pioglitazone / metformin

• Risk factors: Swelling (edema) | History of heart failure | At risk for heart failure

Actoplus Met (pioglitazone / metformin) can make you hold onto fluids in the body, which can look like swelling (especially in the legs, ankles, and feet). This fluid buildup can lead to or worsen heart failure. Talk to your prescriber right away if you experience sudden weight gain, swelling, or trouble breathing while you're taking this medication. These can be signs of heart failure.

• Risk factors: Age 65 or greater \ Kidney or liver problems | Heart problems | Heavy alcohol use | Imaging procedure that uses contrast dye | Recent or planned surgery or medical procedures | Taking medications that affect your kidneys, heart, or acid-base balance | Taking medications that cause metformin to build up in your body

Although rare, some people who've taken medications containing metformin, such as Actoplus Met (pioglitazone / metformin), developed a condition called lactic acidosis. This condition happens when there's too much lactic acid in the blood, and it can lead to other health problems that can be deadly.

Call your prescriber or get medical help right away if you notice that you're having breathing problems (short of breath or breathing too fast) or that you have an irregular heartbeat (too fast or too slow). Other signs of having too much lactic acid in the blood to look out for and to tell your care team about include upset stomach, vomiting, sleepiness, weakness, feeling cold, and muscle pain.

• Risk factors: Taking certain other diabetes medications

It's possible for Actoplus Met (pioglitazone / metformin) to lower your blood sugar. Taking Actoplus Met (pioglitazone / metformin) with insulin, glipizide, or other sulfonylureas can put you at greater risk for having low blood sugar (hypoglycemia). Be sure your prescriber know about the other diabetes medications you're taking. They might need to lower the dose of your other diabetes medications to minimize the risk for low blood sugar.

Be sure you and your loved ones know how to recognize and treat low blood sugar because it can be life-threatening if it's severe. Signs of low blood sugar include fast heartbeat, sweating, pale skin, shakiness, confusion and irritability. Have some form of sugar, such as hard candies or glucose tablets, with you at all times so you can get your blood sugar back up quickly in case it drops too low.

• Risk factors: History of liver problems

Some people who took pioglitazone, one of the components of Actoplus Met, have had liver damage. But it's not clear what caused this liver damage. As a precaution, your prescriber will check your liver function through blood tests before you start Actoplus Met (pioglitazone / metformin). Be aware of signs of liver damage and contact your prescriber if they appear. These signs include loss of appetite, pain in your right upper stomach area, tiredness, dark urine, and yellowing of your skin or eyes. You'll probably need to get a blood test done so your prescriber can decide whether you should continue taking the medication.

• Risk factors: Currently have or have had bladder cancer

Results from various studies are mixed about whether pioglitazone, a component of Actoplus Met, can raise the risk for bladder cancer. There's not enough information to know whether the medication directly causes the cancer. Speak with your prescriber if you're concerned about this risk. Actoplus Met (pioglitazone / metformin) isn't a good option for people who currently have bladder cancer. Discuss with your prescriber about the risks and benefits of taking this medication if you've had bladder cancer in the past.

• Risk factors: Females

Studies show that pioglitazone, one of the components of Actoplus Met, can raise the risk of breaking a bone, especially for females. Talk to your prescriber about how to keep your bones healthy and strong while you're taking Actoplus Met (pioglitazone / metformin).

Some people who've taken pioglitazone, a component of Actoplus Met, have developed swelling in their eye (macular edema). Tell your prescriber or eye specialist right away if you notice blurry vision or vision that's less sharp than usual while you're taking Actoplus Met (pioglitazone / metformin). Make sure to go to all of your recommended eye exams on time.

• Risk factors: Long-term use of Actoplus Met (pioglitazone / metformin) | Poor calcium or vitamin B12 absorption

Taking Actoplus Met (pioglitazone / metformin) for a long period of time can lower your vitamin B12 levels. Low vitamin B12 levels can sometimes lead to anemia (low red blood cell count). You might need to get blood tests done every few years so your prescriber can check your vitamin B12 levels throughout treatment. Let your prescriber know if you have low energy, dizziness, low appetite, or tingling or numbness in your hands or feet while you're taking Actoplus Met (pioglitazone / metformin). These can be symptoms of low vitamin B12 levels.