Limited Coverage Drugs - pioglitazone

Generic Name



  • 15 mg
  • 30 mg
  • 45 mg



Special Authority Criteria

Approval Period

To be administered as part of a combination treatment for type 2 diabetes mellitus:

  • After inadequate glycemic control on maximum tolerated doses of dual therapy of metformin and a sulfonylurea or dual therapy of metformin and an insulin.


  • Pioglitazone is contraindicated for patients with New York Heart Association (NYHA) heart failure Classes I to IV.


Practitioner Exemptions

  • None

Special Notes

  1. PharmaCare coverage for pioglitazone is intended for combination treatment of type 2 diabetes (e.g., not as monotherapy).
  2. Patients intolerant to a sulfonylurea may be considered for coverage. Patients intolerant to glyburide may try another sulfonylurea (e.g., gliclazide, which is available through the PharmaCare Special Authority program). ‪
  3. Clinical judgment is warranted to assess the increased risk of adverse outcomes in patients with concurrent cardiovascular conditions, including heart failure.

Special Authority Request Form(s)