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Troglitazone: an antidiabetic agent

C Chen1

  • 1University HealthSystem Consortium, Oak Brook, IL 60523, USA.

American Journal of Health-System Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists
|May 20, 1998
PubMed
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Troglitazone, an oral thiazolidinedione, effectively treats non-insulin-dependent diabetes mellitus (NIDDM) by improving insulin sensitivity. It shows promise for obese patients and those with high insulin levels, with rare adverse effects reported.

Area of Science:

  • Pharmacology and Therapeutics
  • Endocrinology
  • Metabolic Diseases

Background:

  • Troglitazone is the first oral thiazolidinedione approved for non-insulin-dependent diabetes mellitus (NIDDM).
  • Its precise mechanism of action as an insulin sensitizer is still under investigation.
  • Evidence suggests it may reduce hepatic glucose production via decreased gluconeogenesis or increased glycolysis.

Purpose of the Study:

  • To review the pharmacology, pharmacokinetics, clinical efficacy, adverse effects, and dosage of troglitazone.
  • To evaluate troglitazone's role in managing NIDDM.

Main Methods:

  • Review of existing literature on troglitazone.
  • Analysis of clinical trial data regarding efficacy and safety.
  • Pharmacokinetic and pharmacodynamic assessments.

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Main Results:

  • Troglitazone is rapidly absorbed orally, with increased absorption when taken with food.
  • It is extensively metabolized in the liver.
  • Clinical trials demonstrate efficacy in NIDDM, particularly in obese patients or those with high fasting insulin levels.
  • Adverse effects like hematologic abnormalities, liver toxicity, and hypoglycemia are rare.

Conclusions:

  • Troglitazone is an effective treatment for NIDDM, especially for specific patient populations.
  • Dosage recommendations include starting at 200 mg daily, with potential increase to 400 mg.
  • Further research may elucidate its complete mechanism of action.