Pioglitazone HCl 45 MG Tab (Actos)

Pioglitazone HCl 45 MG Tab (Actos)

Advisories: 1. Second or third line therapy for type 2 diabetes patients with inadequate glycemic control on oral agents, e.g. metformin, glipizide.
2. Not recommended in patients with symptomatic heart failure, risk of bone fractures, hepatic impairment, or fluid retention. 3. Not recommended in combination with insulin therapy. Non-Formulary Use Criteria: 1. Failure to achieve target HbA1c goals in type 2 diabetes despite compliance with and adequate duration of a treatment regimen of sulfonylurea plus metformin, insulin plus
metformin, insulin plus a sulfonylurea (when metformin is contraindicated), or insulin plus metformin plus a sulfonylurea 2. Current total insulin dose must be > 1 unit / kg / day of body weight. OR 3. A type 2 diabetic inmate newly-incarcerated in the BOP who arrives on a glitazone with good glycemic control and a past history of failed therapy with or contraindication to
metformin. (NOTE: If the inmate has never received treatment with metformin and has no contraindication, metformin should be added to the regimen and the glitazone approved by non-formulary request for 6 months to allow for an adequate trial and titration of metformin.) 4. Pioglitazone is the preferred glitazone when non-formulary use criteria are met. Documentation to be included in non-formulary request: type of diabetes (1 or 2), current
treatment regimen and duration at current doses, and most recent HbA1c value with date.

Dr. M Blatstein

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