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Common uses
This combination medication is used along with a proper diet and exercise program to control high blood sugar in people with type 2 diabetes (non-insulin-dependent diabetes). This medication works by helping to restore your body's proper response to the insulin you naturally produce. Controlling high blood sugar helps prevent heart disease, strokes, kidney disease, blindness, and circulation problems, as well as sexual function problems (decrease in sexual ability). Pioglitazone belongs to a class of drugs known as thiazolidinediones or "glitazones". Metformin is a biguanide-type drug.
Before using
Some people have developed a life-threatening condition called lactic acidosis while taking Actoplus Met. Get emergency medical help if you have any of these symptoms of lactic acidosis: weakness, increasing sleepiness, slow heart rate, cold feeling, muscle pain, shortness of breath, stomach pain, feeling light-headed, and fainting.
You may be more likely to develop lactic acidosis if you have congestive heart failure.
Do not use Actoplus Met if you have kidney disease, or if you are in a state of diabetic ketoacidosis (call your doctor for treatment with insulin).
Before taking this medication, tell your doctor if you have:
• congestive heart failure or heart disease;
• a history of heart attack or stroke;
• liver disease; or
• eye problems caused by diabetes.
If you have any of these conditions, you may not be able to use Actoplus Met, or you may need a dosage adjustment or special tests during treatment.
Some women using Actoplus Met 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. FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether Actoplus Met passes into breast milk or if it could harm a nursing baby. Do not take Actoplus Met without first talking to your doctor if you are breast-feeding a baby. Older adults may have a higher risk of developing lactic acidosis. Talk with your doctor about your individual risk.
Directions
Take this medication by mouth, usually once or twice daily with a meal or as directed by your doctor.
The dosage is based on your medical condition and response to therapy. Taking more than 45 milligrams of pioglitazone per day, or more than 2550 milligrams of metformin per day, is not recommended unless your doctor directs you otherwise.
Use this medication regularly in order to get the most benefit from it. To help you remember, use it at the same time(s) each day.
Cautions
This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: kidney disease, history of liver disease, conditions that may cause a low level of oxygen in the blood or poor circulation (e.g., severe congestive heart failure, recent heart attack, recent stroke), lack of body fluids (dehydration), serious infection, metabolic acidosis (e.g., diabetic ketoacidosis), type 1 diabetes (insulin-dependent diabetes).
Before using this medication, tell your doctor or pharmacist your medical history, especially of: severe breathing problems (e.g., obstructive lung disease, severe asthma), other heart problems (e.g., coronary artery disease, history of heart bypass surgery), blood problems (e.g., anemia, vitamin B-12 deficiency), swelling (edema), fertility problems (e.g., ovulation problems), other liver problems, upcoming surgery, alcohol use, eye (retina) problems.
Possible side effects
Side effects that may occur while taking this medicine include diarrhea, headache, nausea, or stomach upset.
Check with your doctor as soon as possible if you experience dizziness, or sore throat.
Contact your doctor immediately if you experience swelling of the hands or feet, unusual tiredness or weakness, muscle aches or pain, sudden weight gain, trouble breathing or shortness of breath, vomiting, yellowing of eyes or skin, loss of appetite, or dark urine.
An allergic reaction to this medicine is unlikely, but seek immediate medical attention if it occurs. Symptoms of an allergic reaction include rash, itching, swelling, severe dizziness, or trouble breathing. If you notice other effects not listed above, contact your doctor, nurse, or pharmacist.
If you take too much
Seek emergency medical attention if you think you have used too much of this medicine. You may have signs of low blood sugar, such as hunger, headache, confusion, irritability, drowsiness, weakness, dizziness, tremors, sweating, fast heartbeat, seizure (convulsions), fainting, or coma. An overdose of Actoplus Met may cause a life-threatening condition called lactic acidosis. Get emergency medical help if you have any of these symptoms of lactic acidosis: weakness, increasing sleepiness, slow heart rate, cold feeling, muscle pain, shortness of breath, stomach pain, feeling light-headed, and fainting.
Additional information
Follow the dietary plan provided by your doctor.
Carry an identification card at all times that says you are diabetic.
Monitor your blood sugar levels regularly according to your doctor's instructions.
If your blood sugar level is often higher than it should be and you are taking this medicine according to directions, check with your doctor.
During times of stress, such as fever, infection, injury or surgery, it may be more difficult to control your blood sugar.
Do not use this medicine for other health conditions.
Drug interactions
Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: birth control pills, bupropion, calcium channel blockers (e.g., nifedipine), cephalexin, cimetidine, corticosteroids (e.g., prednisone), decongestants, other diabetes drugs (e.g., glyburide, acarbose, insulin), estrogens, herbal products (e.g., fenugreek, gymnema, ginseng), isoniazid, niacin, phenothiazines (e.g., chlorpromazine), phenytoin, quinolone antibiotics (e.g., ciprofloxacin), thyroid drugs, "water pills" (diuretics such as hydrochlorothiazide, furosemide), drugs affecting liver enzymes that remove this medication from your body (e.g., gemfibrozil, rifamycins including rifampin).
Beta-blocker medications (e.g., metoprolol, propranolol, glaucoma eye drops such as timolol) may prevent the fast/pounding heartbeat you would usually feel when your blood sugar level falls too low (hypoglycemia). Other symptoms of low blood sugar such as dizziness, hunger, or sweating are unaffected by these drugs.
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