"Teneligliptin & Pioglitazone: Comprehensive Diabetes Treatment"

Introduction

TENELIGOLD PIO 20/15 is a rational fixed-dose combination (FDC) antidiabetic medication that merges the benefits of a DPP-4 inhibitor (Teneligliptin) with a PPAR-γ agonist (Pioglitazone). This dual-drug strategy targets insulin resistance, beta-cell dysfunction, and impaired incretin response, the core pathophysiologic defects in Type 2 Diabetes Mellitus (T2DM).This tablet offers improved glycemic control, lowers both fasting plasma glucose (FPG) and postprandial glucose (PPG) levels, and reduces HbA1c effectively when diet, exercise, or monotherapy are insufficient.

Detailed Pharmacological Profile

Teneligliptin 20 mg

• Class: Dipeptidyl Peptidase-4 (DPP-4) Inhibitor

• Half-life: ~24 hours

• Bioavailability: ≥ 65%

• Metabolism: Primarily hepatic and renal

• Renal Dose Adjustment: Not required in mild to moderate renal impairment

Mechanism of Action:
Teneligliptin inhibits the DPP-4 enzyme, which degrades incretin hormones such as GLP-1 and GIP. By prolonging the activity of these hormones, Teneligliptin:

• Enhances glucose-dependent insulin secretion

• Suppresses inappropriate glucagon secretion

• Delays gastric emptying and promotes satiety

• Helps preserve beta-cell mass and function

Pioglitazone 15 mg

• Class: Thiazolidinedione (TZD)

• Half-life: 3–7 hours (parent), 16–24 hours (active metabolites)

• Metabolism: Hepatic via CYP2C8 and CYP3A4

• Elimination: Mainly feces (biliary) and urine

Mechanism of Action:

Pioglitazone is a selective agonist for Peroxisome Proliferator-Activated Receptor Gamma (PPAR-γ):

• Enhances insulin sensitivity in adipose tissue, muscle, and liver

• Reduces hepatic gluconeogenesis

• Improves lipid profiles (↑ HDL, ↓ triglycerides)

• Modestly reduces blood pressure and inflammatory markers

Indications and Uses

TENELIGOLD PIO 20/15 is indicated as an adjunct to diet and exercise for:

• Adults with Type 2 Diabetes Mellitus uncontrolled by monotherapy

• Patients needing a step-up therapy without initiating insulin

• Individuals with insulin resistance, dyslipidemia, or metabolic syndrome

Clinical Benefits

1. Superior HbA1c Reduction: Dual action reduces HbA1c by 1.5–2.0% on average

2. Weight Neutral (Teneligliptin) & Mild Weight Gain (Pioglitazone)

3. Low Hypoglycemia Risk (no insulinotropic action in absence of glucose)

4. Improved Cardiometabolic Outcomes: Pioglitazone may reduce stroke risk in patients with insulin resistance or prediabetes (PROactive trial)

5. Well-Tolerated in elderly and patients with mild-moderate renal impairment

Dosage and Administration

• Dosage: 1 tablet once daily, preferably at the same time each day

• Route: Oral, with or without meals

• Adjustment: Monitor hepatic and renal function during treatment

• Duration: Long-term as per physician's advice

Teneligliptin & Pioglitazone Uses: At a Glance

Side Effects

Common Side Effects

• Headache, sore throat, and gastrointestinal upset (Teneligliptin)

• Edema, weight gain, myalgia, dizziness (Pioglitazone)

Serious Adverse Effects

• Fluid retention & exacerbation of heart failure (Pioglitazone)

• Fracture risk in postmenopausal women (Pioglitazone)

• Rare hypoglycemia, mostly when used with insulin/sulfonylureas

• Risk of bladder cancer (long-term pioglitazone, monitor urine analysis)

Contraindications

• Type 1 Diabetes Mellitus

• History of heart failure (Class III/IV)

• Active liver disease or ALT >2.5x ULN

• Bladder cancer or unexplained hematuria

• Severe renal impairment (eGFR < 30 mL/min)

Precautions

• Monitor Liver Function Tests (LFTs) every 3–6 months

• Assess for fluid retention or edema

• Avoid in pregnancy/lactation

• Use cautiously in elderly or osteoporotic patients

Drug Interactions

• Gemfibrozil: Increases Pioglitazone plasma levels

• Rifampicin: May decrease Pioglitazone efficacy

• ACE inhibitors or NSAIDs: May enhance risk of fluid overload

• Other antidiabetic drugs: Risk of additive hypoglycemia

Storage

• Store below 25°C in a cool, dry place

• Protect from moisture and sunlight

• Keep out of reach of children

FAQs

Q1. Can TENELIGOLD PIO 20/15 be taken with metformin?
Yes, in triple therapy, it can be combined with metformin for more effective glycemic control.

Q2. Is TENELIGOLD PIO suitable for kidney patients?
Teneligliptin is safe in mild to moderate renal impairment, but pioglitazone requires caution. Avoid in severe renal disease.

Q3. Does Pioglitazone cause weight gain?
Yes, mild weight gain due to fluid retention and fat redistribution may occur, but it improves insulin sensitivity.

Q4. How long does it take to see results with this medicine?
Glycemic improvement is usually seen within 2–4 weeks, with full effects over 8–12 weeks.

Q5. Can it be used as initial therapy?
It is generally preferred as step-up therapy after metformin or in those with marked insulin resistance.

Conclusion

TENELIGOLD PIO 20/15 is a scientifically sound and clinically proven dual oral therapy for Type 2 diabetes. It provides a powerful, convenient, and once-daily solution by combining Teneligliptin 20 mg and Pioglitazone 15 mg to control blood sugar levels, combat insulin resistance, and reduce long-term diabetic complications.

About The Author

STERIS HEALTHCARE PVT LTD

Steris Healthcare Pvt Ltd, known as Sterispharma, was founded in February 2018 by a team of experienced professionals in the pharmaceutical industry. Headquartered in Navi Mumbai, the company holds certifications from WHO, GMP, and ISO, reflecting its dedication to maintaining high standards of quality and safety. Sterispharma’s mission is to provide affordable, high-quality medications across India, strictly adhering to WHO guidelines. With the convenience of an online pharmacy, customers can easily order medicines with home delivery options.

For further information 

Email: info@sterispharma.com / contact@sterispharma.com

Call/WhatsApp: 8209542042 , 8824175417

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