Actos is a brand-name prescription drug. It’s FDA-approved to help control blood sugar levels in adults with type 2 diabetes. The medication should be used along with diet and exercise.

Type 2 diabetes is a condition in which your body doesn’t make enough insulin or doesn’t use insulin properly. This can lead to a high level of sugar in your blood.

You shouldn’t use Actos if you have type 1 diabetes. You also shouldn’t use it if you have diabetic ketoacidosis (a serious problem that occurs when there’s too much acid in your blood).

Actos ingredient and form

Actos contains the active ingredient pioglitazone, which belongs to a class of medications called thiazolidinediones. (A class of medications is a group of drugs that work in a similar way.) These drugs help your cells become more sensitive to insulin. This means the cells can take the sugar from your blood and use it as energy.

Actos comes as a tablet that you swallow, and you’ll likely take it once day. Actos is available in three strengths: 15 mg, 30 mg, and 45 mg.

Effectiveness

For information on the effectiveness of Actos, see the “Actos uses” section below.

Actos is a brand-name medication. It’s also currently available in generic form, which is called pioglitazone.

A generic drug is an exact copy of the active drug in a brand-name medication. The generic is considered to be just as safe and effective as the original drug. Generics also tend to cost less than brand-name drugs.

Actos contains the active drug pioglitazone. (As the active drug, pioglitazone is the ingredient that makes Actos work.)

Actos can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Actos. These lists don’t include all possible side effects.

For more information on the possible side effects of Actos, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to report to the FDA a side effect you’ve had with Actos, you can do so through MedWatch.

Mild side effects

The mild side effects of Actos that are more common* can include:

The mild side effects of Actos that are less common** can include:

* Occurred in 5% or more of people in clinical studies

** Occurred in less than 5% of people in clinical studies

Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Actos aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

Other serious side effects, explained in more detail below in “Side effect details,” include:

* Actos has a boxed warning for CHF. This is the most serious warning from the FDA. For more information, see “FDA warning: Congestive heart failure” at the beginning of this article.

Side effect details

You may wonder how often certain side effects occur with this drug, or whether certain side effects pertain to it.Here’s some detail on several of the side effects this drug may or may not cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Actos. However, it’s not known how many people had an allergic reaction to the medication in clinical trials.

Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth and redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing or speaking

Call your doctor right away if you have a severe allergic reaction to Actos. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Congestive heart failure

CHF* can occur with Actos use. Clinical trials have looked at Actos when the drug was used by itself. People took either Actos or metformin (Glucophage).

  • In the clinical trials, 0.6% of people who took Actos along with metformin were hospitalized for CHF. In comparison, no one who took a placebo (treatment with no active drug) along with metformin was hospitalized.
  • Between 0.5% and 1% of people who took insulin along with Actos were hospitalized for CHF. In comparison, no one who took a placebo along with insulin was hospitalized for CHF.

Actos was also tested with sulfonylurea medications such as glimepiride (Amaryl) or glyburide (DiaBeta).

  • No one who took a sulfonylurea along with Actos was hospitalized for CHF.
  • However, 1.1% of people who took a placebo along with a sulfonylurea were hospitalized for CHF.

CHF is a condition in which your heart can’t pump your blood as well as it should. This can result in fluid building up in your body. CHF can cause many symptoms, including trouble breathing; swelling, especially of the legs and feet; and a change in your heart rate. Actos can also cause edema, which may lead to CHF as well.

If you have any symptoms of CHF while taking Actos, talk with your doctor right away.

* Actos has a boxed warning for CHF. This is the most serious warning from the FDA. For more information, see “FDA warning: Congestive heart failure” at the beginning of this article.

Bladder cancer

Actos use may increase the risk of developing a bladder tumor (mass of tissue), which can be cancerous.

Study results

Studies have shown conflicting results.

  • In clinical trials, about 0.23% of people who took Actos for at least 1 year developed bladder cancer. In comparison, only 0.08% of people who took a placebo developed bladder cancer.
  • However, other studies found no increased risk of developing bladder cancer in people who took Actos. One of the major studies that showed this result followed people for 10 years. Researchers looked at people with type 2 diabetes who had either taken Actos or had never taken the drug. The study found no increased risk in people who took Actos compared with people who did not take Actos.

So it’s possible that taking Actos may increase your risk of developing bladder cancer. But the link between bladder cancer and Actos is still currently being studied.

Symptoms

Symptoms of bladder cancer may include painful urination, pain in the back or abdomen (belly), and blood in the urine.

While you’re taking Actos, it’s important that you watch for these symptoms and tell your doctor if you develop any of them.

If you currently have bladder cancer or had it in the past, talk with your doctor before taking Actos. They may monitor you more closely for symptoms of bladder cancer or recommend a different medication.

Other types of cancer

Actos may also put you at risk for developing other types of cancer. In one study, people who took Actos had an increased risk of developing prostate cancer or pancreatic cancer. However, the link between cancer and Actos needs to be studied more thoroughly.

If you have a history of cancer, especially pancreatic or prostate cancer, talk with your doctor before taking Actos. They may recommend that you take a different medication instead.

Weight gain

Weight gain is a possible side effect of Actos use. In clinical trials over a 16- to 26-week period, researchers found that people who took:

  • 15 mg of Actos a day gained an average of about 2 lb (0.9 kg)
  • 30 mg of Actos a day gained about 2.2 lb (about 1 kg)
  • 45 mg of Actos a day gained about or 5.7 lb (about 2.6 kg)
  • a placebo lost about 3 lb (about 1.4 kg)

Weight gain was related to the dose of Actos that people took. So if you’re taking a higher dose of the medication, you may gain more weight than someone using a lower dose of Actos.

An increase in weight can be due to edema, which may be caused by taking Actos. Weight gain can also be the result of gaining body fat.

Weight loss, on the other hand, wasn’t reported in people who took Actos.

If you begin to gain a lot of weight during your Actos treatment, tell your doctor. They may be able to recommend a diet or exercise plan to help you manage your weight. They may also suggest ways to reduce some of the fluid buildup that may be causing the weight gain.

Edema

Edema, which is swelling due to fluid buildup, is a side effect that may occur during Actos treatment. In one clinical trial, edema occurred in about 27.3% of people who took Actos. In comparison, 15.9% of people who took a placebo had edema.

Edema often occurs in your legs and feet. Symptoms can include:

  • weight gain
  • swelling skin, especially in the feet or ankles
  • headache

If you develop edema while taking Actos, tell your doctor. Although edema may be due to Actos, it can also be a symptom of other conditions such as CHF.* Your doctor will be able to help you determine what is causing your edema and the best way to treat it.

* Actos has a boxed warning for CHF. This is the most serious warning from the FDA. For more information, see “FDA warning: Congestive heart failure” at the beginning of this article.

Macular edema

Macular edema isn’t a side effect that was reported during clinical trials. However, it was reported in post-marketing studies of people who took Actos. These studies are done after the FDA has approved a drug. It’s not known how many people had macular edema while taking Actos.

Macular edema is fluid buildup in a part of your eye called the macula. This can cause blurry vision or colors to look less sharp.

If you notice any vision changes while taking Actos, tell your doctor. They may recommend that you visit an eye doctor or adjust your medication.

The Actos dosage your doctor prescribes will depend on several factors. These include:

Typically, your doctor will start you on a low dosage. Then they’ll adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

* Actos has a boxed warning for CHF. This is the most serious warning from the FDA. For more information, see “FDA warning: Congestive heart failure” at the beginning of this article.

Drug forms and strengths

Actos comes as a tablet that you swallow, and you’ll usually take it once a day. Actos is available in three strengths: 15 mg, 30 mg, and 45 mg.

Dosage for type 2 diabetes

Your doctor will likely have you start taking either a 15-mg or 30-mg dose of Actos once a day. If needed, they may increase the dose by 15 mg for extra control of your blood sugar. The maximum dose of Actos is 45 mg a day.

Your starting dose will depend on if you have other health conditions, such as CHF.* And the dose will be increased over time based on how your body responds.

And in some situations where your body may be very stressed, your doctor may need to change your dose or have you stop taking Actos. So tell your doctor right away if you:

  • have a fever
  • have an infection
  • have had an accident
  • have just had or will have surgery

Never change your dosage of Actos without first talking with your doctor. And before you start taking Actos, be sure to tell them about any medical conditions you have or any other medications that you take. Your doctor will determine what the best dosage is for you.

* Actos has a boxed warning for CHF. This is the most serious warning from the Food and Drug Administration (FDA). For more information, see “FDA warning: Congestive heart failure” at the beginning of this article.

What if I miss a dose?

If you miss your dose, wait and take Actos when your next dose is due. Never take two doses in 1 day. If you have questions on when to take your next dose of Actos after you’ve missed a dose, talk with your doctor or pharmacist.

To help make sure that you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Will I need to use this drug long term?

Actos is meant to be used as a long-term treatment. If you and your doctor determine that Actos is safe and effective for you, you’ll likely take it long term.

Here are answers to some frequently asked questions about Actos.

Is Actos safe to take?

Yes, Actos was approved by the Food and Drug Administration (FDA) as safe and effective for the treatment of type 2 diabetes. However, you shouldn’t use Actos if you have type 1 diabetes or diabetic ketoacidosis (a problem that occurs when there’s too much acid in your blood).

Very rarely, Actos can cause serious side effects that may require you to stop taking it. One of these rare side effects is macular edema, which is fluid buildup in part of your eye. (See the “Actos side effects” section above to learn more.)

And before using Actos, it’s important to tell your doctor about any medical conditions or other medications that you take. Some conditions such as congestive heart failure (CHF)* or liver failure may worsen during your treatment. Also, some medications may interact with Actos, causing you to have too much or too little of the drug in your body. (To learn more, see the “Actos side effects” and “Actos interactions” sections.)

If you have any questions about the safety of Actos, talk with your doctor.

* Actos has a boxed warning for CHF. This is the most serious warning from the FDA. For more information, see “FDA warning: Congestive heart failure” at the beginning of this article.

What happens if I suddenly stop using Actos?

If you suddenly stop using Actos, your blood sugar may increase. And this may cause your type 2 diabetes symptoms to get worse.

Keep in mind that you shouldn’t stop taking Actos without first talking with your doctor. Although there are no known withdrawal symptoms from stopping Actos use, your doctor will determine if it’s safe for you to stop taking the drug. They may also give you a different medication instead of Actos.

If you have any questions about ending your Actos treatment, talk with your doctor.

How long does Actos stay in your system?

After you take a dose of Actos, your body begins breaking down the medication. Your system gets rid of a dose of Actos within 3 to 24 hours after you take it. However, it may be a few days until all of the drug is completely out of your system.

Does Actos cause hair loss?

Hair loss isn’t a side effect that was seen in clinical trials of Actos.

In fact, low doses of Actos are sometimes used off-label to treat a certain type of hair loss called primary cicatricial alopecia (PCA). Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

With PCA, your hair follicles (sacs under your skin that hold the roots of your hair) are destroyed. As a result, your hair can’t grow as it normally should. Some studies have suggested that Actos may be useful in preventing PCA from getting worse.

If you’re concerned about hair loss, talk with your doctor. They can recommend treatments that may help.

Can Actos or other similar drugs cause heart attacks?

Taking Actos or similar drugs called thiazolidinediones, which are in the same class as Actos, doesn’t increase your risk of having a heart attack. (A drug class is a group of medications that work in similar way.)

Heart attacks have occurred in people who have used Actos, but the drug doesn’t cause heart attacks or make you any more likely to have them. In clinical trials, about 4% of people who took Actos had a heart attack. This was compared with 4.5% of people who took a placebo (treatment with no active drug).

However, it’s possible to develop CHF* while you’re taking Actos. (For more about CHF, see the “Side effect details” section above.)

During your Actos treatment, it’s important to tell your doctor if you have CHF symptoms such as swelling of the feet or legs, or trouble breathing.

* Actos has a boxed warning for CHF. This is the most serious warning from the FDA. For more information, see “FDA warning: Congestive heart failure” at the beginning of this article.

The Food and Drug Administration (FDA) approves prescription drugs such as Actos to treat certain conditions. Actos may also be used off-label for other conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Actos for type 2 diabetes

Actos is FDA-approved to help control blood sugar levels in adults with type 2 diabetes. The medication should be used along with diet and exercise.

You shouldn’t take Actos if you have type 1 diabetes or diabetic ketoacidosis (a serious problem that occurs when there’s too much acid in your blood).

Type 2 diabetes explained

Type 2 diabetes is a condition in which there’s a high level of glucose (sugar) in your blood.

Your pancreas makes a hormone called insulin, which takes glucose out of your blood and helps you use the sugar as a source of energy. With type 2 diabetes, either your pancreas isn’t making enough insulin to remove the sugar from your blood or the insulin isn’t working properly. This is why people with type 2 diabetes have high blood sugar levels.

It’s very important to treat type 2 diabetes as soon as possible. A high level of sugar in your blood can cause serious complications. These include:

Actos works to decrease the amount of sugar in your blood so that you don’t develop complications from diabetes.

Actos effectiveness

In clinical trials, Actos was shown to be an effective medication in treating type 2 diabetes.

Fasting blood glucose

Clinical trials have shown that Actos has helped lower fasting blood glucose levels.

Fasting blood glucose is a blood sample that’s taken first thing in the morning before you eat anything (while you’re fasting). The measure tests how much sugar is in your blood. Usually, a fasting blood glucose level should be below 100 mg/dL. However, in people with diabetes, this level may be much higher.

In clinical trials of type 2 diabetes, people who took just Actos with no other diabetes medications saw a decrease in their fasting blood glucose levels. Three studies were done that ranged from 16 to 26 weeks long. People took either Actos or a placebo (treatment with no active drug).

  • In the Actos group, fasting blood glucose levels decreased by 30 mg/dL to 56 mg/dL.
  • The placebo group actually had an increase in their fasting blood glucose levels of 8 mg/dL to 18 mg/dL.

Hemoglobin A1c

Hemoglobin A1c (HbA1c) is another measure used to monitor diabetes. It shows the average blood sugar level for about the past 3 months. Clinical trials looked at people with type 2 diabetes who took Actos or a placebo.

  • In people who took Actos, HbA1c levels decreased by 0.3% to 0.9%.
  • In comparison, people who took a placebo had their HbA1c levels actually increase by 0.7% to 0.9%.

Actos when used with other medications

Actos can also be used along with other medications to treat type 2 diabetes.

In clinical trials, Actos was tested with metformin (Glucophage), insulin, or sulfonylureas. Sulfonylureas are a class of medications used to treat diabetes. (A class of medications is a group of drugs that work in a similar way.) Examples of sulfonylureas include: glyburide (DiaBeta), glimepiride (Amaryl), and glipizide (Glucotrol).

Actos and metformin: Clinical studies of type 2 diabetes looked at people who took Actos and metformin or a placebo and metformin.

  • In the Actos/metformin group, fasting blood glucose levels decreased by about 43 mg/dL. And their HbA1c levels decreased by 0.6%.
  • In comparison, fasting blood glucose levels dropped by only 5 mg/dL in the placebo/metformin group. And the HbA1c levels actually increased by 0.2%.

Actos and insulin: Actos was also tested with insulin in people with type 2 diabetes.

  • In people who took Actos and insulin, fasting blood glucose levels decreased by 35 mg/dL and 48 mg/dL. HbA1c levels also decreased by 1% and 1.3%.
  • In comparison, people who took a placebo along with insulin had an increase in their fasting blood glucose levels of 1 mg/dL. They also had a slight decrease in their HbA1c levels of 0.3%.

Actos and sulfonylureas: In another comparison trial, Actos was tested when used along with sulfonylureas in people with type 2 diabetes.

  • People who took Actos plus any sulfonylurea medication had a decrease in their fasting blood glucose levels of 34 mg/dL and 52 mg/dL. They also had a decrease in their HbA1c levels of 0.8% and 1.2%.
  • In comparison, people who took a placebo along with a sulfonylurea medication had an increase in their fasting blood glucose levels of 6 mg/dL. They also had an increase in their HbA1c levels of about 0.1%.

For more information on the effectiveness of Actos to treat your type 2 diabetes, talk with your doctor or pharmacist.

Off-label use for Actos

In addition to the use listed above, Actos may be used off-label for other uses. Off-label drug use is when a drug that’s approved for one use is used for a different one that’s not approved. One such use is nonalcoholic fatty liver disease (NAFLD).

Nonalcoholic fatty liver disease (under study)

NAFLD is a condition in which fat can gather in your liver and damage it, possibly causing scarring.

NAFLD isn’t a liver condition that’s caused by excess drinking. Almost everyone who develops NAFLD also has insulin resistance. This is a condition where cells don’t respond to insulin, causing an increased level of sugar in your blood.

Studies have shown that Actos may help decrease fibrosis liver scarring and help your body become more sensitive to insulin. However, clinical trials such as this one are still being held to determine if Actos is a safe and effective treatment for NAFLD.

Other drugs are available that can treat type 2 diabetes. Some may be a better fit for you than others. If you’re interested in finding an alternative to Actos, talk with your doctor. They can tell you about other medications that may work well for you.

Sometimes these medications may be used along with Actos to help control your blood glucose level.

Note: Some of the drugs listed here are used off-label to treat these specific conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Alternatives for type 2 diabetes

Here are some examples of other drugs that may be used to treat type 2 diabetes.

You may wonder how Actos compares with other medications that are prescribed for similar uses. Here we look at how Actos and metformin (Glucophage) are alike and different.

Ingredients

The active drug ingredient in Actos is pioglitazone. Metformin is a generic drug that’s also available as the brand-name medication Glucophage. Metformin contains the active drug ingredient metformin.

Uses

The Food and Drug Administration (FDA) has approved both Actos and metformin to help control blood sugar levels in adults with type 2 diabetes. The medications should be used along with diet and exercise.

However, metformin is also approved for use in children ages 10 years and older with type 2 diabetes.

You shouldn’t use Actos or metformin if you have diabetic ketoacidosis (a serious problem that occurs when there’s too much acid in your blood). You also shouldn’t use Actos if you have type 1 diabetes.

Metformin also comes in an extended-release (ER) form, which is approved for use only in adults.

Drug forms and administration

Both Actos and metformin are tablets that you swallow.

Actos is taken once a day with or without food. Metformin is taken once or twice a day with a meal.

Side effects and risks

Actos and metformin both treat type 2 diabetes. Therefore, these medications can cause some very similar side effects, but some different ones as well. Below are examples of these side effects.

Mild side effects

These lists contain examples of mild side effects that can occur with Actos, with metformin, or with both drugs (when taken individually).

Serious side effects

These lists contain examples of serious side effects that can occur with Actos, with metformin, or with both drugs (when taken individually).

* Actos has a boxed warning for CHF. This is the most serious warning from the FDA. For more information, see “FDA warning: Congestive heart failure” at the beginning of this article.

** Metformin has a boxed warning for lactic acidosis. This is the most serious warning from the FDA.

Effectiveness

The only condition both Actos and metformin are used to treat is type 2 diabetes.

The use of Actos and metformin in treating type 2 diabetes has been directly compared in clinical studies.

Fasting blood glucose levels

Researchers looked at fasting blood glucose. This is a blood sample that’s taken first thing in the morning before you eat anything (while you’re fasting). The measure tests how much sugar is in your blood. Usually, a fasting blood glucose level should be below 100 mg/dL. However, in people with diabetes, this level may be much higher.

  • In people who took Actos with metformin, their fasting blood glucose levels decreased by 43 mg/dL.
  • In comparison, people who took a placebo (treatment with no active drug) with metformin had their glucose levels drop by only 5 mg/dL.

Hemoglobin A1c

Hemoglobin A1c (HbA1c) is another measure used to monitor diabetes. It shows the average blood sugar level for about the past 3 months.

In the studies mentioned above, HbA1c levels changed.

  • HbA1c levels decreased by 0.8% in people who took Actos along with metformin.
  • In people who took metformin along with a placebo, their HbA1c levels actually increased by 0.2%.

Combination drug

Actos can also be used along with metformin as combination therapy to treat type 2 diabetes. Studies have shown that these two medications can be effective when used together. There is a combination drug called Actoplus Met that contains both the active drug in Actos (pioglitazone) and metformin.

Costs

Actos is a brand-name drug. It comes in a generic form called pioglitazone.

Metformin is a generic drug. It also comes as a brand-name medication called Glucophage.

Brand-name medications usually cost more than generics.

According to estimates on GoodRx.com, Actos costs significantly more than the generic drug metformin and the brand-name form of metformin (Glucophage). The generic form of Actos (pioglitazone) also costs significantly more than metformin. The actual price you’ll pay for any of these drugs depends on your insurance plan, your location, and the pharmacy you use.

Like metformin (above), the drug Januvia has uses similar to those of Actos. Here’s a comparison of how Actos and Januvia are alike and different.

Ingredients

The active drug ingredient in Actos is pioglitazone. The active drug ingredient in Januvia is sitagliptin.

Uses

The Food and Drug Administration (FDA) has approved both Actos and Januvia to help control blood sugar levels in adults with type 2 diabetes. The medications should be used along with diet and exercise.

You shouldn’t use Actos or Januvia if you have type 1 diabetes or diabetic ketoacidosis (a serious problem that occurs when there’s too much acid in your blood).

Drug forms and administration

Both Actos and Januvia are tablets that you swallow. They’re taken once a day with or without food.

Side effects and risks

Actos and Januvia both treat type 2 diabetes. Therefore, these medications can cause very similar side effects, but some different ones as well. Below are examples of these side effects.

Mild side effects

These lists contain examples of mild side effects that can occur with Actos, with Januvia, or with both drugs (when taken individually).

Serious side effects

These lists contain examples of serious side effects that can occur with Actos, with Januvia, or with both drugs (when taken individually).

* Actos has a boxed warning for CHF. This is the most serious warning from the Food and Drug Administration (FDA). For more information, see “FDA warning: Congestive heart failure” at the beginning of this article.

Effectiveness

The only condition both Actos and Januvia are used to treat is type 2 diabetes.

The use of Actos and Januvia in treating type 2 diabetes has been directly compared in a clinical study. People took metformin (Glucophage) and Actos or metformin (Glucophage) and Januvia.

Hemoglobin A1c (HbA1c) is measure used to monitor diabetes.

Researchers compared the drugs by looking at HbA1c levels. These show the average blood sugar level for about the past 3 months. Both Actos and Januvia were shown to be effective in decreasing HbA1c levels when used with metformin.

  • People who took Actos along with metformin had a decrease of about 0.75% in their HbA1c levels.
  • People who took Januvia and metformin had a decrease of 0.66% in their HbA1c levels.

Costs

Actos and Januvia are both brand-name drugs. There is currently a generic form of Actos called pioglitazone. There is no generic form of Januvia. Brand-name medications usually cost more than generics.

According to estimates on GoodRx.com, Actos generally costs more than Januvia. However, the generic form of Actos (pioglitazone) costs significantly less than Actos or Januvia. The actual price you’ll pay for any of these drugs depends on your insurance plan, your location, and the pharmacy you use.

Actos can interact with several other medications. It’s not known to interact with supplements or foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase the number of side effects or make them more severe.

Actos and other medications

Below is a list of medications that can interact with Actos. This list doesn’t contain all drugs that may interact with Actos.

Before taking Actos, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

Actos and other diabetes medications

Sometimes your doctor may prescribe Actos along with other medications for your type 2 diabetes, such as glyburide (DiaBeta) or insulin. However, this may put you at risk for developing hypoglycemia (low blood sugar).

Hypoglycemia can cause symptoms such as dizziness, sweating, and headache. In severe cases, you may have serious complications such as a seizure or passing out.

Before starting Actos treatment, it’s important to tell your doctor what other medications you’re taking.

You should also talk with your doctor about what to do if you develop symptoms of hypoglycemia, especially if you’re taking multiple diabetes medications.

Actos and gemfibrozil

Gemfibrozil (Lopid) may interact with Actos. If you’re taking gemfibrozil, the level of Actos in your body will rise. Gemfibrozil can also increase the amount of time that Actos stays in your body.

If there’s too much Actos in your body and you’re also taking other diabetes medications such as insulin, your blood sugar can get too low. This can cause symptoms such as dizziness or sweating.

Before you start taking Actos, have your doctor review your all medications. They can adjust your treatment as needed.

Actos and rifampin

Taking rifampin (Rimactane) along with Actos may decrease the level of Actos in your body. This means that you may not get enough Actos, and it may not work to treat your type 2 diabetes.

If you start or stop taking rifampin while using Actos, your doctor may need to change your dose of Actos.

Actos and topiramate

If you take Actos along with topiramate (Topamax, Trokendi XR, Qudexy XR), the level of Actos in your body may decrease. This means that the Actos may not work well to treat your type 2 diabetes.

If you’re taking topiramate and Actos, talk with your doctor. They may recommend changing your dose of Actos or monitoring your blood glucose more often to be sure that Actos is working for you.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Actos and herbs and supplements

There aren’t any herbs or supplements that have been specifically reported to interact with Actos. However, you should still check with your doctor or pharmacist before using any of these products while taking Actos.

Actos and foods

There aren’t any foods that have been specifically reported to interact with Actos. If you have any questions about eating certain foods with Actos, talk with your doctor.

You should take Actos according to your doctor’s or healthcare provider’s instructions.

Actos comes as a tablet that you swallow.

When to take

You’ll take Actos once a day. Try to take this medication at about the same time each day.

Don’t take more than one dose in a day.

To help make sure that you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Taking Actos with food

You can take Actos tablets with or without food.

Can Actos be crushed, split, or chewed?

No, you shouldn’t break, crush, split, or chew Actos tablets. Broken tablets haven’t been studied, so it’s not known if it’s safe to take a tablet that’s broken.

If you’re having trouble swallowing your Actos tablets, talk with your doctor. They may be able to suggest ways to help you take your medication or recommend other drugs that may be easier for you to take.

Actos is a medication that’s used to treat type 2 diabetes. This is a condition in which where your body has a high level of glucose (sugar) in your blood. Your pancreas normally makes a hormone called insulin, which takes glucose out of your blood and helps you use the sugar as a source of energy. With type 2 diabetes, your pancreas may not be making enough insulin to remove the sugar from your blood.

And if you have type 2 diabetes, your cells may also become insulin resistant. This means that your body makes insulin but isn’t responding to it by removing the sugar from your blood. So people with type 2 diabetes have high blood sugar levels.

What Actos does

Actos works by making your cells more sensitive to insulin. The goal is for your cells to take the glucose in your blood and use it more effectively as an energy source. Because you’re using your glucose more effectively, your blood glucose levels will decrease.

This lowers your risk of serious complications of type 2 diabetes, including heart disease, nerve damage such as neuropathy, and kidney failure.

How long does it take to work?

After you start using Actos, it may take 7 days or longer before you notice any changes in your blood glucose level. It’s important to keep taking Actos every day so that it can have the best chance to work in your body.

Depending on how well your blood glucose (sugar) is managed, your doctor may have you take Actos with other medications to treat your type 2 diabetes.

These medications may be drugs that you take by mouth, such as metformin (Glucophage), or injectable drugs such as insulin.

To determine the best medications for your diabetes, your doctor will monitor your blood glucose and hemoglobin A1c (HbA1c) levels. HbA1c shows your average blood sugar level for about the past 3 months.

Alcohol can cause hypoglycemia (low blood sugar), which may worsen when you’re taking Actos. So if your blood glucose (sugar) levels aren’t well managed, your doctor may recommend that you avoid alcohol altogether. But if your blood glucose levels are well managed, they may recommend a safe amount of alcohol that you can drink.

Before you start taking Actos, talk with your doctor what amount of alcohol is safe for you to drink during your treatment.

As with all medications, the cost of Actos can vary. To find current prices for Actos in your area, check out GoodRx.com.

The cost you find on GoodRx.com is what you may pay without insurance. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Your insurance plan may require you to get prior authorization before approving coverage for Actos. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the request and let you and your doctor know if your plan will cover Actos.

If you’re not sure if you’ll need to get prior authorization for Actos, contact your insurance company.

Financial assistance

If you need financial support to pay for Actos, help is available. NeedyMeds lists programs that may provide assistance to lower the cost of Actos. For more information and to find out if you’re eligible for support, visit the website.

It’s not known if Actos is safe to take during pregnancy. In animal studies, there were no birth defects noted in pregnant animals who were given high doses of Actos. However, animal studies don’t always show what will happen in humans.

It’s important to keep your type 2 diabetes well managed during pregnancy. Unmanaged diabetes can cause risks to both the mother and developing baby. These risks can include birth defects, high blood pressure, and miscarriage.

If you’re pregnant or planning to become pregnant, talk with your doctor before starting Actos treatment. They can review the benefits and risks of the medication with you. Your doctor can also advise you on how to best manage diabetes while pregnant.

It’s not known if Actos is safe to take during pregnancy.

It’s possible that women with irregular periods who are taking Actos may ovulate (release an egg during the menstrual cycle). This may lead to pregnancy.

If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Actos.

For more information about taking Actos during pregnancy, see the “Actos and pregnancy” section above.

It’s not known if Actos can pass into human breast milk. In animal studies, animals that were given Actos did have the drug present in their breast milk. However, animal studies don’t always show what will happen in humans.

If you’re breastfeeding or are planning to breastfeed, talk with your doctor before you start taking Actos. They can review the best ways to feed your child and your medication options.

This drug comes with several precautions.

FDA warning: Congestive heart failure

This drug has a boxed warning. This is the most serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.

Actos can cause new or worsening congestive heart failure (CHF), a condition in which your heart can’t pump blood as well as it should. This can cause fluid to build up in your body.

Symptoms of CHF include quick weight gain; trouble breathing; and swelling, especially in the legs and feet. Your doctor will monitor you for symptoms of CHF after you start taking Actos and if they increase your dose. If you develop CHF while taking Actos, your doctor may decrease your dose or have you stop taking the medication.

You shouldn’t take Actos if you already have CHF with symptoms. You also shouldn’t use the drug if you have heart failure that’s classified as New York Heart Association Class III or IV. (These are more serious classes of heart failure.)

Other precautions

Before taking Actos, talk with your doctor about your health history. Actos may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Osteoporosis. Actos can cause an increased risk of bone fractures. So if you already have osteoporosis (fragile bones) and take Actos, you have an even higher risk of developing a fracture or break. If you have a history of osteoporosis, talk with your doctor before taking Actos. They can review your medications and adjust them as needed.
  • Bladder cancer. If you’re being treated for bladder cancer, you shouldn’t take Actos. This is because Actos may increase your risk for developing bladder cancer. If you have a history of bladder cancer, talk with your doctor about it before taking Actos. They may recommend extra monitoring of your bladder or suggest a different medication to treat your type 2 diabetes.
  • Liver failure. It’s possible that Actos may cause liver failure or make current liver conditions, such as cirrhosis, worse. If you have any liver conditions, talk with your doctor before taking Actos. They may recommend more monitoring, a lower dose of Actos, or a different medication altogether.
  • Irregular periods. If you have irregular periods and are taking Actos, you may ovulate (release an egg during the menstrual cycle). This may lead to pregnancy. See the “Actos and birth control section” above to learn more.
  • Pregnancy. It’s not known if Actos is safe to take during pregnancy. For more information, please see the “Actos and pregnancy” section above.
  • Breastfeeding. It’s not known if Actos is safe to take while breastfeeding. For more information, please see the “Actos and breastfeeding” section above.
  • Allergic reaction. If you’re allergic to Actos or any of its ingredients, you shouldn’t use Actos. Ask your doctor what other treatments are better choices for you.

Note: For more information about the potential negative effects of Actos, see the “Actos side effects” section above.

Using more than the recommended dosage of Actos can lead to serious side effects. There was one case of someone taking too much Actos in clinical trials. However, no symptoms of overdose were reported.

Don’t use more Actos than your doctor recommends.

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

When you get Actos from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk with your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

You should store Actos tablets at room temperature (77°F/25°C) in a tightly sealed container away from light. If needed, you can keep the tablets between 59°F and 86°F (15°C and 30°C) for short periods of time.

Avoid storing this medication in areas where it could get damp or wet, such as bathrooms. It should be protected from humidity and moisture.

Disposal

If you no longer need to take Actos and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

This article provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

The following information is provided for clinicians and other healthcare professionals.

Indications

Actos is indicated for use in the treatment of adults with type 2 diabetes. It should not be used to treat patients with type 1 diabetes or with diabetic ketoacidosis.

Mechanism of action

Actos belongs to a class of medications called thiazolidinediones. These drugs work by acting on peroxisome proliferator-activated receptor (PPAR) gamma. PPAR gamma is a receptor that is responsible for controlling insulin sensitivity.

Actos works by agonizing PPAR gamma, which then gets rid of glucose in the body by decreasing insulin resistance. Actos is dependent on the presence of insulin to work properly. This is why it is not indicated for use in type 1 diabetes.

Pharmacokinetics and metabolism

Actos takes about 2 hours to reach maximum concentration after a dose. Taking Actos along with food may make the medication absorb more slowly (about 3 to 4 hours to maximum concentration). However, this does not change the overall absorption of the drug.

Steady-state levels of Actos are reached about 7 days after once-daily dosing. It is about 99% protein bound, mostly to albumin.

Actos is mainly hydroxylated and oxidated in the liver. Cytochrome P450 enzymes, especially CYP2C8, may also play a role in the metabolism of Actos. Other CYP enzymes that may be involved are CYP3A4 and CYP1A1.

Excretion occurs in the bile of the liver. About 15% to 30% of the excretion of Actos is present in the urine. The half-life of Actos is between 3 and 7 hours. The half-life of the major metabolites of Actos is between 16 and 24 hours.

Contraindications

Actos is contraindicated for use in patients with New York Heart Association (NYHA) class III or IV heart failure. This is because Actos can cause new onset or worsening heart failure. If a patient already has severe heart failure, using Actos is contraindicated.

Actos is also contraindicated in patients with a history of allergic reaction to pioglitazone or any excipients in the Actos tablet.

Storage

Actos tablets should be stored at room temperature, at 77°F (25°C) in a tightly sealed container away from light. If needed, the tablets could be stored between 59°F and 86°F (15°C and 30°C). Actos tablets should be protected from humidity and moisture.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.