Relevant BNF section: BNF 18.104.22.168
The glitazones and their combination products are licensed for type 2 diabetes mellitus and now account for over 50% of NHS expenditure on oral hypoglycaemic drugs.1 In 2001, for ▼pioglitazone and rosiglitazone (the two glitazones licensed in the UK), we concluded that evidence (from short-term studies) supported their use in combination with metformin or a sulphonylurea in patients unsuited to one or other of these drugs, but not more practical glitazone use, such as monotherapy or as part of triple therapy.2 We also said that their long-term effects were not yet clear.2 Since then, both drugs have also been licensed for monotherapy, as part of triple therapy that includes metformin and a sulphonylurea and, for pioglitazone, use with insulin.3,4 Here we reassess glitazones in light of published efficacy data and safety concerns raised in recent years.
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