1 What is Duetact?

Brand: Duetact

Generic: Pioglitazone and Glimepiride

Brand name:


Pioglitazone and glimepiride combination is used the management of diabetes mellitus also called type 2 diabetes. This medicine is used in combination with proper diet and exercise as a way of controlling the blood sugar levels in the body.

Pioglitazone enables your body to use insulin as required and more effectively. On the other hand, glimepiride stimulates the synthesis and release of insulin from the pancreas which supports the body in converting the food to chemical energy. This medicine can only be used with a doctor’s prescription.

2 What to Know Before Using

When making a decision on whether to use this medicine, always consider the risks of using the medicine against the potential benefits of using this medicine for treatment of the diabetes mellitus. This decision is reached by both you and your medical doctor. Allergies must be checked before using this medicine or any other medicines. Similarly, inform your doctor if you have any other form of medical allergies to food, dyes, preservatives or animals and their products. In case of non-prescription products, read the manuals or labels in the package for information concerning the medicine.

On the effects of the medicine on pediatric populations, no age related studies have been performed on the effect of pioglitazone and glimepiride combinations. Safety and efficacy have also not been performed.

On the other hand, geriatric studies performed have also not established geriatric factors that limit the usefulness of use of pioglitazone and glimepiride combinations among the elderly. Adverse effects with use of pioglitazone and glimepiride combinations have been demonstrated. However, no adequate studies have been done on women or animal models.

On the other hand, studies on the effect of pioglitazone and glimepiride combinations on breast feeding women and the risk exposure for infant have also not been determined. The potential benefits against the potential risks needs to be weighed before breastfeeding.

It is possible for drug interactions to occur when two different drugs are used together. Certain medicines may not be used together at all times. However, others may be used together even with the possibility of drug interaction.

In such a situation, your doctor will vary the dose and take precautions as will be necessary. When using this medicine, inform your medical doctor that you are using pioglitazone and glimepiride combinations when required to use any of the following medicines. Therefore, using a combination of pioglitazone and glimepiride with these medicines is not recommended but may be required in some cases.

When the medicines are prescribed together, the doctor may change the dose and how often they are used. These medicines include:

  • Balofloxacin
  • Besifloxacin
  • Ciprofloxacin
  • Disopyramide
  • Dulaglutide
  • Enoxacin
  • Entacapone
  • Fleroxacin
  • Flumequine
  • Gatifloxacin
  • Gemifloxacin
  • Ifosfamide


Insulin As part:

  • Recombinant Insulin
  • Bovine Insulin
  • Degludec
  • Insulin Detemir
  • Insulin Glulisine
  • Insulin Lispro
  • Recombinant Isoniazid
  • Lanreotide
  • Levofloxacin
  • Lomefloxacin
  • Metreleptin
  • Miconazole
  • Moxifloxacin
  • Nadifloxacin
  • Nifedipine
  • Norfloxacin
  • Octreotide
  • Ofloxacin
  • Pasireotide
  • Pazufloxacin
  • Pefloxacin
  • Piperaquine
  • Pixantrone
  • Prulifloxacin
  • Rufloxacin
  • Sparfloxacin
  • Tolvaptan
  • Tosufloxacin
  • and Voriconazole

Using this medicine with any of the following medicines may cause an increased risk of certain side effects. However, using these medicines may be the best treatment for you. When both of the medicines are prescribed together, the doctor may vary the dose and how often they can be used together.

These medicines include:

  • Abiraterone
  • Acebutolol
  • Atenolol
  • Atorvastatin
  • Betaxolol
  • Bisoprolol
  • Bitter Melon
  • Carteolol
  • Carvedilol
  • Celiprolol
  • Colesevelam
  • Esmolol
  • Fenugreek
  • Furazolidone
  • Gemfibrozil
  • Glucomannan
  • Guar
  • Gum
  • Iproniazid
  • Isocarboxazid
  • Ketoconazole
  • Labetalol
  • Levobunolol
  • Linezolid
  • Methylene Blue
  • Metipranolol
  • Metoprolol
  • Moclobemide
  • Nadolol
  • Nebivolol
  • Nialamide
  • Nilotinib
  • Oxprenolol
  • Penbutolol
  • Phenelzine
  • Pindolol
  • Practolol
  • Procarbazine
  • Propranolol
  • Psyllium
  • Rasagiline
  • Rifampin
  • Safinamide
  • Selegiline
  • Sotalol
  • Timolol
  • Topiramate
  • Tranylcypromine

Other medicines may cause other interactions when used around the times of eating or when used with certain food. They also need not be used together with alcohol or tobacco since they may cause interactions to occur. Therefore, using these medicines in this manner may not be recommended. When used together, the doctor may need to vary the dose or how often you use the medicine or give you special instruction about the use of the food, alcohol or tobacco. Other medical problems present may cause other effects that affect the use of these medicines.

It is important to let your doctor knows if you have any other medical problems. Some of this problems includes disorders of the adrenal glands (Underactive) or glucose -6 –phosphate dehydrogenase (G6PD) deficiency which is a problem associated with the enzymes. In addition, history or problems with the kidney, pituitary, poorly nourished conditions or weakened medical physical condition. This medicine needs to be used with caution.

Some drugs can also cause some of the side effects to be worse. This drugs need not to be used in people with bladder cancer, active diabetes, ketoacidosis, heart problems, severe liver disease, sulfa drugs allergy, type 1 diabetes.

This medicine needs to be used with caution for diabetics, macule edema characterized by the swelling of the back of the eye, edema or heart diseases. Use of these drugs will increase or make the conditions worse. In case of fever or infections in surgery, use the medicine with caution. The disease may cause problems with blood sugar control and fragile bones in women. This drug can increase the risk of fractures.

3 Proper Usage

This medicine needs to be used only as instructed by the medical doctor. Never use more or less of the medicines as instructed by the doctors. Also, read the medication guide provided by manufacturer of the medicine. Always ask your doctor in case of any questions. Stick to the special diet as instructed by the medical doctor. This is important since this is the main way of controlling diabetes and will always help the medicine work properly. Exercise as regular as possible and take tests for sugar in your blood or urine as directed.

The medicine is also required to taken with the first meal every day. However, if one is taking colesevelam, take it at least 4 hours after taking Duetact. The dose for this drug will also vary from one patient to another. The information provided here with these instructions is just an average dose of this medicine; never change your dose to these doses unless your medical doctor tells you to do so.

The amount of drug you take will vary with the strength of the medicine and number of doses to be taken every day, time allowed between doses, and the duration for which the dose has to be taken.

As for the oral dosage for management of diabetes type 2, and taking glimepiride alone: in adults, first, start with 1 tablet (either pioglitazone 30 milligrams (mg) plus glimepiride 2 mg, or pioglitazone 30 mg plus glimepiride 4 mg) once a day. The dose may be adjusted as required by your doctor. However, even with change of the dose, this dose may not be administered more than a dose of pioglitazone 45 mg plus glimepiride 8 mg per day in adults.

In children, a dose to be administered is determined by the medical doctor. As for the patients that were already using pioglitazone alone, In adults, a single tablet of pioglitazone 30 milligrams (mg) plus glimepiride 2 mg) once a day. Only your medical doctor can adjust the dose you can use as needed.

The dose need not go above pioglitazone 45 mg plus glimepiride 8 mg per day. In children, the dose must be determined by the medical doctor. In patients that are switching from a dose of combined pioglitazone and glimepiride as separate drugs, At first, 1 tablet (either pioglitazone 30 milligrams (mg) plus glimepiride 2 mg, or pioglitazone 30 mg plus glimepiride 4 mg) once a day.

The dose may be changed later as will be required by your doctor. However, the dose is usually not more than pioglitazone 45 mg plus glimepiride 8 mg per day. In children, the doses need to be determined by your medical doctor. For patients switching from other diabetes medicines; a first dose of 1 tablet (pioglitazone 30 milligrams (mg) plus glimepiride 2 mg) once a day.

The dose maybe adjusted as will be deemed appropriate by your medical doctor. The dosage will however not be more than pioglitazone 45 mg plus glimepiride 8 mg per day.

In children: A dose to be administered needs to be administered with your medical doctor. In case of missed doses, take the medicines as soon as possible. But when it is almost time for the next dose, skip the missed dose and resume the normal schedule. Never double the dose at the same time.

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep the medicine from freezing and out of reach of children. Dispose outdated medicine or medicine no longer needed. Seek advice on better ways of disposing such medicines from your medical doctor.

4 Precautions to Take

Regular check-ups need to be done on the patients so as to be able to assess the progress during the regular visits to ensure that the medicines are working properly. Tests may also be carried to check for unwanted effects. It may lead to an increase in risks for pregnancy while on this medicine. If one had problems with ovulations with irregular period, these medicines may make one to ovulate. This will increase the change of one becoming pregnant.

In case you are a woman of child bearing potential, discuss on the options of child bearing potential with your medical doctor. Inform your doctor immediately when you start feeling chest pain, shortness of breath and excessive swelling on the hands, wrist, ankles, or feet. In addition, when you notice rapid gain in weight. This may be an indication of serious problems with the heart. This drug can also lead to allergic reactions including anaphylaxis.

In case of anaphylaxis, you need to seek medical medication. The main characteristics of this reaction are that it occurs very fast, irregular breathing, gasping for breath, wheezing or fainting.

Some of the other signs include:

  • Changes in the skin colour of the face
  • Fast and irregular heartbeat or pulse
  • Hive like swelling on the skin and puffiness
  • Swelling of the eyelid or around the eyelids or around the eyes

In case of this side effects, seek an emergency help at once. In case of:

abdominal or stomach pain

  • Dark urine
  • A loss of appetite
  • Nausea or vomiting
  • Unusual tiredness or weakness
  • or Yellow eyes or skin

Inform your doctor right away. These may be a sign of serious liver problem.

Check also for:

  • Blurred vision
  • Decreased vision
  • or Any other change in vision occurs while you are taking this medicine

It may be required that your eyes are checked by a specialist (ophthalmologist /eye doctor).

In women, the risk for fractures may be increased in women. You will need to consult your doctor on ways of developing strong bone and help prevent fractures. Use of this medicine increases the risk for bladder cancer when used for more than 3 months. In case of blood in your urine, and a frequent urge to urinate, painful urination, pain in the back, lower abdomen, and stomach.

This medicine may also increase the sensitivity of your skin to sunlight. It is recommended that one needs to use sun screen when outdoor. Avoid the sunlamps and tanning beds. Always follow instructions as provided by your medical doctor.

Drinking alcohol may cause severe low blood sugar. Discuss the use of alcohol with your doctor before using it or any other medicines that may have similar effects. Do not take other medicines unless they have been discussed with your medical doctor.

Nonprescription medicines such as:

The family members will also be required to learn how to prevent side effects or help with side effects if they occur. The patients may also be required to be counseled about diabetes medicine, dosing changes that may result to a change of the lifestyle. This may include changes in exercise or diet. Counseling on contraception and pregnancy may be needed because of the problems that can occur during pregnancy in patients with diabetes.

When travelling, always keep a recent prescription and your medical history with you. Always be prepared for an emergency as you would normally. Make allowances for changing time zones and keep your meal times as close as possible to your usual meal times. There are times when you will need an emergency help for a problem caused by diabetes. It is always important to be prepared for emergencies. Always wear a medical identification (ID) bracelet or neck chain at all times. Also, always keep an ID card in your wallet or purse that says you have diabetes and that lists all of your medicines.

Symptoms of fluid retention may occur in some cases and you will be required to know what to do. Fluid retention may worsen or lead to heart problems if not managed in time. The medicines may also induce hypoglycemia (low blood sugar). This can also be the case when there is delay in food, miss meal, food or drink alcohol or cannot eat as a result of nausea or vomiting.

Hypoglycemia needs to be treated before it can lead to unconsciousness (fainting or passing out). Different people feel different symptoms of low blood sugar. Some of the symptoms of low blood sugar include:

  • Anxiety
  • Behavior change similar to being drunk
  • Blurred vision
  • Cold sweats
  • Confusion
  • Cool
  • Pale skin
  • Difficulty with thinking
  • Drowsiness
  • Excessive hunger
  • Fast heartbeat
  • Headache that continues
  • Nausea
  • Nervousness
  • Nightmares
  • Restless sleep
  • Shakiness
  • Slurred speech
  • or Unusual tiredness or weakness

If the symptoms of low blood sugar occur, eat glucose tablets or gel, corn syrup, honey, or sugar cubes, or drink fruit juice, non-diet soft drinks, or sugar dissolved in water to relieve the symptoms. Also, check your blood for low blood sugar.

Glucagon is used in emergency situations when severe symptoms such as:

  • seizures (convulsions) and
  • unconsciousness occur

Have a glucagon kit available, along with a syringe and needle, and know how to use it. Members of your family also should know how to use it.

Hyperglycemia (high blood sugar) may occur if you do not take enough or skip a dose of your medicine, overeat or do not follow your meal plan, has fever or infection, or do not exercise as much as usual.

Symptoms of high blood sugar include:

  • Blurred vision
  • Drowsiness
  • Dry mouth
  • Flushed
  • Dry skin
  • Fruit-like breath odor
  • Increased urination (frequency and amount)
  • Ketones in the urine
  • Loss of appetite
  • Stomachache
  • Nausea, or vomiting
  • Tiredness
  • Trouble breathing (rapid and deep)
  • Unconsciousness or
  • Unusual thirst

If the symptoms of high blood sugar occur, check your blood sugar level and call your doctor for instructions.

5 Potential Side Effects

It is not at all times that side effects may occur, if they do occur they may need medical attention. Check with your doctor immediately if any of the following side effects occur:

More common:

  • Anxiety
  • Bladder pain bloody or cloudy urine
  • Blurred vision
  • Chills
  • Cold
  • Sweats
  • Coma
  • Confusion
  • Cool, pale skin depression difficult
  • Burning, or painful urination
  • Fast heartbeat
  • Frequent urge to urinate
  • Headache increased
  • Hunger increased
  • Weight
  • Lower back or side pain
  • Nausea
  • Nightmares
  • Seizures
  • Shakiness
  • Slurred speech
  • Swelling of the feet or lower legs
  • Unusual tiredness or weakness

Less common:

  • Accidental injury
  • Loss of appetite
  • Pain or swelling in the arms or legs without any injury
  • Pale skin
  • Stomach pain
  • Troubled breathing with exertion
  • Unusual bleeding or bruising vomiting
  • Weight loss
  • Yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common:

  • Body aches or pain
  • Cough
  • Diarrhea
  • Difficulty with moving dryness or soreness of the throat
  • Ear congestion
  • Fever
  • Hoarseness
  • Joint pain
  • Loss of voice
  • Muscle aching or cramping muscle pains
  • Stiffness runny nose
  • Sneezing stuffy nose
  • Swollen joints tender
  • Swollen glands in the neck
  • Tooth disorder
  • Trouble swallowing
  • Voice changes

Some of the less common side effect may include:

  • Dizziness
  • Itching skin
  • Lack or loss of strength
  • Skin rash

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088