Actos: Drug Class and Mechanism of Action
Actos (Pioglitazone) is an anti-diabetic medication belonging to the drug class of thiazolidinediones intended to reduce the amount of glucose in the blood of a type 2 diabetes sufferer.
Actos reduces insulin resistance in peripheral tissues and in the liver thus increasing insulin-dependent glucose absorption and at the same time decreasing the liver's output of glucose. Unlike sulfonylurea medicines, commonly prescribed to treat type 2 diabetes, Actos does not stimulate insulin secretion by beta-cells of the pancreas. As an insulin sensitizer it reduces insulin resistance and thus simultaneously leads to the decrease in glucose concentration in the blood and in the amount of produced insulin in the plasma as well as the decrease in the level of glycated hemoglobin. Besides, Actos targets tissues most liable for insulin action, i.e. adipose tissue, skeletal muscle and tissues of the liver.
To improve glycemic control you can use Actos either as a mono, dual or triple therapy. As a dual therapy Actos allows a concomitant administration with either sulfonylurea medicines or Metformin. A triple therapy involves Actos, Metformin and sulfonylureas.
In patients treated with Actos the blood lipid levels acquire a more favorable profile. In the course of treatment with Actos the level of triglycerides, the chemical forms in which most natural fats and vegetable oils exist, decreases, and the level of high-density lipoproteins, which remove cholesterol from the arteries and transport it back to the liver for excretion, increases.
Actos is usually taken once daily irrespective of your particular dosage. Under the mono therapy with Actos it is prescribed to take 15 mg a day. The maximum dose should not exceed 45 mg a day. If it does not help improve your glycemic control, a combination therapy can be an optional way. It is recommended to start with a dose of 15 mg to 30 mg of Actos daily. One variant of a combination therapy is the concomitant use of Actos and insulin. If you embark on such a therapy it is important to remember that as soon as the level of blood sugar slows down, it is necessary to reduce the dose of insulin to avoid hypoglycemic episodes.
Actos therapy may not be enough for maintaining your well-being if you suffer from type 2 diabetes. It is efficacious only if you combine it with proper dieting, regular exercises and observance of the day regimen. The effectiveness of the drug therapy is usually estimated by the level of glycated hemoglobin (HbA1c) which is considered quite an adequate indicator if your glycemic control over 2-3 months and is regarded as a more reliable index than fasting blood sugar levels. That is why after the first 3 months of taking Actos it is advisable to undergo a test to determine your glycated hemoglobin level. If there is no deterioration and your glycated hemoglobin is within the set limits, the medication is effective and you can continue taking it unless there are other serious side-effects or any contraindications.
Among the typical contraindications to the use of Actos are type 1 diabetes, diabetic ketoacidosis, pregnancy, the period of lactation and hypersensitivity to Pioglitazone or any other component of Actos.