Brand Name: Actos
Generic Name: Pioglitazone

Pioglitazone

(pye-oh-GLI-ta-zone)

NEWLY DISCOVERED USES (OFF-LABEL)
Prevention of cardiovascular disease in type 2 diabetes, prevention in type 2 diabetes

ORIGINAL USES (ON-LABEL)
Type 2 Diabetes ? monotherapy and combination therapy, combination therapy with sulfonylureas, metformin, or insulin are indicated when monotherapy with diet and exercise are inadequate for control

BRAND NAME
Actos

DRUG CLASS
Antidiabetic (thiazolidinedione hypoglycemic)

DESCRIPTION
Lowers blood sugar by improving response to insulin.

POTENTIAL SIDE EFFECTS
Headache, tooth disorder, aggravated diabetes, sore throat, sinusitis, upper respiratory infection, edema, muscle aches, increases in HDL cholesterol, decreases in triglycerides, too low glucose levels, weight gain, anemia.

CAUTIONS

• Active liver disease or elevated liver function tests.
• Inform your doctor if you have a history of jaundice or liver disease, if you currently have anemia or edema, or certain types of cardiac disease (class III or class IV congestive heart failure).
• May result in resumption of ovulation if you are premenopausal but not ovulating.
• Requires periodic monitoring of liver function and blood glucose parameters.
• May cause too low blood glucose levels.
• There is a possibility of fluid retention leading to or exacerbating congestive heart failure with combined therapy of pioglitazone and insulin.

DRUG INTERACTIONS
Delavirdine, fluconazole, gemfibrozil, ketoconazole, nicardipine, NSAIDs, sulfonamides, itraconazole, carbamazepine, phenobarbital, phenytoin, rifampin, rifapentine, secobarbital, oral contraceptives, bile acid sequestrants.

This drug is metabolized by and induces specific set of liver enzymes (cytochrome P450 enzymes). Several other drugs interfere with these liver enzymes, and thus may increase or decrease the clearance of pioglitazone from the body, potentially increasing the risk of side effects or decreasing effectiveness. When these drugs are given in combination with pioglitazone, dosage adjustments may be needed. As these are too numerous to list, you should always check with your doctor or pharmacist prior to starting a new medication, herbal, or nonprescription product.

FOOD INTERACTIONS
May take without regard to meals.

HERBAL INTERACTIONS
St. John?s wort, chromium, garlic, gymnema

PREGNANCY AND BREAST-FEEDING CAUTIONS
FDA Pregnancy Risk Category C. Excretion in the breast milk is unknown. Therapy not recommended for those who are breast-feeding.

SPECIAL INFORMATION
If you miss a dose, do not double the dose the next day. When used in combination with insulin or other oral antidiabetic drugs, the risk of developing too low blood glucose is possible. Discuss risks and signs and symptoms with your doctor. Immediately report to your doctor and development of sudden weight gain, swelling, shortness of breath, nausea, vomiting, abdominal pain, fatigue, dark urine, or jaundice.