Short answer: Both contain pioglitazone, the drug in Actos, and share a boxed warning for congestive heart failure.12 Oseni adds alogliptin, a DPP-4 inhibitor, in one once-daily tablet. In a 26-week trial in the Oseni label, alogliptin 25 mg with pioglitazone 30 mg lowered HbA1c 1.7 points vs 1.2 on pioglitazone 30 mg alone. The label does not name Actos.
| Oseni | Actos | |
|---|---|---|
| What is in it | Alogliptin and pioglitazone1 | Pioglitazone2 |
| Strengths | Alogliptin/pioglitazone 12.5/30, 25/15, 25/30 and 25/45 mg1 | 15, 30 and 45 mg2 |
| Usual start | 25 mg/15 mg or 25 mg/30 mg once daily; tablets not split1 | 15 mg or 30 mg once daily2 |
| Maximum | 25 mg/45 mg once daily1 | 45 mg once daily2 |
| With mild heart failure (NYHA I or II) | Start at 25 mg/15 mg1 | Start at 15 mg2 |
| With gemfibrozil | Up to 25 mg/15 mg1 | Up to 15 mg2 |
| HbA1c change, 26 weeks (Oseni label) | Alogliptin 25 mg + pioglitazone 30 mg: −1.71 | Pioglitazone 30 mg alone: −1.21 |
| Missed dose | Do not double; Medication Guide: take when remembered, skip if the next dose is due1 | Do not double the next day; Medication Guide: take the next dose as prescribed2 |
| Boxed warning | WARNING: CONGESTIVE HEART FAILURE1 | WARNING: CONGESTIVE HEART FAILURE2 |
In a 26-week trial of 655 people not controlled on diet and exercise, starting HbA1c 8.8%, the Oseni label compared alogliptin 25 mg alone, pioglitazone 30 mg alone and the two together. HbA1c fell 1.0, 1.2 and 1.7 points, and 24%, 34% and 63% reached 7% or less. Weight gain was similar on pioglitazone alone and with alogliptin added.1 The pioglitazone arm was not called Actos.
Both labels list heart failure, swelling, liver failure, bladder tumors, fractures in women and macular edema from pioglitazone.12 Oseni adds the alogliptin warnings: pancreatitis, serious allergic reactions, severe joint pain and bullous pemphigoid. With moderate kidney impairment Oseni is 12.5 mg/30 mg, and it is not recommended with severe impairment.1 The missed-dose wording also differs between the two Medication Guides.
Which, if either, fits is for your prescriber. More detail: Oseni side effects, Actos side effects, the Oseni and Actos dosing schedules, the Actos missed-dose page and Actos vs Januvia: how do the two diabetes tablets differ?.