Pioglitazone may cause or worsen congestive heart failure (condition in which the heart is unable to pump enough blood to the other parts of the body). Tell your doctor if you have or have ever had congestive heart failure, especially if your heart failure is so severe that you must limit your activity and are only comfortable when you are at rest or you must remain in a chair or bed. Also tell your doctor if you were born with a heart defect, and if you have or have ever had swelling of the arms, hands, feet, ankles, or lower legs; heart disease; high cholesterol or fats in the blood; high blood pressure; coronary artery disease (narrowing of the blood vessels that lead to the heart); a heart attack; an irregular heartbeat; or sleep apnea. Your doctor may tell you not to take pioglitazone or may monitor you carefully during your treatment.
If you experience any of the following symptoms, call your doctor immediately: large weight gain in a short period of time; shortness of breath; swelling of the arms, hands, feet, ankles, or lower legs; swelling or pain in the stomach; waking up short of breath during the night; needing to sleep with extra pillows under your head in order to breathe easier while lying down; frequent dry cough or wheezing; difficulty thinking clearly or confusion; fast or racing heart beat; not able to walk or exercise as well; or increased tiredness.
You will be given the Medication Guide. Read the information carefully and ask your doctor or pharmacist if you have any questions.
Talk to your doctor about the risks of taking pioglitazone.
Why is this medicine prescribed?
Pioglitazone is used to treat type 2 diabetes (condition in which blood sugar is too high because the body does not make or use insulin normally). Pioglitazone is in a class of medications called thiazolidinediones (TZDs). It works by increasing the body's sensitivity to insulin (a natural substance that helps control blood sugar levels).
Are there other uses for this medicine?
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
How should this medicine be used?
Pioglitazone comes as a tablet to take by mouth. Take with or without food once a day. Take pioglitazone at around the same time every day.
Take pioglitazone exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Your doctor may start you on a low dose of pioglitazone and gradually increase your dose.
Pioglitazone controls type 2 diabetes but does not cure it. It may take 2 weeks for your blood sugar to decrease and 2 to 3 months for you to see the full effect of pioglitazone. Continue to take pioglitazone even if you feel well. Do not stop taking pioglitazone without talking to your doctor.
What special precautions should I follow?
Before taking pioglitazone,
- tell your doctor and pharmacist if you are allergic to this medication, any part of this medication, or any other medications, foods or substances. Tell your doctor or pharmacist about the allergy and what symptoms you had.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements and herbal products you are taking or plan to take while taking pioglitazone. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- you should know the following nonprescription products may interact with pioglitazone: fexofenadine, ranitidine . Be sure to let your doctor and pharmacist know that you are taking these medications before you start taking pioglitazone. Do not start any of these medications while taking pioglitazone without discussing with your healthcare provider.
- tell your doctor if you have or have ever had any of the conditions mentioned in the IMPORTANT WARNING section, or if you have or have ever had bladder cancer, diabetic eye disease, type 1 diabetes, or kidney or liver disease.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking pioglitazone, call your doctor.
- if you have not yet experienced menopause (change of life; end of monthly periods) you should know that pioglitazone may increase the chance that you will become pregnant even if you do not have regular monthly periods or if you have a condition that prevents you from ovulating (releasing an egg from the ovaries). Talk to your doctor about the best birth control method for you.
- ask your doctor what to do if you get sick, develop an infection or fever, experience unusual stress, or are injured. These conditions can affect your blood sugar and the amount of pioglitazone you may need.
- you should know this medication may cause low blood sugar events especially if it is being used in combination with other blood sugar lowering medications. You should know the symptoms of low blood sugar (shakiness, nervousness, sweating, chills irritability, confusion, fast heart beat, feeling lightheaded or dizzy, hunger, headaches, nausea, blurred vision, or feeling weak). If you have these symptoms, consume about 15 grams of carbs [ex. half cup of juice or regular soda] every 15 minutes until your blood sugar has returned to normal.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking pioglitazone.
- ask your doctor about the safe use of alcoholic beverages while you are taking pioglitazone.
What special dietary instructions should I follow?
Be sure to follow all exercise and dietary recommendations made by your doctor or dietitian. It is important to eat a healthy diet, exercise regularly, and lose weight if necessary.
What should I do if I forget to take a dose?
If you remember that same day, take the missed dose as soon as you remember it. However, if you do not remember until the next day, skip the missed dose and continue your regular dosing schedule. Do not take more than one dose in one day and do not take a double dose to make up for a missed one.
What should I do in case of overdose?
In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help . If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.
What side effects can this medicine cause?
Pioglitazone may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- runny or stuffy nose, cough, sneezing
- headache
- muscle pain
- pain in the arms or legs
- sore throat
- gas
Some side effects can be serious. If you experience any of the following symptoms or those mentioned in the IMPORTANT WARNING section, call your doctor immediately:
- changes in vision, vision loss
- frequent, painful, or difficult urination; cloudy, discolored, or bloody urine
- nausea, vomiting, loss of appetite, pain in the upper right part of the stomach, dark urine, yellowing of the skin or eyes,
Pioglitazone may increase the risk of bladder cancer or a fracture, especially in the hands, upper arms, or feet. Talk to your doctor about the risk of taking this medication.
Pioglitazone may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online ( https://www.fda.gov/Safety/MedWatch ) or by phone ( 1-800-332-1088).What should I know about storage and disposal of this medication?
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat, light, and moisture (not in the bathroom).
Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website https://goo.gl/c4Rm4p for more information. Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location – one that is up and away and out of their sight and reach. https://www.upandaway.orgWhat other information should I know?
Keep all appointments with your doctor, your eye doctor, and the laboratory. Your doctor will order regular eye examinations and certain laboratory tests before and during your treatment to check your body's response to pioglitazone.
You should always wear a diabetic identification bracelet to be sure you get proper treatment in an emergency.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.