A variety of combinations tablets (dual therapies) of oral diabetes medication can be prescribed and are available in the Drug Tariff.   

Overall, they may improve compliance in patients, however some combinations would then not allow the flexibility in dosing that is required for diabetes management and in some cases increase the tablet burden. There are specific sick-day rules related to stopping certain medication which would be further complicated where they are not prescribed in their separate formulations.

Furthermore, for the overall health economy not all combination therapies are cost-effective and this will be increasingly so as the patents expire over the near future.

There are some combination therapies that are not recommended in the oral guidance and clinicians are guided to review and discuss these with patients as part of shared -care decision making. 

There are complexities also around the lack of licensing of dual therapies in specific cohorts of patients, related to prescribing for the indication of heart failure or renal disease, making this a complex area for prescribing in primary care. 

A variety of combinations tablets (dual therapies)
of oral diabetes medication can be prescribed and
are available in the Drug Tariff.

Overall, they may improve compliance in patients,
however some combinations would then not allow
the flexibility in dosing that is required for diabetes
management and in some cases increase the
tablet burden. There are specific sick-day rules
related to stopping certain medication which
would be further complicated where they are not
prescribed in their separate formulations.

Furthermore, for the overall health economy not
all combination therapies are cost-effective and
this will be increasingly so as the patents expire
over the near future. There are some combination
therapies that are not recommended in the oral
guidance and clinicians are guided to review and
discuss these with patients as part of shared -care
decision making.

There are complexities also around the lack of
licensing of dual therapies in specific cohorts of
patients, related to prescribing for the indication of
heart failure or renal disease, making this a
complex area for prescribing in primary care

A variety of combinations tablets (dual therapies)
of oral diabetes medication can be prescribed and
are available in the Drug Tariff.

Overall, they may improve compliance in patients,
however some combinations would then not allow
the flexibility in dosing that is required for diabetes
management and in some cases increase the
tablet burden. There are specific sick-day rules
related to stopping certain medication which
would be further complicated where they are not
prescribed in their separate formulations.

Furthermore, for the overall health economy not
all combination therapies are cost-effective and
this will be increasingly so as the patents expire
over the near future. There are some combination
therapies that are not recommended in the oral
guidance and clinicians are guided to review and
discuss these with patients as part of shared -care
decision making.

There are complexities also around the lack of
licensing of dual therapies in specific cohorts of
patients, related to prescribing for the indication of
heart failure or renal disease, making this a
complex area for prescribing in primary care

For existing patients ONLY

For existing patients ONLY

Pioglitazone should not be used in people who have heart failure or who are at higher risk of fracture. Continue Pioglitazone therapy only if there is a reduction of ≥0.5 percentage points in HbA1c in 6 months. Monitor for liver toxicity. There is risk of bladder cancer with pioglitazone. Do not use in active bladder cancer or a past history of bladder cancer, or in those who have uninvestigated macroscopic haematuria. Assess risks for bladder cancer after 3-6months of starting pioglitazone. Refer to current BNF for full contraindications and interactions.