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Actos (PIOGLITAZONE) is used with a diet and exercise program and sometimes with other medications, to treat type 2 diabetes (condition in which the body does not use insulin normally and therefore cannot control the amount of sugar in the blood). Pioglitazone is in a class of medications called thiazolidinediones. It works by increasing the body's sensitivity to insulin, a natural substance that helps control blood sugar levels. Pioglitazone is not used to treat type 1 diabetes (condition in which the body does not produce insulin and, therefore, cannot control the amount of sugar in the blood) or diabetic ketoacidosis (a serious condition that may develop if high blood sugar is not treated).

Common uses

Actos, in addition to diet and exercise, improves blood sugar control in patients with type 2 diabetes (non-insulin dependent diabetes). Actos can be used alone or in combination with a sulfonylurea, metformin, or insulin when diet, exercise, and one of these agents or diet, exercise, plus Actos alone are not are not enough to control blood sugar.
Before using

Before taking pioglitazone,
• tell your doctor and pharmacist if you are allergic to pioglitazone or any other medications.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements and herbal products you are taking or plan to take. Be sure to mention any of the following: atorvastatin (Lipitor), gemfibrozil (Lopid), hormonal contraceptives (birth control pills, patches, rings, implants, and injections), ketoconazole (Nizoral), midazolam, montelukast (Singulair), nifedipine (Procardia), and rifampin (Rifadin, Rifater, in Rifamate). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you have or have ever had any of the conditions mentioned in the IMPORTANT WARNING section or liver disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking pioglitazone, call your doctor. Do not breastfeed while you are taking pioglitazone.
• if you have not yet experienced menopause (change of life; end of monthly periods) you should know that pioglitazone may increase the chance that you will become pregnant even if you do not have regular monthly periods or you have a condition that prevents you from ovulating (releasing an egg from the ovaries). Talk to your doctor about methods of birth control that will work for you.
• if you will be having surgery, including dental surgery, tell the doctor or dentist that you are taking pioglitazone.
• ask your doctor what to do if you get sick, develop an infection or fever, experience unusual stress, or are injured. These conditions can affect your blood sugar and the amount of pioglitazone you may need.

Directions

Pioglitazone comes as a tablet to take by mouth. It is usually taken once daily with or without meals. Take pioglitazone at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take pioglitazone exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Your doctor may start you on a low dose of pioglitazone and gradually increase your dose.
Pioglitazone controls type 2 diabetes but does not cure it. It may take 2 weeks for your blood sugar to decrease and several weeks longer for you to feel the full effect of pioglitazone. Continue to take pioglitazone even if you feel well. Do not stop taking pioglitazone without talking to your doctor.

Cautions

This medication may infrequently cause or worsen a certain heart problem (congestive heart failure). Tell your doctor immediately if you notice any symptoms of heart failure, including: swelling of the hands/feet, unusual/sudden weight gain, trouble breathing, or unusual tiredness.

Possible side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using Actos and call your doctor at once if you have any of these serious side effects:
• feeling short of breath, even with mild exertion;
• swelling or rapid weight gain;
• chest pain, general ill feeling;
• nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
• blurred vision;
• increased thirst or hunger, urinating more than usual; or
• pale skin, easy bruising or bleeding, weakness.
Continue taking Actos and talk to your doctor if you have any of these less serious side effects:
• sneezing, runny nose, cough or other signs of a cold;
• headache;
• gradual weight gain;
• muscle pain; or
• tooth problems.
Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

If you take too much

Seek emergency medical attention if you think you have used too much of this medicine. You may have signs of low blood sugar, such as hunger, headache, confusion, irritability, drowsiness, weakness, dizziness, tremors, sweating, fast heartbeat, seizure (convulsions), fainting, or coma.

Additional information

Avoid drinking alcohol while taking Actos. Alcohol lowers blood sugar and may increase the risk of hypoglycemia while you are taking this medicine.

Drug interactions

Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: other anti-diabetic medications (e.g., insulin, metformin, or sulfonylureas such as glyburide), herbal/natural products (e.g., fenugreek, ginseng, gymnema), drugs affecting liver enzymes that remove pioglitazone from your body (e.g., gemfibrozil, rifamycins including rifampin), quinolone antibiotics (e.g., ciprofloxacin).
This medication may decrease the effectiveness of birth control pills. This can result in pregnancy. You may need to use an additional form of reliable birth control while using this medication. Consult your doctor or pharmacist for details.
Beta-blocker medications (e.g., metoprolol, propranolol, glaucoma eye drops such as timolol) may prevent the fast/pounding heartbeat you would usually feel when your blood sugar level falls too low (hypoglycemia). Other symptoms of low blood sugar such as dizziness, hunger, or sweating are unaffected by these drugs.