GlobalRPh Renal Dosing Masterv6.6
Evidence addition

Pioglitazone (Actos)

Local official-label summaryBase record retrieved 2026-09-05See the evidence for this drug2 sources available - open source summaries, references and comparisons

Actos

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Official source

ACTOS - no renal reduction does not remove heart-failure risk

Product / population
Adults; named product and route only. Selected dosing and renal summary, not the full prescribing information.
Renal measure
No renal-function dose bands specified for this summary.

Dosing / renal protocol and limits

Adult type 2 diabetes without heart failure: begin 15 or 30 mg orally daily, increasing by 15 mg as needed to at most 45 mg daily. For NYHA I-II heart failure the starting dose is 15 mg daily. Renal impairment does not require dose adjustment.

Fluid retention and heart-failure worsening remain major constraints; initiation is contraindicated in NYHA III-IV heart failure. A no-renal-adjustment statement is not permission to ignore edema, weight gain or dyspnea. Fixed combinations require review of every component.

Source revision: DailyMed updated 2025-03-28. | Retrieved: 2026-09-05. Retrieval date is not the revision date.

Source: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d2ddc491-88a9-4063-9150-443b4fa4330c

Scope: Locally included source-specific summary. Regimen differences are not automatically resolved. GlobalRPh v6.6.

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Source-first renal review

Evidence sources and renal implications

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Official product label

ACTOS - no renal reduction does not remove heart-failure risk

Adults; named product and route only. Selected dosing and renal summary, not the full prescribing information.

Renal method: No renal-function dose bands specified for this summary.
Retrieved: 2026-09-05

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Handbook

Renal Drug Handbook, 5th edition - Pioglitazone

Historical adult renal/RRT summary. U.S. product identity anchored to the separate locally included DailyMed label. This is not a current U.S. product label.

Renal method: Book table headed GFR (mL/min); its preface states renal adjustments generally derive from Cockcroft-Gault CrCl. Do not silently relabel as indexed eGFR.
Retrieved: 2026-09-05

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Renal-context checklist: population, kidney trend and dialysis

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Renal dosing and precautions

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Handbook source

Renal Drug Handbook, 5th edition - Pioglitazone

Historical adult renal/RRT summary. U.S. product identity anchored to the separate locally included DailyMed label. This is not a current U.S. product label.

Method: Book table headed GFR (mL/min); its preface states renal adjustments generally derive from Cockcroft-Gault CrCl. Do not silently relabel as indexed eGFR.

Historical renal / replacement-therapy guidanceRead this complete source summary

No dialysis or renal heading shown? Read the complete source summary. Absence of a heading is not evidence that dose adjustment is unnecessary.

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Original content / product scopeACTOS - no renal reduction does not remove heart-failure riskRenal Drug Handbook, 5th edition - Pioglitazone
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Exact product and population matter. This added page contains locally stored, source-specific clinical summaries. Historical handbook information, when present, is identified separately and may conflict with U.S. labeling. Confirm indication, population, kidney-function method, monitoring and the full prescribing information before applying a regimen.
Locally stored source content

Exact product and population

Product identity selected for the separately displayed source protocols below. Reference: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d2ddc491-88a9-4063-9150-443b4fa4330c

Product and population scope

Adult Pioglitazone (Actos). Use only the product, route, indication and renal-replacement setting explicitly stated in the source protocol selected below. Sources are alternatives to compare, not ingredients of a blended regimen.

SCOPE-pioglitazone · Source section: Editorial scope; each clinical recommendation is separately attributed belowRenal section finder
Separate U.S. product-label layer

FDA / DailyMed dosing and renal information

Official

ACTOS - no renal reduction does not remove heart-failure risk

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NIH/NLM DailyMed - U.S. product labeling · Adults; named product and route only. Selected dosing and renal summary, not the full prescribing information.

Renal method: No renal-function dose bands specified for this summary.
Source date: DailyMed updated 2025-03-28.
Retrieved: 2026-09-05

Locally included source-specific summary. Regimen differences are not automatically resolved.

Dosing / renal protocol and limits

Adult type 2 diabetes without heart failure: begin 15 or 30 mg orally daily, increasing by 15 mg as needed to at most 45 mg daily. For NYHA I-II heart failure the starting dose is 15 mg daily. Renal impairment does not require dose adjustment.

Fluid retention and heart-failure worsening remain major constraints; initiation is contraindicated in NYHA III-IV heart failure. A no-renal-adjustment statement is not permission to ignore edema, weight gain or dyspnea. Fixed combinations require review of every component.

RDM30-088-pioglitazone-1 · Source locator: ACTOS - no renal reduction does not remove heart-failure risk; renal/dosing sections and stated qualifiers

Source identity and provenance
Source
https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d2ddc491-88a9-4063-9150-443b4fa4330c
Retrieved
2026-09-05
DailyMed Set ID
d2ddc491-88a9-4063-9150-443b4fa4330c
Renal-function method
No renal-function dose bands specified for this summary.
Source date/version
DailyMed updated 2025-03-28.
Hash meaning
Locally authored summary text; not original SPL, HTML or PDF bytes
Local summary SHA-256
2b0bc657e1c51a51407ca3ec346054047f3ef546b5bd012168f10b78adcbdfd0
Separate handbook layer

Renal Drug Handbook cross-check

Handbook

Renal Drug Handbook, 5th edition - Pioglitazone

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UK Renal Pharmacy Group / CRC Press · Historical adult renal/RRT summary. U.S. product identity anchored to the separate locally included DailyMed label. This is not a current U.S. product label.

Renal method: Book table headed GFR (mL/min); its preface states renal adjustments generally derive from Cockcroft-Gault CrCl. Do not silently relabel as indexed eGFR.
Source date: 5th edition; 2019 copyright; historical reference
Retrieved: 2026-09-05

Historical handbook cross-check; not a current U.S. protocol

Historical renal / replacement-therapy guidance

The 20-50, 10-20 and <10 mL/min bands retain the usual indication-specific dose. RRT recommendations retain usual doses with careful monitoring; removal is considered unlikely. The book separately notes that its manufacturer did not advise dialysis use because studies were lacking. Its 15-45 mg daily range does not override current heart-failure contraindications, fluid-retention precautions or clinical selection.

HB30-pioglitazone-1 · Source locator: Printed page 807: renal impairment, RRT and other information

Source-specific limits

Separate source recommendation, not proof of agreement or contemporary clinical validation. Dialysis predictions are retained with their original certainty.

Source identity and provenance
Retrieved
2026-09-05
Handbook page
5th edition, printed p. 807; uploaded PDF p. 826
Renal-function method
Book table headed GFR (mL/min); its preface states renal adjustments generally derive from Cockcroft-Gault CrCl. Do not silently relabel as indexed eGFR.
Source date/version
5th edition; 2019 copyright; historical reference
U.S. product identity basis
https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d2ddc491-88a9-4063-9150-443b4fa4330c
Hash meaning
Local paraphrase; original book not redistributed
Local summary SHA-256
589e45dc3027ad462f8a0e1d94d8b5d39c2de32c3121ce6e929bddb60deee39e

Provenance and preservation

Additional summaries stored on this page: 1 official-label, 0 RX List, 0 professional, 1 handbook. Empty additional-source groups are not shown. A missing layer is not a no-adjustment recommendation.

Original source
https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d2ddc491-88a9-4063-9150-443b4fa4330c
Source retrieval
2026-09-05. This is not the source publication or label revision date.
Original source type
multisource addition
Local text SHA-256
0559dcd10283ab4d30af03076273c9b4c8dcda182fd343f1c8a3f711d10ea95a
Import versus clinical validation
Source-section locators identify where retained content came from. A source-section identifier does not assert that every numeric statement has been independently corroborated. The local text hash is not a hash of original HTML, an FDA PDF or SPL XML.

This page is an additional exact-product entry, not a recovered GlobalRPh monograph. Its primary scope text and separately attributed clinical summaries are locally included.

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