Why is Actos prescribed?

Pioglitazone is used with a diet and exercise program and sometimes with other medications, to treat type 2 diabetes (condition in which the body does not use insulin normally and therefore cannot control the amount of sugar in the blood). Pioglitazone is in a class of medications called thiazolidinediones. It works by increasing the body's sensitivity to insulin, a natural substance that helps control blood sugar levels. Pioglitazone is not used to treat type 1 diabetes (condition in which the body does not produce insulin and, therefore, cannot control the amount of sugar in the blood) or diabetic ketoacidosis (a serious condition that may develop if high blood sugar is not treated).

How should Actos be used?

Pioglitazone comes as a tablet to take by mouth. It is usually taken once daily with or without meals. Take pioglitazone at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take pioglitazone exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Your doctor may start you on a low dose of pioglitazone and gradually increase your dose.

Pioglitazone controls type 2 diabetes but does not cure it. It may take 2 weeks for your blood sugar to decrease and several weeks longer for you to feel the full effect of pioglitazone. Continue to take pioglitazone even if you feel well. Do not stop taking pioglitazone without talking to your doctor.

What are some Actos precautions and warnings?

Before taking pioglitazone,

• tell your doctor and pharmacist if you are allergic to pioglitazone or any other medications.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements and herbal products you are taking or plan to take. Be sure to mention any of the following: atorvastatin (Lipitor), gemfibrozil (Lopid), hormonal contraceptives (birth control pills, patches, rings, implants, and injections), ketoconazole (Nizoral), midazolam, montelukast (Singulair), nifedipine (Procardia), and rifampin (Rifadin, Rifater, in Rifamate). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you have or have ever had any of the conditions mentioned in the IMPORTANT WARNING section or liver disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking pioglitazone, call your doctor. Do not breastfeed while you are taking pioglitazone.
• if you have not yet experienced menopause (change of life; end of monthly periods) you should know that pioglitazone may increase the chance that you will become pregnant even if you do not have regular monthly periods or you have a condition that prevents you from ovulating (releasing an egg from the ovaries). Talk to your doctor about methods of birth control that will work for you.
• if you will be having surgery, including dental surgery, tell the doctor or dentist that you are taking pioglitazone.
• ask your doctor what to do if you get sick, develop an infection or fever, experience unusual stress, or are injured. These conditions can affect your blood sugar and the amount of pioglitazone you may need.

What are some possible side effects of Actos?

This medication may cause changes in your blood sugar. You should know the symptoms of low and high blood sugar and what to do if you have these symptoms.

You may experience hypoglycemia (low blood sugar) if you are taking this medication in combination with other medications used to treat diabetes. Your doctor will tell you what you should do if you develop hypoglycemia. He or she may tell you to check your blood sugar, eat or drink a food or beverage that contains sugar, such as hard candy or fruit juice, or get medical care. Follow these directions carefully if you have any of the following symptoms of hypoglycemia:

• shakiness
• dizziness or lightheadedness
• sweating
• nervousness or irritability
• sudden changes in behavior or mood
• headache
• numbness or tingling around the mouth
• weakness
• pale skin
• hunger
• clumsy or jerky movements

If hypoglycemia is not treated, severe symptoms may develop. Be sure that your family, friends, and other people who spend time with you know that if you have any of the following symptoms, they should get medical treatment for you immediately.

• confusion
• seizures
• loss of consciousness

Call your doctor immediately if you have any of the following symptoms of hyperglycemia (high blood sugar):

• extreme thirst
• frequent urination
• extreme hunger
• weakness
• blurred vision

If high blood sugar is not treated, a serious, life-threatening condition called diabetic ketoacidosis could develop. Call your doctor immediately if you have any of these symptoms:

• dry mouth
• upset stomach and vomiting
• shortness of breath
• breath that smells fruity
• decreased consciousness

Pioglitazone may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• runny nose and other cold symptoms
• headache
• muscle pain
• tooth or mouth pain
• sore throat

Some side effects can be serious. If you experience any of the following symptoms or those mentioned in the IMPORTANT WARNING section, call your doctor immediately:

• nausea
• vomiting
• loss of appetite
• excessive tiredness
• dark urine
• yellowing of the skin or whites of the eyes
• blurred vision
• vision loss

In clinical studies, more people who took pioglitazone developed bladder cancer than people who did not take pioglitazone. Talk to your doctor about the risk of taking this medication.

In clinical studies, more women who took pioglitazone developed fractures, especially of the hands, arms, feet, ankles, and lower legs than women who did not take pioglitazone. Men who took pioglitazone did not have a greater risk of developing fractures than men who did not take the medication. If you are a woman, talk to your doctor about the risk of taking this medication.

Pioglitazone may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.