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ACTOS an oral antidiabetic agent that acts primarily by decreasing insulin resistance. ACTOS is used in the management of type 2 DM . Pharmacological studies shows that ACTOS improves sensitivity to insulin in muscle and adipose tissue and inhibits hepatic gluconeogenesis. ACTOS enhances glycemic control while reducing circulating insulin levels.
Pioglitazone thiazolidinedione monohydrochloride belongs to a different chemical class and has a different pharmacological action than the sulfonylureas, metformin, or the α-glucosidase inhibitors. The molecule contains one asymmetric carbon and it is synthesized and used as the racemic mixture.
Actos is an odorless white crystalline powder that has a molecular formula of C19H20N2O3S-HCl and a molecular weight of 392.90 daltons. It is soluble in N,N-dimethylformamide and slightly soluble in anhydrous ethanol, very slightly soluble in acetone and acetonitrile, practically insoluble in water, and insoluble in ether.
ACTOS is available as a tablet for oral administration containing 15 mg, 30 mg, or 45 mg of pioglitazone formulated with the following excipients: lactose monohydrate NF, hydroxypropylcellulose NF, carboxymethylcellulose calcium NF, and magnesium stearate NF. It is recommended that ACTOS should be taken once daily without regard to meals. The management of antidiabetic therapy should be individualized to achieve optimum results. Ideally, the response to therapy should be assessed using HbA1c which is a better indicator of long-term glycemic control. HbA1c indicates glycemia over the past two to three months. In clinical setting, it is recommended that patients be treated with ACTOS for a period of time adequate to evaluate change in HbA1c unless glycemic control deteriorates. After initiation of ACTOS or with dose increase, patients should be carefully monitored for adverse events related to fluid retention in the body.
ACTOS monotherapy in patients not adequately controlled with diet and exercise with starting dose at 15 mg or 30 mg once daily. For patients who respond inadequately to the initial dose of this drug, the dose can be increased in increments up to 45 mg once daily. For patients not responding adequately to monotherapy, combination therapy should be put into consideration.