Comparative Pharmacology
Head-to-head clinical analysis: AVANDIA versus FORTAMET.
Peer-Reviewed Evidence
Head-to-head clinical analysis: AVANDIA versus FORTAMET.
AVANDIA vs FORTAMET
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Selective agonist at peroxisome proliferator-activated receptor gamma (PPARγ), increasing insulin sensitivity in adipose tissue, skeletal muscle, and liver.
Metformin decreases hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization.
Initial dose 4 mg orally once daily; may increase to 8 mg once daily or 4 mg twice daily if inadequate glycemic control after 8-12 weeks. Maximum dose 8 mg/day.
Initial: 500 mg orally twice daily or 1000 mg orally once daily; titrate in increments of 500 mg weekly; maximum daily dose: 2000 mg.
None Documented
None Documented
3-4 hours (terminal elimination half-life). No clinically significant accumulation with once-daily dosing.
Terminal elimination half-life is approximately 6.2 hours (range 4–9 hours) in patients with normal renal function; half-life is prolonged in renal impairment (up to 18 hours in moderate impairment and 24 hours in severe impairment).
Primarily hepatic metabolism via CYP2C8, with minimal renal excretion of unchanged drug (<1%). Approximately 64% of the dose is excreted in urine as metabolites and 23% in feces as metabolites.
Renal excretion of unchanged drug accounts for approximately 90% of elimination; the remainder is excreted fecally (via bile).
Category C
Category C
Antidiabetic
Antidiabetic