Drugs - Actos

What is Actos?

Actos (pioglitazone) is an oral diabetes medicine that helps control blood sugar levels.

Actos is for people with type 2 (non-insulin-dependent) diabetes. Pioglitazone is sometimes used in combination with insulin or other medications, but it is not for treating type 1 diabetes.

Actos may also be used for purposes not listed in this medication guide.
Important information about Actos

You should not use Actos 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 Actos 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 Actos, 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 Actos 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 Actos. 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 Actos.
Before taking Actos

You should not use Actos 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 Actos, 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 Actos.

Some women using Actos 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 Actos. Talk with your doctor if you are concerned about this possibility.

Do not take Actos 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 Actos will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using Actos. It is not known whether pioglitazone passes into breast milk or if it could harm a nursing baby. Do not take Actos without first talking to your doctor if you are breast-feeding a baby.


How should I take Actos?

Take Actos 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.

Actos is usually taken once daily. You may take Actos 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 Actos dose if needed. Do not change your medication dose or schedule without your doctor's advice.

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

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

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 Actos?

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

Actos side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Actos: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using Actos 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 Actos 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.

What other drugs will affect Actos?

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 Actos 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).