Wednesday, September 14, 2016

pioglitazone



Generic Name: pioglitazone (oral) (PYE o GLIT a zone)

Brand Names: Actos


What is pioglitazone?

Pioglitazone is an oral diabetes medicine that helps control blood sugar levels.


Pioglitazone is for people with type 2 diabetes. Pioglitazone is sometimes used in combination with insulin or other medications, but it is not for treating type 1 diabetes.


Pioglitazone may also be used for purposes not listed in this medication guide.


What is the most important information I should know about pioglitazone?


You should not use this medication if you are allergic to pioglitazone, if you have severe heart failure, if you have active bladder cancer, or if you are in a state of diabetic ketoacidosis (call your doctor for treatment with insulin). Do not take pioglitazone for longer than recommended. Taking this medication for longer than 1 year (12 months) may increase your risk of developing bladder cancer. Talk with your doctor about your specific risk.

Before taking pioglitazone, tell your doctor if you have congestive heart failure or heart disease, fluid retention, a history of bladder cancer, a history of heart attack or stroke, or liver disease.


Take care not to let your blood sugar get too low. Low blood sugar (hypoglycemia) can occur if you skip a meal, exercise too long, drink alcohol, or are under stress. Symptoms include headache, hunger, weakness, sweating, tremors, irritability, or trouble concentrating. Carry hard candy or glucose tablets with you in case you have low blood sugar. Other sugar sources include orange juice and milk. Be sure your family and close friends know how to help you in an emergency.


Some women using pioglitazone have started having menstrual periods, even after not having a period for a long time due to a medical condition. You may be able to get pregnant if your periods restart. Talk with your doctor about the need for birth control. Women may also be more likely than men to have bone fractures in the upper arm, hand, or foot while taking pioglitazone. Talk with your doctor if you are concerned about this possibility. Certain oral diabetes medications may increase your risk of serious heart problems. However, not treating your diabetes can damage your heart and other organs. Talk to your doctor about the risks and benefits of treating your diabetes with pioglitazone.

What should I discuss with my healthcare provider before taking pioglitazone?


You should not use this medication if you are allergic to pioglitazone, if you have severe heart failure, if you have active bladder cancer, or if you are in a state of diabetic ketoacidosis (call your doctor for treatment with insulin).

To make sure you can safely take pioglitazone, tell your doctor if you have any of these other conditions:



  • congestive heart failure or heart disease;




  • fluid retention;




  • a history of bladder cancer;




  • a history of heart attack or stroke; or




  • liver disease.




Certain oral diabetes medications may increase your risk of serious heart problems. However, not treating your diabetes can damage your heart and other organs. Talk to your doctor about the risks and benefits of treating your diabetes with pioglitazone. Some women using pioglitazone have started having menstrual periods, even after not having a period for a long time due to a medical condition. You may be able to get pregnant if your periods restart. Talk with your doctor about the need for birth control. Women may also be more likely than men to have bone fractures in the upper arm, hand, or foot while taking pioglitazone. Talk with your doctor if you are concerned about this possibility. Do not take pioglitazone for longer than recommended. Taking this medication for longer than 1 year (12 months) may increase your risk of developing bladder cancer. Talk with your doctor about your specific risk. FDA pregnancy category C. It is not known whether pioglitazone will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. It is not known whether pioglitazone passes into breast milk or if it could harm a nursing baby. Do not take pioglitazone without first talking to your doctor if you are breast-feeding a baby.

How should I take pioglitazone?


Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results.


Pioglitazone is usually taken once daily. You may take the medicine with or without food.


Your blood sugar will need to be checked often, and you may need other blood tests at your doctor's office. Visit your doctor regularly.


Know the signs of low blood sugar (hypoglycemia) and how to recognize them: headache, hunger, weakness, sweating, tremors, irritability, or trouble concentrating.

Always keep a source of sugar available in case you have symptoms of low blood sugar. Sugar sources include orange juice, glucose gel, candy, or milk. If you have severe hypoglycemia and cannot eat or drink, use an injection of glucagon. Your doctor can give you a prescription for a glucagon emergency injection kit and tell you how to give the injection.


Check your blood sugar carefully during a time of stress or illness, if you travel, exercise more than usual, drink alcohol, or skip meals. These things can affect your glucose levels and your dose needs may also change.


Ask your doctor how to adjust your pioglitazone dose if needed. Do not change your medication dose or schedule without your doctor's advice.

Use pioglitazone regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.


Pioglitazone is only part of a complete program of treatment that may also include diet, exercise, weight control, foot care, eye care, dental care, and testing your blood sugar. Follow your diet, medication, and exercise routines very closely. Changing any of these factors can affect your blood sugar levels.


Store at room temperature away from moisture, heat, and light.

See also: Pioglitazone dosage (in more detail)

What happens if I miss a dose?


Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.


What happens if I overdose?


Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. You may have signs of low blood sugar, such as extreme weakness, blurred vision, sweating, trouble speaking, tremors, stomach pain, confusion, and seizure (convulsions).

What should I avoid while taking pioglitazone?


Avoid drinking alcohol. It lowers blood sugar and may interfere with your diabetes treatment.

Pioglitazone 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 pioglitazone and call your doctor at once if you have any of these serious side effects:

  • stomach pain, blood in your urine;




  • painful urination;




  • feeling short of breath, even with mild exertion;




  • swelling or rapid weight gain;




  • chest pain, general ill feeling;




  • nausea, upper stomach pain, itching, 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.



Less serious side effects may include:



  • cold symptoms such as stuffy nose, sneezing, cough, sore throat;




  • headache;




  • gradual weight gain;




  • muscle pain;




  • back pain; or




  • tooth problems.



This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.


Pioglitazone Dosing Information


Usual Adult Dose for Diabetes Mellitus Type II:

Monotherapy:
Initial dose: 15 mg to 30 mg orally once a day. Doses may be taken without regard to meals.
Maintenance dose: In patients who respond inadequately to the initial dose, it may be increased in increments up to 45 mg once daily.

Combination Therapy:
15 mg to 30 mg orally once a day in combination with metformin, a sulfonylurea or insulin. Doses may be taken without regard to meals.


What other drugs will affect pioglitazone?


Tell your doctor about all other medicines you use, especially:



  • bosentan (Tracleer);




  • delavirdine (Rescriptor);




  • digoxin (Lanoxin);




  • gemfibrozil (Lopid);




  • midazolam (Versed);




  • morphine (MS Contin, Kadian, Oramorph);




  • tolbutamide (Orinase);




  • trimethoprim (Proloprim, Primsol, Bactrim, Cotrim, Septra);




  • vancomycin (Vancocin, Lyphocin);




  • amiloride (Midamor), furosemide (Lasix), or triamterene (Dyrenium);




  • cimetidine (Tagamet) or ranitidine (Zantac);




  • fluconazole (Diflucan) or ketoconazole (Nizoral);




  • nicardipine (Cardene) or nifedipine (Nifedical, Procardia);




  • procainamide (Procan, Pronestyl, Procanbid), quinidine (Quin-G), or quinine (Qualaquin);




  • rifampin (Rifater, Rifadin, Rifamate) or rifapentine (Priftin);




  • a non-steroidal anti-inflammatory drug (NSAID) such as celecoxib (Celebrex), flurbiprofen (Ansaid), ibuprofen (Advil, Motrin), indomethacin (Indocin), mefenamic acid (Ponstel), or piroxicam (Feldene); or




  • seizure medication such as carbamazepine (Carbatrol, Equetro, Tegretol), phenytoin (Dilantin), phenobarbital (Solfoton), primidone (Mysoline), and others.



You may be more likely to have hypoglycemia (low blood sugar) if you take pioglitazone with other drugs that can lower blood sugar, such as:



  • insulin;




  • probenecid (Benemid);




  • some nonsteroidal anti-inflammatory drugs (NSAIDs);




  • aspirin or other salicylates (including Pepto-Bismol);




  • a blood thinner (warfarin, Coumadin and others);




  • heart or blood pressure medication (Accupril, Altace, Lotensin, Prinivil, Vasotec, Zestril, and others);




  • sulfa drugs (Bactrim, Gantanol, Gantrisin, Septra, SMX-TMP, and others);




  • a monoamine oxidase inhibitor (MAOI); or




  • other oral diabetes medications, especially acarbose (Precose), metformin (Glucophage), miglitol (Glyset), or rosiglitazone (Avandia).



These lists are not complete and there are many other medicines that can increase or decrease the effects of pioglitazone on lowering your blood sugar. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.



More pioglitazone resources


  • Pioglitazone Side Effects (in more detail)
  • Pioglitazone Dosage
  • Pioglitazone Use in Pregnancy & Breastfeeding
  • Pioglitazone Drug Interactions
  • Pioglitazone Support Group
  • 26 Reviews for Pioglitazone - Add your own review/rating


  • pioglitazone Advanced Consumer (Micromedex) - Includes Dosage Information

  • Pioglitazone MedFacts Consumer Leaflet (Wolters Kluwer)

  • Actos Prescribing Information (FDA)

  • Actos Consumer Overview

  • Actos Monograph (AHFS DI)



Compare pioglitazone with other medications


  • Diabetes, Type 2
  • Nonalcoholic Fatty Liver Disease


Where can I get more information?


  • Your pharmacist can provide more information about pioglitazone.

See also: pioglitazone side effects (in more detail)


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