Two medicines, side by side
Pioglitazone vs glimepiride
Pioglitazone and glimepiride are both labeled for type 2 diabetes. Drugs@FDA records approvals of pioglitazone since 1999 and of glimepiride since 1995. Pharmacies paid $0.0675 per pioglitazone HCl 15 mg tablet and $0.0507 per glimepiride 4 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. In FDA's classes, pioglitazone is a peroxisome proliferator receptor gamma agonist and glimepiride a sulfonylurea.
Check it at the source: the pioglitazone FDA label on DailyMed (effective March 28, 2025); the glimepiride FDA label on DailyMed (effective May 12, 2025).
Highlights of the pioglitazone record
Pioglitazone (Actos) · label of March 28, 2025
CONGESTIVE HEART FAILURE
Thiazolidinediones, including ACTOS ® , cause or exacerbate congestive heart failure in some patients [see Warnings and Precautions (5.1) ].
After initiation of ACTOS, and after dose increases, monitor patients carefully for signs and symptoms of heart failure (e.g., excessive, rapid weight gain, dyspnea, and/or edema).
Used for
From the label: indicationsMonotherapy and Combination Therapy ACTOS is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus in multiple clinical settings [see Clinical Studies (14) ]. Important Limitations of Use ACTOS exerts its antihyperglycemic effect only in the presence of endogenous insulin. […]
On the market
- Earliest approval on file
- July 15, 1999
- Generic labelers
- 22 labelers
- Pharmacy cost
- $0.0675 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 2
Highlights of the glimepiride record
Glimepiride (Amaryl) · label of May 12, 2025
Used for
From the label: indicationsGlimepiride tablets are indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus [see Clinical Studies (14.1) ]. Limitations of Use Glimepiride tablets should not be used for the treatment of type 1 diabetes mellitus or diabetic ketoacidosis, as it would not be effective in these settings. […]
On the market
- Earliest approval on file
- November 30, 1995
- Generic labelers
- 27 labelers
- Pharmacy cost
- $0.0507 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 19
Source: FDA drug labels via openFDA (Pioglitazone label of March 28, 2025, Glimepiride label of May 12, 2025); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do pioglitazone and glimepiride differ on the record?
In FDA's classes, pioglitazone is a peroxisome proliferator receptor gamma agonist and glimepiride a sulfonylurea.
How each works, in its label's words: Pioglitazone, “ACTOS is a thiazolidinedione that depends on the presence of insulin for its mechanism of action.”; Glimepiride, “Glimepiride primarily lowers blood glucose by stimulating the release of insulin from pancreatic beta cells.”
Only the pioglitazone label carries a boxed warning.
Generics: pioglitazone since 2012; glimepiride since 2005 (Drugs@FDA).
| Pioglitazone | Glimepiride | |
|---|---|---|
| Labeled for | Type 2 diabetes | Type 2 diabetes |
| Pharmacologic class | Peroxisome Proliferator Receptor alpha Agonist, Peroxisome Proliferator Receptor gamma Agonist, Thiazolidinedione | Sulfonylurea |
| How it works (label) | ACTOS is a thiazolidinedione that depends on the presence of insulin for its mechanism of action. | Glimepiride primarily lowers blood glucose by stimulating the release of insulin from pancreatic beta cells. |
| Half-life (label) | The mean serum half-life (t 1/2 ) of pioglitazone and its metabolites (M-III and M-IV) range from three to seven hours and 16 to 24 hours, respectively. | n/a |
| Earliest approval on file (Drugs@FDA) | July 15, 1999 | November 30, 1995 |
| First generic approved | August 17, 2012 | October 6, 2005 |
| Generic labelers (NDC) | 22 labelers | 27 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0675 per tablet (Pioglitazone HCl 15 mg tablet) | $0.0507 per tablet (Glimepiride 4 mg tablet) |
| 12-month price change | -7% | +4% |
| Boxed warning | Yes | No |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 2 | 19 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 44,186 | 38,737 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What next?
- Alternatives to pioglitazone
- every medicine labeled for the same conditions