METFORMIN AND PIOGLITAZONE

(met FOR min and PYE o GLI ta zone) Brand: Actoplus Met, Actoplus Met XR

What is the most significant information I must know about metformin and pioglitazone?

• You must not use this medication if you have severe or uncontrolled heart failure, kidney problems, metabolic acidosis, or if you have bladder cancer. Do not use this medication if you are in a state of diabetic ketoacidosis (call your doctor for treatment with insulin). Metformin and pioglitazone is not for treating type 1 diabetes.

• Metformin and pioglitazone can reason or worsen congestive heart failure. Call your doctor at once if you have shortness of breath (even with mild exertion), swelling, or rapid weight gain.

• If you need to have any type of x-ray or CT scan using a paint that is injected into your veins, you will need to temporarily stop taking metformin and pioglitazone.

• Some people develop lactic acidosis while taking metformin. Get abnormal medical help if you have even mild symptoms such as: muscle pain or weakness, numb or cool feeling in your arms and legs, trouble breathing, stomach pain, nausea with vomiting, slow or uneven heart course, dizziness, or feeling very weak or weary.

What is metformin and pioglitazone?

• Metformin and pioglitazone is a combination of two oral diabetes medicines that help control blood sugar levels.

• Metformin and pioglitazone is for people with type 2 diabetes who do not use daily insulin injections. This medicine is not for treating type 1 diabetes.

• Metformin and pioglitazone may also be used for purposes not listed in this medicine guide.

What must I discuss with my healthcare provider till taking metformin and pioglitazone?

• Do not use this medication if you are in a state of diabetic ketoacidosis (call your doctor for treatment with insulin).

• You must not use metformin and pioglitazone if you are allergic to it, or if you have:

· severe or uncontrolled heart failure;

· kidney problems;

· active bladder cancer; or

· metabolic acidosis.

• If you need to have any type of x-ray or CT scan using a paint that is injected into your veins, you will need to temporarily stop taking metformin and pioglitazone. Be certain your caregivers know onward of time that you are using this medication.

• Some people taking metformin develop a serious condition called lactic acidosis. This may be more likely if you have liver or kidney malady, congestive heart failure, a severe infection, if you are dehydrated, or if you drink big amounts of alcohol. Conversation with your doctor about your risk.

• To create certain metformin and pioglitazone is safety for you, speak your doctor if you have:

· congestive heart failure or heart disease;

· fluid retention;

· a history of bladder cancer;

· a history of heart onslaught or stroke;

· liver malady; or

· if you are 80 years or older.

• Taking metformin and pioglitazone may magnify your risk of serious heart problems. However, not treating your diabetes can hurt your heart and another organs. Conversation to your doctor about the risks and benefits of treating your diabetes with this medicine.

• This medicine may magnify your risk of developing bladder cancer. Conversation with your doctor about your specific risk.

• Women may be more likely than men to have bone fractures in the upper hand, arm, or foot while taking medication that contains pioglitazone. Conversation with your doctor if you are concerned about this possibility.

• FDA pregnancy category C. It is not known whether metformin and pioglitazone will harm an unborn child. Speak your doctor if you are pregnant or plan to become pregnant.

• Some women using metformin and pioglitazone have started having menstrual periods, even after not having a period for a long time due to a medical condition. You may be able to get pregnant if your periods restart. Conversation with your doctor about the need for birth control.

• It is not known whether metformin and pioglitazone passes into breast milk or if it could harm a nursing child. You must not breast-feed while using this medicine.

How must I take metformin and pioglitazone?

• Follow all directions on your prescription label. Do not take this medication in larger or less amounts or for longer than recommended.

• Take metformin and pioglitazone with meals. Take the extended-release (XR) tablet once daily with your evening meal.

• Do not crush, chew, or interrupt an extended-release tablet. Swallow it intact.

• Your blood sugar will need to be checked often, and you may need another blood trials at your doctor's office.

• Low blood sugar (hypoglycemia) can happen to everyone who has diabetes. Symptoms include headache, famine, sweating, pale skin, irritability, dizziness, feeling shaky, or trouble concentrating. Always hold a source of sugar with you in case you have low blood sugar. Sugar sources include fruit juice, heavy candy, crackers, raisins, and non-diet soda. Be certain your family and close friends know how to help you in an emergency.

• If you have severe hypoglycemia and can't ate or drink, use a glucagon injection. Your doctor can prescribe a glucagon abnormal injection kit and speak you how to use it.

• Check your blood sugar carefully during times of stress, travel, diseases, surgery or medical abnormal, vigorous exercice, or if you drink alcohol or skip meals. These things can affect your glucose levels and your doze needs may also change. Do not change your medicine doze or schedule without your doctor's advice.

• Use metformin and pioglitazone regularly to get the most benefit. Get your prescription refilled till you run out of medication completely.

• If you take extra vitamin B12 while you are taking metformin and pioglitazone, take only the amount of vitamin B12 that your doctor has prescribed.

• Metformin and pioglitazone is only part of a treatment program that may also include diet, exercice, weight control, blood sugar testing, and particular medical care. Follow your doctor's instructions very closely.

• Store at room temperature away from moisture, heat, and easy. Hold the bottle tightly closed when not in use.

What happens if I miss a dose?

• Take the missed doze as soon as you remember (be certain to take the medication with food). Skip the missed doze if it is nearly time for your following scheduled doze. Do not take extra medication to create up the missed dose.

What happens if I overdose?

• Search abnormal medical attention or call the Poison Help line at 1-800-222-1222.

What must I avoid while taking metformin and pioglitazone?

• Avoid drinking alcohol. It can lower your blood sugar and may magnify your risk of lactic acidosis.

What are the possible side effects of metformin and pioglitazone?

• Some people develop lactic acidosis while taking metformin. Early symptoms may get worse over time and this condition can be fatal. Get abnormal medical help if you have even mild symptoms such as: muscle pain or weakness, numb or cool feeling in your arms and legs, trouble breathing, stomach pain, nausea with vomiting, quick or uneven heart course, dizziness, or feeling very weak or weary.

• Get abnormal medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your person, lips, tongue, or throat.

• Call your doctor at once if you have:

· shortness of breath (even with mild exertion), swelling, rapid weight gain;

· pink or red urine, painful or difficult urination, urinating more than usual;

· pale skin, light bruising or bleeding;

· nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or

· changes in your vision.

• General side effects may include:

· headache;

· diarrhea; or

· cool symptoms such as stuffy nose, sinus pain, sneezing, sore throat.

• This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may message side effects to FDA at 1-800-FDA-1088.

What another drugs will affect metformin and pioglitazone?

• Speak your doctor if you use insulin. Taking metformin and pioglitazone while you are using insulin may magnify your risk of serious heart problems.

• Speak your doctor about all medicines you use, and those you start or stop using during your treatment with metformin and pioglitazone, especially:

· gemfibrozil;

· morphine;

· ranitidine;

· an antibiotic--rifampin, trimethoprim, vancomycin; or

· heart or blood pressure medication--digoxin, nifedipine, procainamide, quinidine.

• You may be more likely to have hyperglycemia (high blood sugar) if you also take another drugs that can raise blood sugar, such as:

· isoniazid;

· diuretics (water pills);

· steroids (prednisone and others);

· niacin (Advicor, Niaspan, Niacor, Simcor, Slo-Niacin, and others);

· phenothiazines (Compazine and others);

· thyroid medication (Synthroid and others);

· birth control pills and another hormones; and

· diet pills or medicines to treat asthma, colds or allergies.

• These lists are not complete and much another medicines can magnify or decrease the effects of metformin and pioglitazone on lowering your blood sugar. This includes prescription and over-the-counter medicines, vitamins, and herbal commodity. Give a list of all your medicines to any healthcare provider who treats you.

Where can I get more information?

• Your pharmacist can provide more information about metformin and pioglitazone.

Remember, hold this and all another medicines out of the reach of children, never share your medicines with others, and use this medicine only for the indication prescribed.

Disclaim: Each effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses external of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way must be construed to indicate that the drug or drug combination is safety, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the help of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.