Metformin: Pioglitazone in combination with metformin may be initiated at 15 mg or 30 mg once daily. Continue current metformin dose when starting pioglitazone therapy.
Combination Therapy with Sulfonylurea: Pioglitazone in combination with a sulfonylurea may be initiated at 15 mg or 30 mg once daily. Continue current sulfonylurea dose when starting pioglitazone therapy. Decrease the sulfonylurea dose if patients report hypoglycemia during combination therapy.
Combination with Insulin: Continue current insulin dose upon starting pioglitazone therapy. Decrease insulin dose by 10-25% if the patient reports hypoglycemia or if fasting plasma glucose (FPG) decreases to <100 mg/dL. Individualize further adjustments based on the glucose-lowering response.
Co-administration with Strong CYP2C8 Inhibitors (see Interactions): Maximum Recommended Dose: 15 mg once a day.
Missed Dose: When a dose is missed, pioglitazone should be taken as soon as the patient remembers. In cases where the time is too close to the next dose, the missed dose should be skipped and treatment should be resumed with the next scheduled dose.