Pioglitazone with Abiraterone Acetate Interaction Details

Brand Names Associated with Pioglitazone

  • Actoplus Met® (as a combination product containing Metformin, Pioglitazone)
  • Actoplus Met® XR (as a combination product containing Metformin, Pioglitazone)
  • Actos®
  • Duetact® (as a combination product containing Glimepiride, Pioglitazone)
  • Oseni® (as a combination product containing Alogliptin, Pioglitazone)
  • Pioglitazone

Brand Names Associated with Abiraterone Acetate

  • Abiraterone
  • Zytiga®

Medical Content Editor
Last updated Feb 25, 2024

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Interaction Effect

Increased pioglitazone exposure and an increased risk of severe hypoglycemia

Interaction Summary

Coadministration of pioglitazone and a strong CYP2C8 inhibitor significantly increases the exposure and half-life of pioglitazone. When concomitant use is required, the maximum dose of pioglitazone should be 15 mg/day[1]. Coadministration of abiraterone acetate with antidiabetic agents such as pioglitazone may increase the risk of severe hypoglycemia. Monitor blood glucose in patients with diabetes during coadministration and assess if antidiabetic agent dose modifications are required [2].

Severity

Major

Onset

Unspecified

Evidence

Probable

How To Manage Interaction

Coadministration of pioglitazone and a strong CYP2C8 inhibitor significantly increases the exposure and half-life of pioglitazone. When concomitant use is required, the maximum dose of pioglitazone should be 15 mg/day[1]. Coadministration of abiraterone acetate with antidiabetic agents such as pioglitazone may increase the risk of severe hypoglycemia. Monitor blood glucose in patients with diabetes during coadministration and assess if antidiabetic agent dose modifications are required [2].

Mechanism Of Interaction

Inhibition of CYP2C8-mediated pioglitazone metabolism; additive hypoglycemia

Literature Reports

A) The AUC of pioglitazone (CYP2C8 substrate) was increased by 46% when pioglitazone was given to healthy subjects with a single dose of abiraterone acetate [2].

References

    1 ) Product Information: ACTOS oral tablets, pioglitazone oral tablets. Takeda Pharmaceuticals America, Inc. (per FDA), Deerfield, IL, 2017.

    2 ) Product Information: AKEEGA(TM) oral tablets, niraparib, abiraterone acetate oral tablets. Janssen Biotech, Inc. (per FDA), Horsham, PA, 2023.

Pioglitazone Overview

  • Pioglitazone is used with a diet and exercise program and sometimes with other medications, to treat type 2 diabetes (condition in which the body does not use insulin normally and therefore cannot control the amount of sugar in the blood). Pioglitazone is in a class of medications called thiazolidinediones. It works by increasing the body's sensitivity to insulin, a natural substance that helps control blood sugar levels. Pioglitazone is not used to treat type 1 diabetes (condition in which the body does not produce insulin and, therefore, cannot control the amount of sugar in the blood) or diabetic ketoacidosis (a serious condition that may develop if high blood sugar is not treated).

  • Over time, people who have diabetes and high blood sugar can develop serious or life-threatening complications, including heart disease, stroke, kidney problems, nerve damage, and eye problems.Taking medication(s), making lifestyle changes (e.g., diet, exercise, quitting smoking), and regularly checking your blood sugar may help to manage your diabetes and improve your health. This therapy may also decrease your chances of having a heart attack, stroke, or other diabetes-related complications such as kidney failure, nerve damage (numb, cold legs or feet; decreased sexual ability in men and women), eye problems, including changes or loss of vision, or gum disease. Your doctor and other healthcare providers will talk to you about the best way to manage your diabetes.

See More information Regarding Pioglitazone

Abiraterone Acetate Overview

  • Abiraterone is used in combination with prednisone to treat a certain type of prostate cancer that has spread to other parts of the body. Abiraterone is in a class of medications called androgen biosynthesis inhibitors. It works by decreasing the amount of certain hormones in the body.

See More information Regarding Abiraterone

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Definitions

Severity Categories

Contraindicated

These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.


Major

This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.


Moderate

This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.


Minor

While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.

Onset

Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.

Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.

Evidence

Level of documentation of the interaction.

Established: The interaction is documented and substantiated in peer-reviewed medical literature.

Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.

How To Manage The Interaction

Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.

It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.

Mechanism Of Interaction

The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.

Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.

Where Does Our Information Come From?

Information for our drug interactions is compiled from several drug compendia, including:

The prescribing information for each drug, as published on DailyMED, is also used. 

Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.

The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.