pioglitazone
Pioglitazone (Actos) is an oral medication used to treat Type 2 diabetes in adults, along with diet and exercise. It's a thiazolidinedione, which works by helping your body respond better to insulin. This medication is taken by mouth once a day and is available in both brand and generic forms. Side effects include headache, swelling in the body, and weight gain. There's also a serious warning that it can cause or worsen heart failure.
What is Pioglitazone (Actos)?
What is Pioglitazone (Actos) used for?
- Type 2 diabetes in adults, along with diet and exercise
How Pioglitazone (Actos) works
Pioglitazone (Actos) is thiazolidinedione. It helps by making your body become more sensitive to insulin, which is a hormone that controls blood sugar. When your body uses insulin better, it can move more blood sugar into cells to be used for energy. Pioglitazone (Actos) also works in the liver to lower the amount of sugar your liver makes.
Drug facts
Side effects of Pioglitazone (Actos)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Swelling (27%)
- Upper respiratory tract infection (13%)
- Headache (9%)
- Heart failure (8%)
- Sinus infection (6%)
- Pain in the arms and legs (6%)
Side effects above are for pioglitazone (Actos) taken alone. These might differ if it's taken with other medications.
Less Common Side Effects
- Sore throat
- Muscle pain
- Back pain
- Chest pain
- Weight gain
Pioglitazone (Actos) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Worsening heart failure: trouble catching your breath, unusual swelling, tiredness, sudden weight gain
- Serious liver problems: feeling tired or weak, poor appetite, losing weight without trying, dark urine, eyes and skin turning more yellow, upper right stomach pain
- Low blood sugar: shakiness, fast heartbeat, sweating, dizziness, anxiety, confusion, feeling very hungry
More on Pioglitazone (Actos) side effects
The following Pioglitazone (Actos) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
decreased urine output
dilated neck veins
extreme fatigue
irregular breathing
irregular heartbeat
problems with teeth
swelling of the face, fingers, feet, or lower legs
tightness in the chest
trouble breathing
Less common
Pain or swelling in the arms or legs without an injury
pale skin
swelling
trouble with breathing when active
unusual bleeding or bruising
unusual tiredness or weakness
Incidence not known
Dark urine
loss of appetite
nausea or vomiting
stomach pain
unexplained, rapid weight gain
yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Blurred vision or other changes in vision
flushed, dry skin
fruit-like breath odor
headache
increased hunger
increased thirst
increased urination
loss of consciousness
muscle pain or soreness
problems with your teeth
runny or stuffy nose
stomachache
sweating
unexplained weight loss
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Pioglitazone (Actos)
Pros
- Only taken once a day
- Rarely causes dangerously low blood sugar when taken by itself
- Can be taken with or without food
Cons
- Can cause fluid buildup in the body
- Not safe for people with moderate to severe heart failure
- Not a good choice for people with bladder cancer
Pharmacist tips for Pioglitazone (Actos)
- Take pioglitazone (Actos) at the same time every day with or without food. If you accidentally miss a dose, don't double up the next day since it raises your risk for side effects.
- Tell your healthcare team if you experience sudden weight gain, trouble breathing, unusual tiredness, or swelling in the feet, ankles, or legs while taking pioglitazone (Actos). Though rare, it's possible that this medication can cause or worsen heart failure. Let your prescriber know if you have a history of heart problems before starting pioglitazone (Actos).
- Talk to an optometrist if you notice blurry vision or vision changes while taking pioglitazone (Actos). This medication can cause an eye condition called diabetic macular edema. Be sure to keep up with regular eye exams so your healthcare team can check that this medication is safe for you.
- Pioglitazone (Actos) can interact with other medications. Let your prescriber know about all the medications and supplements you take before starting pioglitazone (Actos).
- It's important to eat healthy and exercise regularly to keep your blood sugar under control while taking pioglitazone (Actos). Work with your prescriber on a diet and exercise plan.
- If you're taking pioglitazone (Actos) along with other diabetes medications, like insulin or glipizide, you might be at risk of having low blood sugar. Check your blood sugar if you feel shaky, confused, or have a fast heartbeat. If you have low blood sugar (less than 70 mg/dL), know how to treat it and when you need to call 911.
- Pioglitazone (Actos) can raise your chances of becoming pregnant. Speak to your OB-GYN about possible birth control options before you start this medication.
Common questions about Pioglitazone (Actos)
Yes, weight gain is a common side effect of pioglitazone (Actos). But some weight gain might be due to swelling since this medication can cause your body to hold on to more fluid. This can be dangerous because it can lead to or worsen heart failure symptoms. Your healthcare team might ask you to check your weight regularly while you're taking this medication. Let your cardiologist know if you notice patterns of weight gain, as they’ll want to check if it’s causing any signs of heart failure. Talk with your healthcare team if you're concerned about pioglitazone (Actos) and weight gain.
Pioglitazone (Actos) might not be safe for people with moderate to severe heart failure because it can cause fluid retention, leading to swelling in the body. This can cause or worsen heart failure symptoms. If you have a history of heart problems, talk to your prescriber before starting this medication.
You should take pioglitazone (Actos) for as long as your healthcare team instructs. Some people with Type 2 diabetes will need to take this medication for life to manage blood sugar, but it might not be necessary for people who can control their blood sugar through a healthy diet and regular exercise alone. Make sure to work with your prescriber on a diet and exercise plan while taking pioglitazone (Actos).
In general, most people take pioglitazone (Actos) with few serious side effects. But this medication might not be right for those with certain medical conditions, such as bladder cancer. Some studies show a possible link between pioglitazone (Actos) and bladder cancer, though the research is mixed. Because of this possible risk, it's not recommended for people with active bladder cancer. If you've had bladder cancer in the past, talk to your oncologist first before starting pioglitazone (Actos) because they might suggest a different medication. If you have questions about this medication and bladder cancer, talk with your healthcare team.
People who have moderate to severe heart failure shouldn't take pioglitazone (Actos). If you have heart failure with symptoms, such as sudden weight gain, swelling, or shortness of breath, talk to your prescriber right away. Even if these symptoms are mild, this medication might not be right for you.
No. Pioglitazone (Actos) isn't the same as metformin, but both medications work in different ways to help manage your blood sugar. Metformin is a biguanide that lowers the amount of sugar that your liver makes and reduces the amount of sugar absorbed through your gut. In some cases, pioglitazone (Actos) can be taken together with metformin to treat Type 2 diabetes. Speak with your prescriber to learn more about comparing both medications.
Yes, pioglitazone (Actos) and glipizide can be taken together to treat Type 2 diabetes in adults. Keep in mind that when these medications are taken together, you are also at higher risk of low blood sugar. Make sure to keep fast-acting sugars, such as glucose tablets or boxes of fruit juice, with you at all times in case your blood sugar level drops too low.
Pioglitazone (Actos) alone isn't known to affect blood pressure. But in clinical studies, people who took pioglitazone (Actos) with insulin have experienced higher blood pressure. Speak with your prescriber if you have questions about this medication and blood pressure.
In some clinical studies, people who took pioglitazone (Actos) saw their hemoglobin A1C drop 0.3% to 0.9% after 5 to 6 months. Keep in mind that you need to take this medication regularly along with diet and exercise to experience maximum benefit from this medication.
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Risks and warnings for Pioglitazone (Actos)
Pioglitazone (Actos) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Heart failure and swelling
- *Risk factors: Heart failure | Higher dose of pioglitazone (Actos) | Using insulin at the same time *
Pioglitazone (Actos) can lead to or worsen heart failure. This is because it can cause your body to hold onto more water, which puts extra strain on the heart. Let your care team know right away if you experience symptoms such as trouble breathing, tiredness, swelling in your body, or sudden weight gain. They might recommend lowering the dose or stopping the medication altogether if you show symptoms of heart failure.
Low blood sugar (when used with other medications)
- *Risk factors: Using insulin or sulfonylureas at the same time *
Pioglitazone (Actos) rarely causes low blood sugar on its own. But taking it with other diabetes medications, like insulin or sulfonylureas (e.g.,glipizide, glimepiride), can raise your risk. Know the signs of low blood sugar and how to treat it. If you experience shakiness, hunger, swating, confusion, or fast heartbeat while taking this medication, tell your prescriber as they might need to adjust the doses of your other medications.
Liver problems
- Risk factors: Type 2 diabetes | Heart failure | Heart problems
Though rare, there have been reports that people who took pioglitazone (Actos) experienced serious liver problems. It's unclear if these problems were caused by the medication or were related to health conditions people already had. If you’re worried about potential liver damage, talk with your healthcare team. You might have blood tests before and during treatment to check your liver health. Let your healthcare team know right away if you experience extreme tiredness, weight loss, belly discomfort, dark urine, or yellowing of the eyes or skin.
Bladder cancer
Pioglitazone (Actos) might be linked to bladder cancer, though evidence is mixed. To be safe, it’s not recommended for people with active bladder cancer. If you have a history of bladder cancer, let your prescriber know so they can review the risks and benefits with you. Report any symptoms, like blood in your urine, pain while urinating, or changes in urination, to your prescriber while taking this medication.
Risk of bone fractures
- Risk factors: Weaker bones | Females
Some studies showed that females who took pioglitazone (Actos) might have a higher risk of bone fractures in their arms and feet. Before starting this medication, your prescriber might recommend checking your bone health to make sure it's safe for you.
Eye problems
Pioglitazone (Actos) can cause swelling in the eye, leading to a condition called macular edema, which can affect your vision. Keep in mind that diabetes can also impact your eyesight, so it's important to have regular eye exams while taking this medication. If you notice cloudy, blurry, or dim vision, talk with your prescriber right away.
Pioglitazone (Actos) dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 15mg | 90 tablets | $17.12 | $0.19 |
| 30mg | 30 tablets | $12.44 | $0.41 |
| 45mg | 90 tablets | $21.44 | $0.24 |
Typical dosage for Pioglitazone (Actos)
The typical dose is 15 mg to 30 mg by mouth once daily. The maximum daily dose is 45 mg by mouth once daily.
Your dose might differ depending on other medications you're taking and if you have heart failure.
Interactions between Pioglitazone (Actos) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acarbose
- Balofloxacin
- Besifloxacin
- Chloroquine
- Chlorpropamide
- Ciprofloxacin
- Enoxacin
- Fleroxacin
- Flumequine
- Gatifloxacin
- Gemifloxacin
- Glimepiride
- Glipizide
- Glyburide
- Hydroxychloroquine
- Ifosfamide
- Insulin
- Insulin Aspart, Recombinant
- Insulin Bovine
- Insulin Degludec
- Insulin Detemir
- Insulin Glargine, Recombinant
- Insulin Glulisine
- Insulin Lispro, Recombinant
- Lanreotide
- Levofloxacin
- Lomefloxacin
- Lumateperone
- Metformin
- Moxifloxacin
- Nadifloxacin
- Nateglinide
- Nifedipine
- Norfloxacin
- Octreotide
- Ofloxacin
- Pasireotide
- Pazufloxacin
- Pefloxacin
- Piperaquine
- Pixantrone
- Prulifloxacin
- Repaglinide
- Rufloxacin
- Sparfloxacin
- Thioctic Acid
- Tolazamide
- Tolbutamide
- Tolvaptan
- Tosufloxacin
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acebutolol
- Atenolol
- Atorvastatin
- Betaxolol
- Bisoprolol
- Bitter Melon
- Carteolol
- Carvedilol
- Celiprolol
- Clopidogrel
- Esmolol
- Fenugreek
- Glucomannan
- Guar Gum
- Ketoconazole
- Labetalol
- Levobunolol
- Metipranolol
- Metoprolol
- Nadolol
- Nebivolol
- Nilotinib
- Oxprenolol
- Penbutolol
- Pindolol
- Practolol
- Propranolol
- Psyllium
- Rifampin
- Sotalol
- Timolol
- Topiramate
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Pioglitazone (Actos) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Pioglitazone (Actos) will not be safe for you to take.
- People with moderate to severe heart failure
What are alternatives to Pioglitazone (Actos)?
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