Pioglitazone (Oral)

Pioglitazone is an oral diabetes medication that helps control blood sugar levels in type 2 diabetes. It is not used in type 1 diabetes. It's also known by US brand name Actos.


Pioglitazone is a drug used in the treatment of type 2 diabetes. It may be used alone or with other medicines such as metformin, insulin, or sulfonylurea agents. Pioglitazone is used in conjunction together with regular exercise and a proper diet to help regulate blood sugar levels. It does this by aiding your body to use and metabolize insulin better. This medication is only available with your doctor's prescription and is available in the dosage form tablet.

Condition(s) treated?

  • Type 2 Diabetes

Type of medicine?

  • Oral tablet

Side Effects

Along with the intended effects, the use of this drug could produce unwanted effects. Not all of these side effects may be present, but if they are, then you may need to seek medical attention.

Inform your doctor immediately if you suffer from any of the following side effects whilst taking pioglitazone.

More common side effects

  • Extreme fatigue

Less common side effects

  • Swelling

Incidence not known

  • Loss of appetite

Some side effects that occur with this drug do not usually require urgent medical attention. However, if you find them bothersome, you can ask your local healthcare professional or local pharmacist for advice on ways to prevent or reduce the various side effects. Speak with your healthcare professional if any of the following side effects continue:

More common

  • Increased urination

Not all side effects that may occur are listed above. Seek advice from your healthcare professional or doctor if you notice any problems.

Remember you can report all side effects to the FDA on 1-800-FDA-1088.


The final dose of any medication will depend upon a number of factors. This includes your weight, age, and height. It will also include any other medical conditions you currently suffer from and how you react to the first dose. Do not change or stop taking your medication without speaking to your doctor first. If you take too much medication it could increase your risk of serious side effects and if you take too little it could reduce the effectiveness of the drug. Each dose will be based on individual experience.

For the treatment of type 2 diabetes:

Adults: Begin with 15 or 30 milligrams once daily. Your doctor may adjust your dose as necessary. Typically the dose is usually not more than 45 mg once daily.

Children: The dose and use will be determined by your doctor.

Missed Dose If you miss a dose of this medication, take it as soon as you remember. However, if it's almost time for your scheduled dose, skip the missed dose and revert back to your regular dosing schedule. You should not double dose.


Drug interactions can produce serious side effects and reduce the effectiveness of either drug. To avoid these interactions it's important you give your doctor a full list of all the current and past medication you are taking. This should include all prescription and non-prescription drugs, vitamins and herbal products. You should also let your doctor know of any other medical conditions you may suffer from including conditions that run in your family.

The use of this medication alongside any of the following medications is not usually recommended, but in some cases, it may be required. If you are prescribed both medications, your doctor may alter your dose of either medication or change how often you use each of them.

  • Rufloxacin

The use of this medication with any of the following medications can increase your risk of some side effects, but it may be necessary to use both. If you are given both drugs at the same time, your doctor may alter your dose or change how often you use either medication.

  • Guar Gum

There are over 600 drugs that interact with this medication. You should let your doctor know if you are currently taking any of the following medications.

  • Letermovir

If you suffer from any other medical conditions it may affect the use of this medication. Ensure you inform your doctor if you suffer from any other medical problems, especially:


Inform your doctor or healthcare professional if you have ever suffered from any allergic or unusual reactions to this medication or any other medications. You should also inform them of any other allergies you suffer from including to animals, foods, dyes or preservatives.

Pediatric population Appropriate studies have not been conducted on the relationship of age to the effects of pioglitazone in the younger population. Therefore efficacy and safety have not yet been established.

Geriatric population Appropriate studies conducted to date have not indicated a geriatric-specific problem that could limit the usefulness of pioglitazone in the older population. However, elderly patients are more likely to have age-related conditions such as heart disease, which could require adjustments of dose in those who are receiving this medication.

This drug is under FDA Pregnancy category C. You should let your doctor know if you are pregnant and follow instructions. It's important to ensure your blood sugars are controlled during pregnancy to prevent the risk of birth defects and your dose may need to be adjusted during different trimesters.

Some women who use pioglitazone have begun to have menstrual periods, even after not having a period for a long period of time. You are at risk of falling pregnant if your periods restart. You should discuss the need for effective birth control with your doctor or healthcare professional.

It is unknown whether this drug can pass into breast milk or if it could harm a nursing infant. You should avoid breastfeeding whilst using this medication for the duration you are taking it.

It's extremely important that your doctor monitors your progress at regular visits to make sure that this medicine is working properly.

Some women could be at an increased risk of pregnancy whilst taking this medication. If you have had difficulties with ovulating and irregular periods in the past, this medication may cause you to ovulate which could increase your chance of falling pregnant. You should discuss effective birth control options with your healthcare professional or doctor.

Check with your doctor immediately if you start experiencing shortness of breath, chest pain, excessive swelling of the hands, feet or ankles, or if you are gaining weight rapidly. These could be symptoms of a serious heart issue.

If you have stomach or abdominal pain, a loss of appetite, dark urine, vomiting or nausea, unusual weakness or tiredness, or yellow skin or eyes, check with your doctor immediately. These could be signs of a serious liver problem.

Check with your doctor immediately if you experience a change in your vision such as blurred vision or decreased vision whilst you are taking this medication. Your doctor may want you to get your eyes checked by an eye doctor.

This medication could increase the risk of bone fractures in women. Speak with your doctor about ways to prevent fractures and keep your bones strong.

This medication can increase your risk of bladder cancer if you take it for more than a 12 month period. Inform your doctor immediately if you have blood in the urine, a strong or increased urge to urinate, or pain in the stomach, back or lower abdomen.

It's important to carefully follow instructions from your doctor regarding:

Alcohol: The consumption of alcohol may cause severe low blood sugar.

Other medicines: Do not take other medications unless they have been discussed and prescribed by your doctor. This especially includes medications such as aspirin, and medications for asthma, appetite control, colds, cough, sinus problems or hay fever.

Counseling: Other family members should learn how to prevent and help any side effects that occur. Also, those patients suffering from type 2 diabetes may need special counseling about diabetes medicine dosing changes that could occur due to lifestyle changes, such as changes in diet or exercise.

Travel: Always keep a recent prescription and your medical history with you. Stay prepared for emergencies and take into consideration time zone changes by keeping all your meals as close to the time of your usual meals.

In case of emergency: You need to be prepared for emergencies by carrying some form of diabetic ID, either in the form of a piece of jewelry or a medical ID card. Include a full list of your medications in your wallet or purse.

Symptoms of fluid retention: Fluid retention can lead to heart problems so it's important that you know what to do if you start to retain fluid.

This medication does not cause low blood sugar (hypoglycemia). However, low blood sugar can occur if you exercise more than usual, miss or delay a snack or meal, drink alcohol or take pioglitazone with another type of diabetes medication. The symptoms of low blood sugar must be treated immediately with sugar before they lead to unconsciousness. It's important that you learn which symptoms of low blood sugar you experience so you can treat them quickly and effectively.

Symptoms of low blood sugar include:

  • Behavior change similar to being drunk

If the symptoms of low blood sugar occur, eat some form of sugar to raise them such as glucose tablets or gel, or drink fruit juice and non-diet soft drinks. It needs to be fast-acting sugar, so a chocolate bar will not treat your low blood sugar quickly. Also, test your blood for low blood sugar.

Glucagon is used in emergency situations when severe symptoms such unconsciousness or as seizures occur. Ensure you have a glucagon kit available, along with a needle and be aware of how to use it - your family members and friends should also know how to use it.

Hyperglycemia (high blood sugar) can occur if you skip a dose of your medication or you do not take enough, overeat or do not follow your meal plan, have an infection or fever or do less exercise.

Symptoms of high blood sugar include:

  • Drowsiness

If these symptoms of high blood sugar occur, test your blood sugar level and seek advice from your doctor or healthcare professional.

Proper Use:

Take this medication only as directed by your doctor or healthcare professional. Do not use more of this drug, or use it more frequently or for a longer period of time than your doctor has ordered.

Follow the special diet your doctor has given you carefully. This is the most important part of controlling your type 2 diabetes and it will help the medication work properly. You should also exercise regularly and test your blood sugar and urine as you have been directed.

This medication comes with a Medication Guide. Follow and read these instructions carefully. Speak with your doctor or healthcare professional if you have any questions regarding taking this medication.

These tablets can be taken with or without food. Your tablets will be given on a specific schedule based on your meals and physical activity. It's important you stick to this schedule as diverting from it could cause high and low blood sugars.


This medication should be stored in a closed container and kept at room temperature. You should keep the medication away from moisture, heat, and light. Do not let the medication freeze. Keep this medication out of the reach of children and dispose of any medication that is no longer needed or has expired. Seek advice from your healthcare professional or local pharmacist on the best way to dispose of this medication once you are finished.


When used correctly, this medication is successful in the treatment of type 2 diabetes. It cannot be used in patients who suffer from type 1 diabetes. Due to a large number of interactions possible with this drug, it's important that you give your doctor a complete list of all the current medications you are taking. It is important that you monitor your blood sugars whilst taking this medication to prevent hypoglycemia and hyperglycemia.

Let your doctor know if you are pregnant as extra precautions will need to be made and do not use this medicine whilst breastfeeding. Let your doctor or healthcare professional know if your blood sugar measurements are too low or high. Your dosage may need to be altered. It can take up to two-three months before you experience the full benefit of this drug. If you have any other questions or require further advice on the practical uses of this medication, you should contact your local healthcare professional or doctor.