pioglitazone, Actos (cont.)

Pharmacy Author:

Omudhome Ogbru, PharmD

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.

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Medical and Pharmacy Editor:

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.

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SIDE EFFECTS AND PRECAUTIONS: The most common side effects of pioglitazone alone or in combination with sulfonylureas, metformin, or insulin are upper respiratory tract infection, headache, sinusitis, muscle aches, tooth disorders, hypoglycemia, and sore throat.

In addition, dose related fluid accumulation (edema) can occur especially when combined with insulin. Fluid accumulation can worsen or lead to heart failure. Pioglitazone 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. Pioglitazone also can reduce red blood cells.

Pioglitazone has been associated with liver injury. Periodic monitoring of liver-related side effects and liver tests should be conducted in patients taking pioglitazone. Side effects while taking pioglitazone which may be due to liver injury include nausea, vomiting, abdominal pain, fatigue, anorexia (loss of appetite), or dark urine. Liver blood tests also are recommended during pioglitazone therapy.

Pioglitazone 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 pioglitazone, there is an increased risk of bone fractures of the distal bones of the arm and leg. Patients taking pioglitazone should maintain proper bone health.

Reference: FDA Prescribing Information

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