Pioglitazone
Pioglitazone is an oral antidiabetic drug classified as a thiazolidinedione, primarily used to enhance glycemic control in adults with type 2 diabetes by improving insulin sensitivity.
Pioglitazone is a diabetes medication that improves insulin sensitivity to help control blood sugar levels in type 2 diabetes.
This medication carries a boxed (black box) warning — the strongest type of FDA warning. Review the full prescribing information before use.
Key facts at a glance
- ATC
- A10BG03
- RxNorm
- 33738
- Generic
- Pioglitazone
- Class
- atc-a10
- Brands
- Oseni, Actos, Actoplus Met, Duetact
- Availability
- rx
- Lactation
- unknown
- Routes
- oral
- Forms
- tablet
- Regions
- US, EU, CN, JP
- Monitoring
- —
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Dosage and administration
- Usual dose
- 15-45mg once daily
- Maximum
- consult physician
- Frequency
- once daily
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 0.5mg/kg once daily
- Maximum
- consult physician
- Frequency
- once daily
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 15mg once daily
- Maximum
- consult physician
- Frequency
- once daily
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
Overdose information
Special Populations
11 groupspregnancy
first trimesteravoid if possible
avoid use during pregnancy unless benefits outweigh risks
regular fetal monitoring
Use of this medication in this population requires careful consideration of risks and benefits.
pregnancy
second trimesteravoid
discontinue therapy and switch to insulin if needed
fetal growth monitoring
Use of this medication in this population requires careful consideration of risks and benefits.
pregnancy
third trimesteravoid
discontinue before delivery
fetal monitoring
Use of this medication in this population requires careful consideration of risks and benefits.
lactation
breastfeedingcontraindicated
do not breastfeed while on pioglitazone
not applicable
Use of this medication in this population requires careful consideration of risks and benefits.
pediatric_age
children under 18not recommended
not approved for use in pediatric patients
not applicable
Use of this medication in this population requires careful consideration of risks and benefits.
geriatric
elderly 65 plusstart at lowest dose
use with caution due to increased risk of bladder cancer and fractures
regular monitoring of renal function and bladder symptoms
Use with caution and monitor for adverse effects.
renal_impairment
mild to moderateno dose adjustment required
monitor renal function periodically
check serum creatinine and eGFR regularly
Use with caution and monitor for adverse effects.
renal_impairment
severeuse with caution
monitor closely for adverse effects
frequent renal function monitoring
Use with caution and monitor for adverse effects.
hepatic_impairment
mild to moderateuse with caution
monitor liver function tests
regular LFT monitoring
Use with caution and monitor for adverse effects.
hepatic_impairment
severeavoid
do not use in patients with active liver disease or elevated ALT
liver function tests required
Use of this medication in this population requires careful consideration of risks and benefits.
alcohol_users
chronic heavy drinkingavoid excess alcohol
limit alcohol consumption, may increase risk of lactic acidosis
monitor liver function
Use with caution and monitor for adverse effects.
Statistics and clinical data
FDA approval year
Pioglitazone first approved by FDA for type 2 diabetes treatment
Drug class
Pioglitazone belongs to the thiazolidinedione class of peroxisome proliferator-activated receptor gamma (PPARγ) agonists
Common uses
Primary therapeutic use is improving insulin sensitivity in patients with type 2 diabetes mellitus
Mechanism of action
Activates peroxisome proliferator-activated receptor gamma to improve insulin sensitivity
Treatment of type 2 diabetes mellitus in adults, typically as monotherapy or in combination with other antidiabetic agents (such as metformin, sulfonylureas, or insulin) when diet and exercise alone do not provide adequate glycemic control.
Pioglitazone is a thiazolidinedione that decreases insulin resistance in peripheral tissues and the liver. It increases insulin-dependent glucose disposal in muscle and adipose tissue while reducing hepatic glucose production, leading to improved blood glucose control.
Pioglitazone requires the presence of insulin to be effective and is not indicated for type 1 diabetes or diabetic ketoacidosis. Common side effects include weight gain, edema, and fluid retention; it may increase risk of heart failure, bone fractures, and liver abnormalities. Regular monitoring of liver function tests is recommended during treatment.
Contraindications
Conditions and patient states where this medication should be avoided or used with caution.
Do not use (1)
Known allergy to this medication or its components
Use caution (1)
Consult healthcare provider for benefits vs risks assessment
Official drug label
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed July 26, 2026. · Read our editorial policy