Actoplus Met: Dual-Action Control for Type 2 Diabetes
| Product dosage: 500mg | |||
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Synonyms
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Actoplus Met combines two proven antidiabetic agents, pioglitazone and metformin hydrochloride, into a single, convenient tablet designed to improve glycemic control in adults with type 2 diabetes mellitus. This fixed-dose combination therapy is indicated when treatment with both components is appropriate, offering a synergistic mechanism to target multiple pathophysiological defects of the disease. It addresses both insulin resistance and hepatic glucose production, providing a comprehensive approach to diabetes management under appropriate medical supervision. This medication should be used as an adjunct to diet and exercise, not as a substitute for lifestyle modifications.
Features
- Contains two active ingredients: pioglitazone (a thiazolidinedione) and metformin hydrochloride (a biguanide)
- Available in multiple strength combinations (e.g., pioglitazone/metformin HCl: 15mg/500mg, 15mg/850mg)
- Film-coated tablets for ease of administration
- Typically administered once or twice daily with meals
- Requires regular monitoring of glycemic control, renal function, and liver enzymes
Benefits
- Provides dual mechanisms of action to improve insulin sensitivity and reduce hepatic glucose production
- Helps lower both fasting and postprandial blood glucose levels
- May reduce hemoglobin A1c by addressing multiple pathophysiological aspects of type 2 diabetes
- Convenient combination therapy may improve medication adherence compared to separate pills
- Can be used as both initial combination therapy or when monotherapy provides insufficient glycemic control
- May help preserve beta-cell function through improved insulin sensitivity
Common use
Actoplus Met is commonly prescribed for the management of type 2 diabetes mellitus in adults when treatment with both pioglitazone and metformin is appropriate. It is typically used when monotherapy with metformin, a thiazolidinedione, or other antidiabetic agents has provided inadequate glycemic control. The medication may also be initiated as first-line combination therapy in patients with significantly elevated hemoglobin A1c levels who are likely to benefit from dual-mechanism intervention. Clinical decisions should consider the patient’s renal function, cardiovascular status, and individual risk factors.
Dosage and direction
The dosage of Actoplus Met should be individualized based on the patient’s current regimen, effectiveness, and tolerability. Typically administered once or twice daily with meals to reduce gastrointestinal side effects. The maximum recommended daily dose is pioglitazone 45mg/metformin 2550mg. Treatment should be initiated at the lowest appropriate dose and titrated gradually. Renal function must be assessed before initiation and regularly during treatment. Dose adjustments may be necessary in elderly patients or those with impaired renal function. Do not crush or chew tablets; swallow whole with water.
Precautions
Regular monitoring of liver function is recommended due to potential hepatotoxicity concerns. Assess renal function before initiation and at least annually during treatment (more frequently in patients at risk). Monitor for signs and symptoms of heart failure, as thiazolidinediones can cause fluid retention. Regular ophthalmologic examinations are recommended due to potential macular edema risk. Monitor for vitamin B12 deficiency with long-term metformin use. Use caution in elderly patients, those with impaired hepatic function, or patients consuming alcohol. May cause ovulation in premenopausal anovulatory women, increasing pregnancy risk.
Contraindications
Contraindicated in patients with renal impairment (eGFR below 30 mL/min/1.73m²) or renal disease. Not recommended for use in patients with metabolic acidosis, including diabetic ketoacidosis. Contraindicated in patients with acute or chronic disease which may cause tissue hypoxia. History of hypersensitivity to pioglitazone, metformin, or any component of the formulation. Avoid use in patients with severe heart failure (NYHA class III or IV). Not indicated for type 1 diabetes mellitus or diabetic ketoacidosis. Should not be used in patients with acute or chronic metabolic acidosis.
Possible side effects
Common side effects include gastrointestinal symptoms such as diarrhea, nausea, vomiting, flatulence, indigestion, and abdominal discomfort. Hypoglycemia may occur when used with other antidiabetic agents. Weight gain and edema have been reported with thiazolidinedione components. Other potential adverse reactions include headache, upper respiratory infection, sinusitis, myalgia, tooth disorder, and increased sweating. Serious but rare side effects include lactic acidosis, hepatotoxicity, congestive heart failure, macular edema, fractures (particularly in women), and vitamin B12 deficiency with metformin component.
Drug interaction
May potentiate hypoglycemic effects when combined with other antidiabetic agents, requiring dose adjustment. Drugs that affect renal function may increase metformin accumulation. Cationic drugs (amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamterene, trimethoprim, vancomycin) may compete for renal tubular transport systems. corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid may reduce hypoglycemic effectiveness. Alcohol potentiates metformin’s effect on lactate metabolism, increasing lactic acidosis risk.
Missed dose
If a dose is missed, it should be taken as soon as remembered unless it is almost time for the next scheduled dose. Do not double the dose to make up for a missed one. Patients should maintain regular dosing schedule and not take extra tablets to compensate for missed doses. If multiple doses are missed, patients should contact their healthcare provider for guidance on resuming therapy. Consistent dosing is important for maintaining stable glycemic control.
Overdose
Metformin overdose may result in lactic acidosis, a medical emergency characterized by elevated blood lactate levels, metabolic acidosis, hypothermia, hypotension, and resistant bradyarrhythmias. Symptoms may include malaise, myalgia, respiratory distress, abdominal pain, hypothermia, and hypotension. Pioglitazone overdose may potentiate hypoglycemia and fluid retention. Treatment involves supportive care, monitoring of blood glucose, electrolyte and acid-base balance. Hemodialysis may be effective in removing accumulated metformin. Hypoglycemia should be treated with glucose administration.
Storage
Store at controlled room temperature 20°C to 25°C (68°F to 77°F). Keep container tightly closed and protect from moisture and light. Keep out of reach of children. Do not use if the blister pack or bottle seal is broken. Do not store in bathroom areas where moisture levels may be high. Properly discard any unused medication after the expiration date. Do not flush medications down the toilet or pour into drain unless instructed to do so.
Disclaimer
This information is for educational purposes only and does not constitute medical advice. Actoplus Met is available by prescription only and should be used under appropriate medical supervision. Individual response to medication may vary. Patients should not initiate, discontinue, or change dosage without consulting their healthcare provider. The prescribing physician should be aware of the complete medical history and concurrent medications. Regular monitoring and follow-up are essential for safe and effective use.
Reviews
Clinical studies demonstrate that Actoplus Met provides significant improvements in glycemic control compared to monotherapy components. In comparative trials, the combination therapy showed greater reductions in HbA1c, fasting plasma glucose, and postprandial glucose than either component alone. Many patients report improved convenience and adherence with the combination product. Some users note gastrointestinal side effects during initial treatment phase, which often diminish with continued use. Healthcare providers appreciate the dual-mechanism approach for addressing multiple pathophysiological defects in type 2 diabetes. Long-term studies continue to evaluate cardiovascular outcomes and durability of effect.