Side Effects:

Common Weight gain, Blurred vision, Respiratory tract infection, Numbness, Bone fracture.

Expert advice for Pepar Tablet
Pepar helps to control blood sugar level and avoids long-term complications. You should continue to exercise regularly, eat a healthy diet, and take your other diabetes medicines along with Pepar. Full effect may be visible after several weeks of starting Pepar. Weight gain, headache, and swelling due to fluid build-up may occur. Notify your doctor if you experience shortness of breath, heart problems, or any abnormal swelling. May not be suitable for patients with a history of heart failure or bladder cancer.

Frequently Asked Questions

Q. Is Pepar a blood thinner?
No. Pepar is an anti-diabetic medication. Blood thinners are the medicine that prevents the formation of a harmful blood clot. These include medicines like Aspirin, Heparin and Warfarin.

Q. Is Pepar a diuretic?
No. Pepar is not a diuretic. It is used in the treatment of Diabetes Mellitus. Diuretics are those medicine which increases urination.

Q. Can Pepar used in Hepatitis B infection?
Some studies have shown that Pepar may be helpful in preventing Hepatitis B Virus-associated Hepatocellular Cancer (Liver Cancer). However, these findings are still very preliminary and clear role has not been established.

Q. Can Pepar used in Hepatitis C infection?
Pepar has been shown to inhibit Liver Cancer (HCC) recurrence in overweight Hepatitis C Virus-infected diabetic patients. It also improved insulin resistance (a state where the body is resistant to the effects and functions of the insulin hormone) in them.

Q. Can Pepar used along with Vitamin D?
Studies indicate that Vitamin-D combined with Pepar may be more effective in improving Bone Mineral Density and Bone Metabolism than Vitamin-D or Pepar alone in the treatment of Diabetes Mellitus patients with kidney dysfunction (Diabetic Nephropathy).

Q. Can Pepar be used along with sitagliptin?
Combination therapy with Sitagliptin and Pepar leads to a substantial and sustained improvement in glycemic (blood sugar) control compared to the treatment with Pepar alone. This is useful for patients who cannot tolerate Metformin or Sulfonylureas.

Q. Is there any role of Pepar in Alzheimer disease?
Recent evidence suggests that Pepar may be beneficial in Alzheimer's disease (AD), decreasing the cognitive decline early in the disease process. However, larger studies are now in progress to establish the same.

Q. Can Pepar and repaglinide combined in diabetes treatment?
For patients who previously failed oral antidiabetic therapy, the combination of Repaglinide and Pepar have acceptable safety, with greater reductions of glycemic parameters (blood sugar levels) than using either agent alone.

Q. Does Pepar cause urinary bladder tumour?
Large population studies indicate that Pepar is associated with an increased risk of bladder cancer. The absence of an association of bladder cancer with the other drug of the same class, Rosiglitazone, suggests that the increased risk is drug specific and not a class effect.

Q. Are Pepar and rosiglitazone same?
Pepar & Rosiglitazone both belong to a class of antidiabetics called Thiazolidinediones. Rosiglitazone has been removed from the market because using this drug was associated with increased risk of cardiovascular events like heart attack and stroke. This is not seen with Pepar.

Q. Can Pepar be used along with glimepiride in diabetes?
Pepar when added to Glimepiride in Patients with Diabetes Mellitus, has been found to significantly reduce plasma lipid levels and significant improvement in blood pressure control related to a reduction in the insulin resistance.

Q. Is Pepar a steroid?
No. Pepar is not a steroid. It is an anti-diabetic medication which belongs to the class of thiazolidinediones.

Q. How to use Pepar?
Pepar is an anti-diabetes drug used along with a proper diet and exercise program to control high blood sugar in patients with type 2 diabetes. Pepar acts as an insulin sensitizer and decreases the extent of insulin resistance in the body too.

Q. How safe is Pepar?
Pepar cardiovascular safety profile compares favourably with that of Rosiglitazone. Pepar has been found to be associated with bladder tumours but causality assessment has not been proved yet.

Q. How does Pepar cause oedema?
Pepar increases the permeability of fluid in tiny blood vessels called capillaries. This results in easier movement of fluids across the membrane and their consequent accumulation, resulting in oedema (puffiness). Also, Pepar causes increased sodium and water reabsorption from the kidney that contributes to the oedema.

Q. How does Pepar cause bladder cancer?
The mechanism behind the link between Pepar use and bladder cancer is still unknown. Studies have suggested that use of Pepar for more than one year results in increased risk of development of tumour of the urinary bladder.

Q. How does Pepar cause heart failure?
Pepar can cause fluid retention and edema. Consequently, there is a lot of fluid in the body (fluid overload). As a result, it may precipitate heart failure (which worsens with fluid overload in those at risk).

Q. How Pepar protects against atherosclerosis?
Studies in animals have concluded that Pepar improves the elasticity of the aortic wall ( the aorta is a large blood vessel that arises from the heart and supplies oxygenated blood to the rest of the body). This may be a mechanism by which it protects against atherosclerosis, but more studies are needed to confirm this.

Q. Can Pepar be used with insulin?
The addition of Pepar reduces daily insulin dosages, but study findings have not been consistent. Improvement of lipid profiles has also been weak with this combination therapy. Long-term studies are needed before any conclusions can be reached. Combination therapy should be primarily used for patients who achieve an insufficient reduction in blood sugar with insulin alone.

Q. Which is not safe in heart failure, Pepar or rosiglitazone?
Pepar & Rosiglitazone both belong to a class of antidiabetics called Thiazolidinediones. Rosiglitazone has been removed from the market because using this drug was associated with increased risk of cardiovascular events like heart attack and stroke. Pepar can cause heart failure too, but the risk is less that that with Rosiglitazone. Both the medicines should be avoided in heart failure.

Q. What are the alternatives to Pepar?
Fortunately, there are many alternatives to Pepar- Metformin, Acarbose, Sitagliptin, Exenatide, Insulin or combination therapies of these medicines can be used.

Q. Can Pepar used for dementia?
Findings indicate that Pepar treatment is associated with a reduced dementia risk in Diabetes mellitus patients. Prospective studies are needed to evaluate a possible neuroprotective effect in these patients in an ageing population.

Q. Can Pepar used for infertility?
Pepar may be of use in infertile patients with polycystic ovary syndrome (PCOS) who are resistant to conventional ovulation induction such as by drugs like Clomiphene, Dexamethasone, or Metformin.

Q. Can Pepar used for psoriasis?
The use of Pepar for plaque psoriasis treatment is controversial. Some studies revealed no effect of Pepar 30 mg daily neither on the clinical response of moderate-to-severe psoriasis whereas others demonstrate that it could be considered as an efficacious and safe agent for the treatment of plaque psoriasis.

Q. Can Pepar used for autism?
In a research study in a small number of autistic children, daily treatment with 30 or 60 mg Pepar for 3–4 months induced apparent clinical improvement. Pepar should be considered for further testing of therapeutic potential in autistic patients but as of now, autism is not an approved indication for Pepar use.

Q. Can Pepar be used in depression?
Pepar, either alone or as add-on therapy to conventional treatments, could clinically benefit patients of major depression according to a study.

Q. Can Pepar used for weight loss?
A recent study shows that although Pepar causes a significant decrease in blood sugar, HbA1C and lipid levels, it is associated with weight gain, which would limit its utility. It has not been shown to cause weight loss.

Q. Can Pepar be used to treat fatty liver?
Pepar has also been used to treat non-alcoholic steatohepatitis (fatty liver), but this use is presently considered experimental.

Q. Can Pepar be used for secondary stroke prevention?
Pepar reduces recurrent stroke and major vascular events in stroke patients with insulin resistance, prediabetes, and diabetes mellitus. However, its use as a preventive therapy requires more research.