Pioglitazone Hydrochloride, Oral

What are other names for this medicine?

Type of medicine: antidiabetic

Generic and brand names: pioglitazone hydrochloride, oral; Actos

What is this medicine used for?

This medicine is taken by mouth to treat type 2 diabetes mellitus. This medicine helps control excess blood sugar. Usually you will take this medicine while you follow a diet and exercise program prescribed by your healthcare provider. This medicine may be taken while you are having insulin shots or are taking another diabetes medicine by mouth.

What should my healthcare provider know before I take this medicine?

Before you take this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• edema (swelling)
• congestive heart failure or other heart disease
• liver problems.

Tell your provider if you take nitrate medicines or insulin. Also tell your healthcare provider if you are scheduled to have surgery.

This medicine stimulates ovulation. Some women near the age of menopause may be able to become pregnant while taking this medicine. This medicine may make birth control pills less effective. Talk to your healthcare provider if you need another method of birth control.

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I take it?

Take this medicine exactly as your healthcare provider prescribes, at the same time every day. You may take this medicine with or without food.

Your blood sugar level should improve in 2 to 12 weeks. Your healthcare provider may increase your dosage or prescribe another medicine to be taken with this one. Take all your medicines exactly as prescribed.

Be sure to take any other medicine (insulin or other oral medicine for diabetes) that your healthcare provider prescribes for you.

If you miss a dose, take it as soon as you remember that day. If you forget a dose for a whole day, take only one dose the next day. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What should I watch out for?

You may need a liver function test at the start of treatment and regularly while you take this medicine.

Follow the diet and exercise program prescribed for you. Your healthcare provider will need to check your blood sugar control regularly. Be sure to keep all of your appointments. You will probably be set up with a schedule for testing your blood sugars at home. Keep records of your blood sugar readings and bring this with you to your appointments with your provider.

Alcohol may affect the way your body responds to this medicine and to food. Do not drink alcohol unless your healthcare provider approves.

This medicine may increase your risk for a heart attack, heart failure, or other heart problems, especially if you also take insulin or nitrate medicines. Talk with your healthcare provider about this.

Some people, particularly women, are at higher risk of having bone fractures while taking this medicine. Talk to your healthcare provider about how to keep your bones healthy.

Rarely, this medicine may cause vision problems. You need to have regular eye exams while taking this medicine. You may also need bone scans or X-rays to see if this medicine is affecting your bones. This medicine may increase the risk of fractures in women. Keep all appointments.

Low blood sugar (hypoglycemia) can occur if you miss or delay meals, drink too much alcohol, take too much medicine, or exercise more than usual. Symptoms of low blood sugar include confusion, shaking, weakness, strong hunger, cold sweats, headache, nausea, vision problems, and feeling faint. Treat the condition quickly by eating or drinking something with sugar in it such as candy, juice, or nondiet soda. Taking glucose tablets or gels (available in drug stores) is another quick way to treat hypoglycemia. Talk with your healthcare provider about this.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this medicine. Wear some form of identification stating that you are a diabetic (such as a Medic Alert bracelet). If you become unconscious, the ID tells emergency healthcare providers that you are a diabetic and need special care.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (report these to your healthcare provider right away): Yellowing of eyes or skin, dark urine, light-colored bowel movements, unexplained tiredness, stomach pain, confusion, shaking, vision problems, cold sweats, strong hunger, weakness, headache, lightheadedness, nausea, vomiting, loss of appetite, rapid heartbeat, trouble breathing, rapid weight gain, swelling in legs, hands, or feet.

Other: Runny nose, sinus congestion, cough, headache, muscle aches, weight gain.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• antibiotics such as erythromycin (EES, EryPed), clarithromycin (Biaxin), ciprofloxacin (Cipro), doxycycline, rifampin (Rifadin), and rifabutin (Mycobutin)
• antidepressants such as fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil)
• antifungals such as ketoconazole (Nizoral), itraconazole (Sporanox), and fluconazole (Diflucan)
• anti-HIV medicines such as atazanavir (Reyataz) and ritonavir (Norvir)
• antiseizure medicines such as carbamazepine (Tegretol), phenytoin (Dilantin, and valproic acid (Depakote, Depakene)
• birth control pills
• corticosteroids such as cortisone (Cortone), dexamethasone, hydrocortisone (Cortef, Hydrocortone, methylprednisolone (Medrol), prednisolone (Delta-Cortef, Prelone), prednisone (Meticorten, Orasone), and triamcinolone (Aristocort, Kenacort)
• gemfibrozil (Lopid)
• sedatives such as midazolam (Versed) and triazolam (Halcion)
• St. John's wort.

Do not drink alcohol unless your healthcare provider approves.

Keep a list of all your medicines (prescription, nonprescription, supplements, natural remedies, and vitamins) with you. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.