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Thiazolidinediones are recommended for persons with type 2 diabetes who have poorly controlled blood glucose and high Hb A1c levels.


Oral tablet – There are two types of thiazolidinediones that are currently available:
  • Pioglitazone (marketed as Actos)
  • Rosiglitazone (marketed as Avandia).
  • Combination pills containing pioglitazone and rosiglitazone along with other diabetes medications such as metformin are available
These pills work primarily by enhancing the body’s ability to respond to insulin.
The treatment plan will differ for each patient, but in general:
  • Pioglitazone is taken once a day; the typical dose is 15, 30 or 45 mg daily
  • Rosiglitazone is generally taken once or twice daily starting with 2-4 mg once or twice daily to a maximum daily dose of 8 mg.
  • These medications typically lower A1c levels by 1 – 1.5%.
  • When taken alone, these medications do not usually lead to low blood glucose levels.
  • Rosiglitazone and pioglitazone may cause or worsen heart failure and are not recommended in persons with history of severe heart failure.
  • Patients may experience fluid retention and weight gain while taking thiazolidinedione drugs.
  • Studies suggest that pioglitazone may be linked to the development of bladder cancer but evidence is not conclusive
  • Women who take these drugs may be more prone to bone fractures.


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