Actos

Brand Name:Actos

Prescription needed: Yes

What is this drug used for?

Pioglitazone is used, alone or in combination with other medications, to treat type-2 diabetes and to decrease the amount of sugar (glucose) in your blood when it cannot be controlled by diet and/or exercise. It works by making the body more sensitive to insulin and by decreasing the amount of sugar (glucose) being made by the liver.  

Is there any reason not to take this drug?

You should not use this drug if you are allergic to rosiglitazone, pioglitazone or troglitazone. Tell your doctor specifically if you have or have ever had:

  • a history of alcohol abuse
  • edema (swelling of the ankles, feet or legs)
  • congestive heart failure
  • high cholesterol
  • problems with your liver (including cirrhosis and hepatitis)
  • a condition called macular edema or diabetic retinopathy
  • a condition called polycystic ovary disease (PCOD) or polycystic ovarian syndrome (PCOS)

What about possible side effects?

  • swollen ankles and feet - contact doctor if experience increased tiredness, weakness, or shortness of breath at rest, with activity or when lying down
  • weight gain
  • low blood sugar - rare and only when used with other medications for type-2 diabetes
  • liver problems – rare; contact your doctor if you experience unexplained nausea, vomiting, stomach pain, fatigue, loss of appetite, dark urine, yellowing of the skin and/or eyes
  • headache

Some side effects may go away as your body gets used to the medicine. However, contact your doctor if these side effects persist or get worse.

This is not a complete list of side effects. If you are concerned about these or other unusual symptoms, ask your doctor and/or pharmacist for more information and advice.

What if I am taking other drugs?

Always provide your doctor with a list of all other drugs you are taking (including over-the-counter medications and herbal/natural products) as they may interact and may change the safety or effectiveness of either drug. Tell your doctor specifically if you are taking any of these drugs as he/she may need to make changes or check you more closely:

  • prednisone, dexamethasone, cortisone, high dose hydrochlorothiazide (>25mg), albuterol, pseudoephedrine, olanzapine, risperidone, niacin - these drugs may increase your blood sugar and interfere with how acarbose works
  • other medications for type-2 diabetes (i.e. insulin, glyburide and other sulfonylureas, repaglinide, nateglinide, metformin, acarbose):
    • in some cases, you may need to have your medication changed to prevent your blood sugar from going too low - this may not happen right away so check your blood sugars more often and contact your physician if you experience frequent episodes of dizziness, sweating, headache, rapid heart beat, shaking hands or confusion
    • if you are using insulin, you have a higher chance of experiencing edema
  • fenugreek, licorice, bitter melon, eucalyptus, ginseng, St. John’s Wort - these and other natural products have varying effects on blood sugar
  • ketoconazole and other drugs that may decrease how the body gets rid of pioglitazone

This is not a complete list of drug interactions. Ask your doctor or pharmacist to review your list of medications.

Other information:

Monitoring: Regularly check your blood sugar as discussed with your nurse, pharmacist or doctor.

During the first year of treatment with this drug, you will need to have your blood tested every two to three months to check your liver.

Onset of medication: It takes time for this medication to work, about eight to 12 weeks (two to three months). You will likely not see any changes in your blood sugars until this time.

Side effect management: This medication on its own does not cause low blood sugar. However, if you are started on another medication, or pioglitazone is added to another medication, you may start to see some episodes of low blood sugar.

Polycystic Ovary Disease/Polycystic Ovarian Syndrome: This medication can restart ovulation in women with polycystic ovary disease/polycystic ovarian syndrome. You may become pregnant if adequate birth control is not used.

Children: Not recommended.

Seniors: May be at increased risk for edema, especially when used in combination with insulin.

Pregnant women: Safety not established. Consult your doctor if you become pregnant during treatment.

Women who are nursing: Safety not established. Talk to your doctor.

People who drive or operate machinery: Should not be a problem unless you are taking other medications for diabetes that may put you at risk for low blood sugar. There is a greater risk of an accident if you engage in these activities when your blood sugar is low.

Overdose: If you experience any unusual reactions or if you seriously exceed the recommended dosage, call your doctor or 911.

Stopping the drug: Always talk to your doctor before you stop taking this drug. If you stop taking this medicine, you may not be able to control your blood glucose levels.

If you miss a dose: Take it as soon as you remember. If your next scheduled dose is within two hours, take the forgotten dose but skip the next one. Never take a double dose.

Storage conditions: Closed container; cool, dry location away from excess moisture (not in the bathroom); always out of reach of children.

Alcohol: No known problems. If you drink, always drink in moderation and monitor your blood sugar more frequently.

Dietary precautions: Follow your doctor’s recommendations. In order to keep your blood glucose levels in control, you need to balance your medicine with the right amount of food and exercise.