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Other strengths and forms by Rephco Pharmaceuticals Ltd.
Indications & Uses
Polimet is indicated for:
Pharmacology
Pioglitazone only works when insulin is present in the body. It lowers insulin resistance in the periphery and in the liver, so the body disposes of more glucose in an insulin-dependent way and the liver releases less glucose. Pioglitazone is a potent and highly selective agonist for peroxisome proliferator-activated receptor-gamma (PPARg). When PPARg nuclear receptors are activated, they modulate the transcription of a number of insulin responsive genes involved in the control of glucose and lipid metabolism.
Metformin hydrochloride improves glucose tolerance in patients with type 2 diabetes and lowers both basal and postprandial plasma glucose. Metformin decreases hepatic glucose production and decreases intestinal absorption of glucose. It also improves insulin sensitivity by increasing peripheral glucose uptake and utilization. Unlike sulfonylureas, metformin does not produce hypoglycemia in patients with type 2 diabetes or in normal subjects, and it does not cause hyperinsulinemia.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
General
Antihyperglycemic treatment for type 2 diabetes should be chosen to suit the individual patient, based on how well it works and how well it is tolerated. The daily dose must not go above the maximum of Pioglitazone 45 mg and Metformin 2550 mg.
Dosage Recommendations
The starting dose of Pioglitazone & Metformin should depend on what the patient is already taking, Pioglitazone, Metformin, or both. The tablets should be given in divided daily doses with meals, which helps reduce the stomach and bowel side effects linked to Metformin.
Starting dose for patients inadequately controlled on Metformin monotherapy
The usual starting dose of Pioglitazone is 15 to 30 mg daily. On that basis, Pioglitazone & Metformin may be started at either the 15 mg/500 mg or the 15 mg/850 mg tablet strength, once or twice daily. The dose is then raised gradually after checking how well the patient has responded.
Starting dose for patients who initially responded to Pioglitazone monotherapy and require additional glycemic control
The usual starting doses of Metformin are 500 mg twice daily or 850 mg daily. On that basis, Pioglitazone & Metformin may be started at either the 15 mg/500 mg tablet twice daily or the 15 mg/850 mg tablet once daily. The dose is then raised gradually after checking how well the patient has responded.
Starting dose for patients switching from combination therapy of Pioglitazone plus Metformin as separate tablets
Pioglitazone & Metformin may be started with either the 15 mg/500 mg or the 15 mg/850 mg tablet strength, depending on the doses of Pioglitazone and Metformin the patient is already taking.
Maximum Recommended Dose
Pioglitazone & Metformin tablets come as 15 mg Pioglitazone plus 500 mg Metformin, or 15 mg Pioglitazone plus 850 mg Metformin, for oral use. The maximum recommended dose of Pioglitazone is 45 mg daily. The maximum recommended daily dose of Metformin in adults is 2550 mg.
Special Patient Populations
In patients of advanced age, both the starting dose and the maintenance dose of the Pioglitazone and Metformin combination should be conservative, because kidney function may be reduced in this group. Elderly, debilitated and malnourished patients generally should not be raised to the maximum dose. Kidney function needs to be monitored to help prevent Metformin-associated lactic acidosis, particularly in the elderly.
Don't start therapy with the combination if the patient shows clinical evidence of active liver disease, or if serum transaminase levels are raised (ALT greater than 2.5 times the upper limit of normal) at the start. Liver enzymes should be checked in all patients before starting the combination of Pioglitazone and Metformin, and then periodically afterwards.
Side Effects
Most people tolerate the pioglitazone and metformin hydrochloride combination well. The side effects seen most often are upper respiratory tract infection, diarrhea, peripheral edema and headache, in that order, and they are mild in severity.
Cautions & Contraindications
Warnings & Precautions
Pioglitazone only lowers blood sugar when insulin is present in the body. So Pioglitazone should not be used in people with type 1 diabetes, and it should not be used to treat diabetic ketoacidosis. Take care when using it in combination, especially with insulin, and also in people with hepatic insufficiency or heart diseases. Metformin is largely cleared from the body by the kidney. The more the kidney function is impaired, the higher the risk that Metformin builds up and causes lactic acidosis. For this reason, patients whose serum creatinine is above the upper limit of normal for their age should not receive Pioglitazone + Metformin Hydrochloride.
Contraindications
Pioglitazone + Metformin Hydrochloride must not be given to patients with kidney disease or poor kidney function. Serum creatinine levels above 1.5 mg/dl in men, above 1.4 mg/dl in women, or an abnormal creatinine clearance, can point to this. Poor kidney function may also come from conditions such as cardiovascular collapse (shock), acute myocardial infarction and septicemia. It is also contraindicated in anyone with known hypersensitivity to Pioglitazone, Metformin or any other component of this combination. Patients with acute or chronic metabolic acidosis, including diabetic ketoacidosis with or without coma, should not take it either.
Pregnancy & Breastfeeding
Pregnancy: No adequate and well-controlled studies have been done in pregnant women, either with Pioglitazone + Metformin Hydrochloride together or with each of the two medicines alone. So the combination should be used only if the possible benefit justifies the possible risk to the fetus.
Nursing mother: It isn't known whether Pioglitazone and/or Metformin pass into human milk. Many drugs are excreted in human milk, so this combination should not be given to a breastfeeding woman.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Use in Special Populations
For Pioglitazone and Metformin, the starting dose and the maintenance dose need to be chosen with care in older patients, because kidney function may be lower at an advanced age. Kidney function should be monitored, especially in the elderly, to help prevent lactic acidosis linked to Metformin.
Don't start Pioglitazone and Metformin if the patient shows clinical evidence of active liver disease. Liver enzymes should be checked in every patient before therapy with this combination begins, and then at regular intervals afterwards.
Overdose
If Overdosage happens, start supportive treatment that suits the patient's clinical signs and symptoms.
⚠️ In an emergency call 999 or go to the nearest hospital emergency department.
Storage
Keep Pioglitazone + Metformin Hydrochloride in a cool, dry place. Protect it from light and moisture, and keep it out of the reach of children.
Drug Interactions
Common questions about Polimet 15 mg+850 mg
What is Polimet 15 mg+850 mg Tablet?
Polimet 15 mg+850 mg Tablet is a medicine that contains Pioglitazone + Metformin Hydrochloride. It is made by Rephco Pharmaceuticals Ltd. It belongs to the Combination Oral hypoglycemic preparations group of medicines.
What is Polimet used for?
Polimet is used for: Type 2 Diabetes Mellitus, Diabetes Mellitus.
What are the side effects of Polimet?
Most people tolerate the pioglitazone and metformin hydrochloride combination well. The side effects seen most often are upper respiratory tract infection, diarrhea, peripheral edema and headache, in that order, and they are mild in severity.
Can I take Polimet during pregnancy or while breastfeeding?
Pregnancy: No adequate and well-controlled studies have been done in pregnant women, either with Pioglitazone + Metformin Hydrochloride together or with each of the two medicines alone. So the combination should be used only if the possible benefit justifies the possible risk to the fetus. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
What happens if I take too much Polimet?
If Overdosage happens, start supportive treatment that suits the patient's clinical signs and symptoms. In an emergency call 999 or go to the nearest hospital emergency department.
How should I store Polimet?
Keep Pioglitazone + Metformin Hydrochloride in a cool, dry place. Protect it from light and moisture, and keep it out of the reach of children.
Can I take other medicines with Polimet?
Some medicines can interact with Pioglitazone + Metformin Hydrochloride, for example: Rifampicin, Gemfibrozil. Tell your doctor or pharmacist about every medicine you take.
Is there a cheaper medicine with the same ingredient?
Polimet is already among the lowest-priced brands of Pioglitazone + Metformin Hydrochloride at this strength.
Do I need a prescription for Polimet?
Polimet is a prescription (Rx) medicine. Take it as your doctor advises.