Pioglitazone/metformin (By mouth)

Introduction:

Metformin Hydrochloride (met-FOR-min hye-droe-KLOR-ide), Pioglitazone Hydrochloride

Used together with diet and exercise to control blood sugar levels in adults with type 2 diabetes.

Brand Name(s):

Actoplus Met

When This Medicine Should Not Be Used:

How to Use This Medicine:

Tablet

• Your doctor will tell you how much of this medicine to use and how often. Your dose may need to be changed several times in order to find out what works best for you. Do not use more medicine or use it more often than your doctor tells you to.
• It is best to take this medicine with food or milk.
• To best manage your diabetes, carefully follow your doctor's instructions about any special diet, exercise, or weight loss. Test your blood sugar regularly.
• Drink extra fluids so you will pass more urine while you are using this medicine. This will keep your kidneys working well and help prevent kidney problems.

If a dose is missed:

• If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine:

• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep the medicine in its original container.
• Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any leftover medicine after you have finished your treatment. You will also need to throw away old medicine after the expiration date has passed.
• Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are also using diabetes medicine that you take by mouth (such as glyburide, glipizide, Actos®, Amaryl®, Avandia®, Glucophage®, Glucotrol®, or Glucovance®).
• Your doctor should know if you also use digoxin (Lanoxin®), gemfibrozil (Lopid®), isoniazid (Nydrazid®), morphine, nicotinic acid (Nicobid®, Nicolar®), phenytoin (Dilantin®), procainamide (Procanbid®, Pronestyl®), quinidine (Quinidex®), quinine, ranitidine (Zantac®), rifampin (Rifadin®), trimethoprim (Bactrim®, Primsol®, Proloprim®, Septra®), or vancomycin (Vancocin®, Vancoled®).
• Tell your doctor if you use asthma medicine, decongestants, diuretics or "water pills" (such as amiloride, furosemide, triamterene, Dyrenium®, Lasix®), a steroid medicine (such as dexamethasone, prednisolone, prednisone, Medrol®), a phenothiazine medicine (such as prochlorperazine, Compazine®, Mellaril®, Phenergan®, Thorazine®, Trilafon®), thyroid replacement (such as levothyroxine, liothyronine, Cytomel®, Synthroid®), estrogen hormones (Premarin®), or birth control pills. Make sure your doctor knows if you use heart or blood pressure medicine (such as amlodipine, nifedipine, verapamil, Adalat®, Cardizem®, Lotrel®, Norvasc®, Procardia®, or Tiazac®).
• Do not drink alcohol while you are using this medicine.
• Make sure your doctor knows about all other treatments you are using for diabetes, including insulin.

Warnings While Using This Medicine:

• Make sure your doctor knows if you are pregnant or breastfeeding. This medicine can increase your chance of getting pregnant, even if you have irregular periods or have gone through menopause. Talk to your doctor about effective birth control while you are using this medicine.
• Tell your doctor if you have kidney disease, liver disease, or a history of alcoholism, heart attack, congestive heart failure, edema (problems with fluid retention or swelling), or problems with your adrenal or pituitary gland.
• If your blood sugar gets too low, you may feel weak, drowsy, confused, anxious, or very hungry. You may also sweat, shake, or have blurred vision, a fast heartbeat, or a headache that will not go away. If you have symptoms of low blood sugar (hypoglycemia), check your blood sugar. If your blood sugar is 70 mg/dL (milligrams per deciliter) or below, do one of the following: Drink 4 ounces (one-half cup) of fruit juice, or eat 5 to 6 pieces of hard candy, or take 2 to 3 glucose tablets. Re-check your blood sugar 15 minutes later. If your blood sugar is above 70 mg/dL, eat a snack or a meal. If your blood sugar is still below 70 mg/dL, drink one-half cup juice, or eat 5 to 6 pieces of candy, or take 2 to 3 glucose tablets. Carry candy or some type of sugar with you at all times, especially if you are away from home. You can take this if you feel that your blood sugar is too low, even if you do not have a blood glucose meter. Always carefully follow your doctor's instructions about how to treat your low blood sugar. Learn what to do if your blood sugar gets too low. Teach friends, co-workers, and family members what they can do to help if you have low blood sugar.
• This medicine may not work as well if you have surgery, get hurt, or get sick. Also, avoid getting dehydrated while you are using this medicine, especially if you have a fever, vomiting, or diarrhea. Be sure to drink extra fluids whenever you exercise or increase your activity, or if you sweat more than usual. If you are at least 80 years of age, your doctor may need to check your kidneys before you start using this medicine.
• Tell your doctor about any sudden change in your medical condition.
• Check with your doctor if blurred vision, decreased vision, or any other change in vision occurs during your treatment. Your doctor may want you to have your eyes checked by an ophthalmologist (eye doctor).
• This medicine may increase the risk of bone fractures in women. Ask your doctor about ways to keep your bones strong to help prevent fractures.
• Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain medical tests.
• Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery or medical tests.
• Your doctor will need to check your blood or urine at regular visits while you are using this medicine. Be sure to keep all appointments.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
• Blurred vision or other changes in vision.
• Cold feeling in your arms or legs.
• Dark-colored urine or pale stools.
• Extreme weakness, tiredness, or confusion.
• Lightheadedness or fainting, slow or uneven heartbeat.
• Nausea, vomiting, loss of appetite, or pain in your upper stomach.
• Pain or swelling in your arms or legs without any injury.
• Rapid breathing, trouble breathing, or stomach pain with nausea and vomiting.
• Rapid weight gain.
• Severe vomiting with fever or diarrhea.
• Shortness of breath with cold sweat and bluish-colored skin.
• Swelling in your hands, ankles, or feet.
• Unusual weakness, bruising, or pale skin.
• Yellowing of your skin or the whites of your eyes.

If you notice these less serious side effects, talk with your doctor:

• Cold or flu symptoms.
• Headache.
• Mild nausea, diarrhea, or stomach upset.
• Muscle pain.
• Problems with your teeth.

If you notice other side effects that you think are caused by this medicine, tell your doctor: