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Pioglitazone is the generic form of the prescription drug known by the brand name Actos.
Its used along with diet and exercise to help lower blood sugar in people who have type 2 diabetes.
When you have type 2 diabetes, your body doesnt make or use the hormone insulin normally, so it cant control the amount of sugar, or glucose, in the blood.
Pioglitazone is in a class of drugs known as thiazolidinediones.
It lowers blood-sugar levels by making the bodys cells more sensitive to insulin, allowing them to take up more glucose from your blood.
Taking pioglitazone, along with adopting a healthy lifestyle, can decrease your risk of developing the serious or life-threatening complications of type 2 diabetes.
These may include cardiovascular diseases, such as heart attack, stroke, and problems related to blood circulation; nerve damage; kidney disease; or eye conditions.
The drug is manufactured by Takeda Pharmaceuticals, and was approved by the Food and Drug Administration (FDA) in 1999.

Pioglitazone Warnings

Pioglitazone carries a black-box warning because it may cause or worsen congestive heart failure.
Before taking pioglitazone, tell your doctor about any conditions youve had that may be related to or affect the heart, such as:

• Congestive heart failure
• Heart disease
• A heart attack
• A heart defect
• High cholesterol
• High blood pressure
• An irregular heartbeat
• Sleep apnea

Tell your doctor immediately or get emergency medical attention if you experience symptoms of congestive heart failure, which may include:

• Shortness of breath
• Swelling of the arms, hands, feet, ankles, lower back, or lower legs
• Stomach swelling or pain
• Waking up during the night feeling short of breath
• Inability to sleep while laying flat
• Frequent dry cough or wheezing
• Fast or racing heartbeat
• Confusion or difficulty thinking clearly
• Increased fatigue
• Difficulty walking or exercising
• Significant weight gain in a short period of time

Before taking this medication, also tell your doctor if you have or have ever had:

• Bladder cancer
• Diabetic eye disease
• Kidney disease

Pioglitazone may cause liver problems. Tell your doctor if youve ever had liver disease.
Stop taking the medicine and call your healthcare provider right away if you experience:

• Nausea
• Vomiting
• Loss of appetite
• Pain in the upper right part of your stomach
• Flu-like symptoms
• Dark urine
• Unusual bruising or bleeding
• Yellowing of the eyes or skin
• Profound lack of energy

Pioglitazone may also increase a womans chances of experiencing a broken bone. Tell your doctor right away if you experience any kind of bone pain.
Also, tell your healthcare providers that youre taking pioglitazone before having any type of surgery, including a dental procedure.
You shouldnt take pioglitazone if you have type 1 diabetes (the body doesnt produce any insulin) or diabetic ketoacidosis (a dangerous condition that can occur if high blood sugar is untreated).
Pioglitazone may cause changes in your blood sugar. You should know the symptoms of high (hyperglycemic) or low (hypoglycemic) blood-sugar episodes and be prepared to treat them.
Tell your physician if you experience an illness, fever, injury, or unusual stress while taking pioglitazone, because these can change your blood sugar and the dosage you need.
Pioglitazone controls diabetes, but it doesnt cure it. Continue to take it even if you feel well.
It may take two weeks for your blood sugar to decrease and up to three months to feel the full effects of this drug.
Your physician will probably want to check your glucose levels often while you are taking pioglitazone.
Always wear a diabetic ID bracelet to be sure you get proper treatment in case of an emergency.

Pioglitazone and Bladder Cancer

People who took pioglitazone for more than a year were more likely to develop bladder cancer than those who didnt take the medicine.
The FDA recommends that this drug shouldnt be prescribed to people with bladder cancer or a history of bladder cancer.
Tell your doctor right away if you notice symptoms that could be associated with bladder cancer. These may include:

• Red or bloody urine
• Difficult or painful urination
• An increased need to urinate

Thousands of U.S. patients who took pioglitazone have filed lawsuits against the manufacturer because they believe the risk of bladder cancer wasnt fully disclosed.

Pregnancy and Pioglitazone

Pioglitazone is an FDA Pregnancy Category C drug, which means harm to an unborn baby is possible.
Discuss the risks and benefits of taking this drug during pregnancy with your doctor.
The medicine may also increase the chance that you will become pregnant, even if you dont have regular monthly periods. Talk to your doctor about effective birth-control methods.
Its not known whether pioglitazone passes into breast milk or could harm a breastfeeding baby.
Dont take this medication while breastfeeding without talking to your doctor first.

Common Side Effects of Pioglitazone

Tell your doctor if any of the following side effects become severe or dont go away:

• Headache
• Sore throat
• Gas
• Muscle pain
• Sinus pain
• Weight gain
• Tooth problems
• Pain in the arms or legs

Serious Side Effects of Pioglitazone

Contact your physician immediately if you experience any of the symptoms listed in the Warning section or any of the following serious side effects:

• Vision changes or vision loss
• Discolored, cloudy, or bloody urine
• Back or abdominal pain

Tell your doctor about all prescription, non-prescription, illegal, recreational, herbal, nutritional, or dietary drugs youre taking, especially:

• Atorvastatin (Lipitor)
• Gemfibrozil (Lopid)
• Contraceptives, such as birth-control pills, patches, rings, implants, and injections
• Diabetes medications
• Insulin
• Ketoconazole (Nizoral)
• Midazolam (Versed)
• Nifedipine (Procardia)
• Rifampin (Rifadin, Rifater, Rimactance, in Rifamate)

Pioglitazone and Alcohol

Alcohol can cause your blood-sugar levels to decrease.
Ask your doctor if its safe for you to consume alcoholic beverages while taking pioglitazone.

Pioglitazone comes as a tablet and is typically taken by mouth once a day, with or without meals.
Your dosage will be based on your medical condition, response to treatment, and other drugs youre taking.
Try to take pioglitazone around the same time each day.
Your doctor might start you on a low dose and gradually increase it.
Follow the instructions on your prescription label carefully. Dont take more or less than is prescribed.

Pioglitazone Overdose

If you suspect an overdose, you should contact a poison-control center or emergency room immediately.
You can get reach a poison-control center at (800) 222-1222.

Missed Dose of Pioglitazone

If you miss a dose of pioglitazone, and you remember that same day, take the missed dose as soon as you remember.
If you dont remember until the next day, dont take an extra pill. Just continue on your regular medication schedule.
Dont take more than one dose a day or double up to make up for a missed one.