Heart Failure
Actoplus Met can cause or worsen congestive heart failure because pioglitazone may cause the body to retain fluid.
The risk may be higher if you already have heart disease.
Contact your healthcare provider right away if you develop:
- Shortness of breath
- Rapid weight gain
- Swelling in the legs, ankles, or feet
- Unusual tiredness
Actoplus Met carries a boxed warning about this risk.
Lactic Acidosis
Metformin can rarely cause a serious condition called lactic acidosis.
This happens when too much lactic acid builds up in the blood and can be life-threatening.
Seek emergency medical attention if you develop symptoms such as:
- Severe weakness or tiredness
- Muscle pain
- Trouble breathing
- Stomach pain
- Feeling unusually cold
- Dizziness or lightheadedness
- A slow or irregular heartbeat
The risk is higher in people with severe kidney problems and certain other medical conditions.
Liver Problems
Tell your healthcare provider if you have liver disease or abnormal liver test results.
Your healthcare provider may check your liver function before and during treatment.
Contact your healthcare provider if you develop yellowing of the skin or eyes, dark urine, severe tiredness, or persistent nausea.
Bladder Cancer
Pioglitazone has been associated with a possible increased risk of bladder cancer.
Actoplus Met may not be appropriate if you have active bladder cancer.
Tell your healthcare provider if you have a history of bladder cancer.
Contact your healthcare provider if you notice:
- Blood in your urine
- Pain when urinating
- A sudden need to urinate more often
Low Blood Sugar
Actoplus Met does not usually cause low blood sugar when used by itself.
However, the risk can increase when it is taken with other diabetes medications, such as insulin or sulfonylureas.
Signs of low blood sugar may include:
- Sweating
- Shaking
- Hunger
- Dizziness
- Confusion
- Fast heartbeat
Check your blood sugar as directed by your healthcare provider.
Fluid Retention and Swelling
Pioglitazone can cause the body to retain fluid.
This may lead to swelling in the legs, ankles, or feet and may worsen heart failure.
Tell your healthcare provider if you develop new or worsening swelling or sudden weight gain.
Bone Fractures
Pioglitazone may increase the risk of bone fractures, particularly in women.
Talk to your healthcare provider about ways to protect your bone health if you have other risk factors for fractures.
Pregnancy
Tell your healthcare provider if you are pregnant or planning to become pregnant.
Your diabetes treatment may need to be changed during pregnancy to maintain good blood sugar control.
Pioglitazone may also cause ovulation in some women who previously did not ovulate regularly, which may increase the chance of becoming pregnant.
Breastfeeding
Tell your healthcare provider if you are breastfeeding.
Your healthcare provider will decide whether Actoplus Met is appropriate based on your treatment needs and the possible risks to your baby.
Kidney Problems
Metformin is removed from the body through the kidneys.
Poor kidney function can increase the risk of metformin buildup and lactic acidosis.
Your healthcare provider should check your kidney function before starting Actoplus Met and periodically during treatment.
Drug Interactions
Tell your healthcare provider about all prescription medications, over-the-counter products, vitamins, and supplements you take.
Actoplus Met may interact with:
- Insulin or other diabetes medications
- Certain diuretics
- Steroids
- Some seizure medications
- Certain antibiotics
- Gemfibrozil
- Rifampin
- Medications that can affect kidney function
Some combinations may change your blood sugar levels or increase the risk of side effects.
When to Contact Your Healthcare Provider
Contact your healthcare provider if you develop severe swelling, rapid weight gain, shortness of breath, blood in your urine, repeated low blood sugar, or symptoms of liver or kidney problems.
Seek emergency medical care if you develop symptoms of lactic acidosis or severe breathing problems.
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