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Treats type 2 diabetes mellitus
Therapeutic Use
Type 2 diabetes mellitus, with or without drug therapy with insulin or metformin (Glucophage) |
Adverse Drug Reactions
Fluid retention |
Hepatotoxicity (potential) |
Increased serum lipid levels |
Increased risk for bladder cancer |
Upper respiratory tract infection |
Headaches |
Myalgia |
Nursing Interventions
Monitor for edema, weight gain, or indications of heart failure. |
Hepatotoxicity |
Obtain serum alanine aminotransferase (ALT) levels: Baseline and every 3 to 6 months thereafter. |
Stop drug therapy for indications of liver injury. |
Monitor serum lipid levels. |
Watch for increases in triglycerides |
Watch for increases in both high-density (favorable) and low-density (unfavorable) lipoproteins. |
Drug Administration
Give orally once per day with or without food. |
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Patient Education
Follow instructions provided in access program. |
Report swelling, weight gain, or shortness of breath immediately. |
Report jaundice, dark urine, abdominal pain, vomiting, or fatigue |
Expect periodic cholesterol testing. |
Report chest pain or discomfort, diaphoresis, or atypical fatigue. |
Report swelling, rapid weight gain, dyspnea |
Contraindications
Cardiovascular disease, including hypertension |
Severe heart failure |
Active hepatic disease |
Type 1 diabetes |
Diabetic ketoacidosis |
Precautions
Mild heart failure, risk for heart failure |
Hepatic impairment |
Pioglitazone – may increase risk of bladder cancer after 1 year of use |
Caution should be used in clients with a history of bladder cancer. |
Interactions
Insulin increases the risk of heart failure and edema. |
Gemfibrozil (Lopid) and ketoconazole increase hypoglycemic effects. |
Reduced effectiveness of contraceptives. |
Glucosamine can have a negative impact on blood glucose control |
Chromium as well as coenzyme Q10 can increase hypoglycemic effects. |
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