Actos vs. Glipizide
See how Actos and Glipizide compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Actos is a thiazolidinedione taken once daily and does not cause low blood sugar on its own, while glipizide is a sulfonylurea that can trigger hypoglycemia.
Actos carries a boxed warning for heart failure and costs far more per month than glipizide, one of the least expensive diabetes drugs on the market.
Glipizide lowers blood sugar faster than Actos but comes with a higher risk of hypoglycemia, especially in older or medically fragile patients.
Actos vs. Glipizide Drug Summary
Actos
Actos (pioglitazone) is a thiazolidinedione that helps the body use its own insulin more effectively in adults with type 2 diabetes. It is taken as a single tablet once a day, alone or with other diabetes medications, and does not cause low blood sugar when used by itself.
Glipizide
Glipizide is a sulfonylurea that prompts the pancreas to release more insulin, lowering blood sugar in adults with type 2 diabetes. It comes as an immediate-release tablet taken once or twice daily, or an extended-release tablet taken once daily, alongside diet and exercise.
Actos vs. Glipizide Side Effects
Actos
Glipizide
Actos vs. Glipizide Dosage
Actos
Glipizide
| STAGE | DOSE | WHEN |
| Starting dose | 15 mg once daily | At the start |
| Maximum dose | 45 mg once daily | If needed |
| Dose changes | 2 increases | As tolerated |
| STAGE | DOSE | WHEN |
| Starting dose | 5 mg once daily | At the start |
| Maximum dose | 5-20 mg once daily | If needed |
| Dose changes | 5 increases | As tolerated |
Actos
| STAGE | DOSE | WHEN |
| Starting dose | 15 mg once daily | At the start |
| Maximum dose | 45 mg once daily | If needed |
| Dose changes | 2 increases | As tolerated |
Glipizide
| STAGE | DOSE | WHEN |
| Starting dose | 5 mg once daily | At the start |
| Maximum dose | 5-20 mg once daily | If needed |
| Dose changes | 5 increases | As tolerated |
Actos vs. Glipizide Indications
Actos
Actos is FDA-approved to lower blood sugar in adults with type 2 diabetes, used alone or combined with other diabetes medications. Doctors sometimes prescribe it off-label for nonalcoholic fatty liver disease, including NASH.
Type 2 diabetes, as monotherapy
Type 2 diabetes, combined with metformin, insulin, or other agents
Off-label: nonalcoholic fatty liver disease and NASH
Not approved for type 1 diabetes or diabetic ketoacidosis
Glipizide
Glipizide is FDA-approved to lower blood sugar in adults with type 2 diabetes, used as an add-on to diet and exercise. It has no established off-label uses and is not approved for other conditions.
Type 2 diabetes, as an add-on to diet and exercise
Type 2 diabetes, often combined with metformin or other agents
Not approved for type 1 diabetes or diabetic ketoacidosis
No common off-label uses
Actos vs. Glipizide Pros and Cons
Actos
Actos does not cause hypoglycemia on its own and is taken as a single once-daily tablet. It carries a boxed warning for heart failure risk and costs considerably more per month than glipizide.
Pros
Does not cause low blood sugar when used alone
Simple once-daily dosing with only two maintenance steps
May help reduce liver fat in off-label NASH use
Cons
Boxed warning for heart failure, contraindicated in NYHA Class III or IV
Increased bladder cancer risk with long-term use
Increased fracture risk in women
Costs roughly $588 to $700 per month without insurance
Glipizide
Glipizide has decades of clinical use and is one of the least expensive diabetes medications available. It works quickly to lower blood sugar but carries a real risk of hypoglycemia, especially in older or medically fragile patients.
Pros
Costs roughly $10 to $35 per month without insurance
Works quickly, with doses adjustable every few days
Available in both immediate-release and extended-release forms
Cons
Can cause hypoglycemia, especially in elderly or kidney-impaired patients
Sulfonylureas as a class carry a possible cardiovascular mortality signal
Extended-release tablets cannot be crushed, chewed, or split
No off-label uses to fall back on if diabetes control needs change
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