Actos (pioglitazone)

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

What is Actos (pioglitazone)?

  • Pioglitazone is an oral drug that reduces the amount of glucose (sugar) in the blood. It is in a class of anti-diabetic drugs called thiazolidinediones that are used in the treatment of type 2 diabetes. The other member in this class is rosiglitazone (Avandia). (Another member of this class, troglitazone or Rezulin, was removed from the market because of liver toxicity.)

Is Actos (pioglitazone) available as a generic drug?

Yes

Do I need a prescription for Actos (pioglitazone)?

Yes

Why is Actos (pioglitazone) prescribed to patients?

  • Actos is used for the treatment of type 2 diabetes in adults. It is used along with a healthy diabetic diet, regular exercise, weight control, smoking reduction, and careful monitoring of blood glucose.
  • Actos may be used alone or in combination with metformin (Glucophage, Glucophage XR, Glumetza, Fortamet, Riomet), a drug in a different class of anti-diabetic drugs, that also lowers blood glucose.
  • Actos requires naturally-secreted insulin to be effective so it is not recommended in type 1 diabetes where the amount of insulin is very low or absent.
  • Nevertheless, Actos is approved for treating type 2 diabetes in combination with insulin as well as another class of diabetes drugs, the sulfonylureas, that increases the amount of insulin produced.

What are the side effects of Actos (pioglitazone)?

ACTOS BLACK BOX WARNING
  • Actos and similar drugs can cause or women congestive heart failure in some patients.
  • Patients should be monitored for signs and symptoms of heart failure (for example, excessive, rapid weight gain, dyspnea, and/or edema) at the beginning of treatment and after dose increases.
  • Actos is not recommended for patients with symptomatic heart failure and patients with established New York Heart Association (NYHA) Class III or IV heart failure should not use Actos.
Other side effects of Actos

The most common side effects of Actos alone or in combination with sulfonylureas, metformin, or insulin are:

Possible serious side effects of Actos include:

Dose related fluid accumulation (edema) can occur especially when combined with insulin. Fluid accumulation can worsen or lead to heart failure. Actos should not be used in patients with heart disease classified by the New York Heart Association (NYHA) as Class III and IV heart failure or symptomatic heart failure.

Fluid accumulation also may lead to macular edema, resulting in reduced vision. Actos also can reduce red blood cells.

There have been post-marketing reports of liver failure while taking Actos.

Actos has been associated with liver injury. Periodic monitoring of liver-related side effects and liver tests should be conducted in patients taking Actos.

Symptoms of liver injury are:

Actos should be stopped if patients have symptoms of liver injury and liver function test results that are greater than three times the normal level. Liver blood tests are obtained before starting treatment. Monitoring liver tests during treatment is not recommended for patients without liver disease.

Actos may cause ovulation in women who have stopped ovulating if they are premenopausal and insulin resistant. This may lead to pregnancy. For women (but not men) taking Actos, there is an increased risk of bone fractures of the distal bones of the arm and leg. Patients taking Actos should maintain proper bone health.

Medically Reviewed by a Doctor on 11/1/2016

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