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. It should not be used to treat type 1 diabetes or diabetic ketoacidosis. 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 alone or with other diabetes medicine.

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)
• eye problems
• heart failure or other heart problems
• liver problems

Tell your healthcare provider if you get sick, injured, or 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. Talk to your healthcare provider about an effective 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?

Check the label on the medicine for directions about your specific dose. 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.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not use 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 if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: hunger, headache, confusion, irritability, drowsiness, weakness, dizziness, tremors, sweating, fast heartbeat, seizures, fainting, coma.

What should I watch out for?

This medicine may increase your risk for heart failure. Talk with your healthcare provider about this.

You may need a liver function test at the start of treatment and regularly while you take this medicine. Keep all appointments for visits with your provider.

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.

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 ID 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): Chest pain or pressure; 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 or shortness of breath (especially when lying down); swelling in legs, hands, or feet, or any unexplained swelling.

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:

• atorvastatin (Lipitor)
• ketoconazole (Nizoral)
• hormonal birth control such as pills, implants, shots, patches, or vaginal rings
• midazolam (Versed)
• nifedipine (Procardia)
• anti-HIV medicines such as atazanavir (Reyataz) and ritonavir (Norvir)
• antiseizure medicines such as carbamazepine (Tegretol) and phenytoin (Dilantin)
• corticosteroids such as cortisone (Cortone), dexamethasone, hydrocortisone (Cortef, Hydrocortone, methylprednisolone (Medrol), prednisolone (Delta-Cortef, Prelone), prednisone (Meticorten), and triamcinolone (Aristocort, Kenacort)
• gemfibrozil (Lopid)
• insulin and any other medicine for diabetes
• rifampin (Rifadin)
• herbal remedies such as ginger, garlic, ginseng, alfalfa, fenugreek, and St. John's wort

Do not drink alcohol unless your healthcare provider approves.

Many nonprescription products may interfere with this medicine or affect your blood sugar. Check product labels for warnings for diabetics or ask your healthcare provider or pharmacist for advice.

Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. 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.