Generic Name: pioglitazone hydrochloride
Product Name: Actos
Indication: What Actos is used for
Actos is a tablet that is used to improve the action of the body’s naturally produced insulin. Actos is used in the management of type 2 diabetes not controlled by diet. Actos helps to control the level of glucose in your blood when you have type 2 diabetes. This is the ‘adult onset’ type of diabetes and is controlled by diet, certain oral medications and occasionally insulin.
Ask your doctor if you have any questions about why this medicine has been prescribed for you. Your doctor may have prescribed it for another reason.
Actos can be used alone (when diet and exercise are not enough to treat your diabetes) or together with other anti-diabetic medicines.
This medicine is available only with a doctor’s prescription.
The use of Actos has not been studied in children.
Action: How Actos works
This medicine is also called pioglitazone hydrochloride and belongs to a group of medicines called glitazones. Glitazones decrease insulin resistance.
Actos is a thiazolidinedione antidiabetic agent that depends on the presence of insulin for its unique mechanism of action. Actos decreases insulin resistance in the periphery and in the liver resulting in increased insulin-dependent glucose disposal and decreased hepatic glucose output. Unlike sulfonylureas, pioglitazone is not an insulin secretagogue. Pioglitazone is a potent and highly selective agonist for peroxisome proliferator-activated receptor-gamma (PPARγ). PPAR receptors are found in tissues important for insulin action such as adipose tissue, skeletal muscle, and liver. Activation of PPARγ nuclear receptors modulates the transcription of a number of insulin responsive genes involved in the control of glucose and lipid metabolism.
Actos contains 15mg, 30mg or 45mg of pioglitazone (as hydrochloride) as the active ingredient. It also contains lactose, hyprolose, carmellose calcium, and magnesium stearate.
This medicine does not contain sucrose, gluten, tartrazine or any other azo dyes.
Dose advice: How to use Actos
Before you take Actos
When you must not take it
Do not take Actos if:
- You have heart failure requiring treatment. Talk to your doctor if you have heart failure;
- You have type 1 diabetes or diabetic ketoacidosis) often caused by very high blood glucose levels);
- You have an allergy to any medicine containing pioglitazone hydrochloride or any of the ingredients listed here.
Some of the symptoms of an allergic reaction may include shortness of breath, wheezing or difficulty breathing; swelling of the face, lips, tongue or other parts of the body; rash, itching or hives on the skin.
Do not take this medicine after the date printed on the pack or if the packaging is torn or shows signs of tampering. If it has expired or is damaged, return it to your pharmacist for disposal.
If you are not sure whether you should start taking this medicine, talk to your doctor.
Before you start to take it
Tell your doctor if you have allergies to any other medicines, foods, preservatives or dyes.
Tell your doctor if you have or have had any of the following medical conditions:
- Heart disease with shortness of breath after minimal physical activity;
- Heart disease with severe symptoms at rest;
- Swelling of hands, ankles or feet;
- Bladder cancer or symptoms associated with bladder cancer such as blood in the urine (hematuria) often accompanied by pain and burning or, sudden urges to urinate;
- Problems with your liver;
- Problems with your kidneys that requires dialysis. Actos is not recommended for use if you are on dialysis;
- Some women who do not have monthly periods and have not been through menopause may restart their periods when taking Actos. These women may be at increased risk of pregnancy;
- Bone fractures, usually in the hand, upper arm or foot, have been seen in some women when taking Actos. Talk to your doctor for advice on how to keep your bones healthy.
Tell your doctor if you are pregnant or plan to become pregnant or are breastfeeding. Like most medicines, Actos is not recommended for use during pregnancy. If there is a need to consider Actos during your pregnancy, your doctor will discuss with you the benefits and risks of taking Actos. It is recommended that you do not breastfeed while taking Actos, as it is not known whether Actos passes into breast milk.
Tell your doctor if you are using another medicine for diabetes. Actos can enhance the action of other medicines. You may be at risk of low blood sugar (hypoglycaemia). If this happens, your doctor may need to adjust the dose of your other medicines.
Tell your doctor if you suffer from lactose intolerance (because Actos tablets contain lactose).
If you have not told your doctor about any of the above, tell them before you start taking Actos.
Taking other medicines
Tell your doctor or pharmacist if you are taking any other medicines, including any that you get without a prescription from your pharmacy, supermarket or health food shop. Some medicines and Actos may interfere with each other. These include:
- Oral contraceptives;
These medicines may be affected by Actos or may affect how well it works. You may need different amounts of your medicines, or you may need to take different medicines.
Your doctor or pharmacist has more information on medicines to be careful with or to avoid while taking this medicine.
How to take Actos
Follow all directions given to you by your doctor or pharmacist carefully. They may differ from the information contained here.
If you do not understand the instructions on the carton, ask your doctor or pharmacist for help.
How much to take
Your doctor will tell you how many Actos tablets you should take. The dose your doctor will prescribe for you will usually be in the range of 15 mg to 45 mg per day.
Actos tablets should be taken once a day as advised by your doctor.
Your doctor may increase or decrease your dose in order to find the appropriate dose for your condition.
How to take it
Actos tablets should be swallowed whole with a glass of water.
When to take it
Take your medicine at about the same time each day. Taking it at the same time each day will have the best effect. It will also help you remember when to take it.
It does not matter if you take this medicine before or after food.
How long to take it
Continue taking your medicine for as long as your doctor tells you. This medicine helps to control your condition but does not cure it. It is important to keep taking your medicine even if you feel well.
If you forget to take it
If it is almost time for your next dose, skip the dose you missed and take your next dose when you are meant to. Otherwise, take it as soon as you remember, and then go back to taking your medicine as you would normally.
Do not take a double dose to make up for the dose that you missed.
If you are not sure what to do, ask your doctor or pharmacist. If you have trouble remembering to take your medicine, ask your pharmacist for some hints.
If you take too much (overdose)
Immediately telephone your doctor or the Australian Poisons Information Centre (13 11 26) or the New Zealand National Poisons Centre (0800 POISON or 0800 764 766), or go to Accident and Emergency at the nearest hospital, if you think that you or anyone else may have taken too much Actos. Do this even if there are no signs of discomfort or poisoning. You may need urgent medical attention.
While you are taking Actos
Things you must do
It is important that you remember to take Actos daily and at the dose prescribed by your doctor.
Tell any other doctors, dentists, and pharmacists who treat you that you are taking Actos.
If you are about to be started on any new medicine, remind your doctor and pharmacist that you are taking Actos.
If you are going to have surgery, tell the surgeon or anaesthetist that you are taking this medicine. It may affect other medicines used during surgery.
If you become pregnant while taking this medicine, tell your doctor immediately.
If you are about to have any blood tests, tell your doctor that you are taking this medicine. It may interfere with the results of some tests.
Keep all of your doctor’s appointments so that your progress can be checked. Your doctor may do some tests from time to time to make sure the medicine is working and to prevent unwanted side effects.
Tell your doctor if you have gained weight since taking Actos. Weight gain can be associated with improved blood sugar control, however; it may also be a symptom of heart failure.
Things you must not do
Do not take Actos to treat any other complaints unless your doctor tells you to.
Do not give your medicine to anyone else, even if their symptoms seem similar to yours or they have the same condition as you.
Do not stop taking your medicine or lower the dosage without checking with your doctor. If you stop taking it suddenly, your condition may worsen or you may have unwanted side effects.
Things to be careful of
Actos alone is unlikely to affect your ability to drive or operate machinery. However, be careful whilst driving or operating machinery if using Actos combination with other diabetes medicines.
If your blood glucose level becomes too low, you may feel dizzy, lightheaded, weak or tired and your reaction time may be slower than usual. If you have any of these symptoms, do not drive or do anything else that could be dangerous.
After using Actos
Keep your tablets in the aluminum blister pack until it is time to take them.
Keep your tablets in a cool, dry place where the temperature stays below 25°C. Do not store Actos or any other medicine in the bathroom or near a sink. Do not leave it on a windowsill or in the car. Heat and dampness can destroy some medicines.
Keep it where children cannot reach it. A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.
If your doctor tells you to stop taking Actos or the expiry date has passed, ask your pharmacist what to do with any medicine that is left over.
Schedule of Actos
Actos is a prescription only medicine (Schedule 4).
Side effects of Actos
Tell your doctor or pharmacist as soon as possible if you experience any undesirable effect or feel unwell while you are taking Actos. This medicine helps most people with type 2 diabetes not controlled by diet, but it may have unwanted side effects in some people. All medicines can have side effects. Sometimes they are serious, most of the time they are not. You may need medical attention if you get some of the side effects.
Some side effects may be related to the dose of Actos. Accordingly, it is important that you tell your doctor as soon as possible about any unwanted effects. Your doctor may then decide to adjust the dose of Actos you are taking.
Do not be alarmed by the following list of side effects. You may not experience any of them.
Ask your doctor or pharmacist to answer any questions you may have.
A few patients have experienced the following side effects whilst taking Actos:
- A small increase in weight;
- Low blood sugar levels (hypoglycaemia). This occurs more often when Actos is taken with a sulfonylurea or insulin;
- Heart failure which may show as localised swelling of the ankles, feet, and hands (oedema) and/or fluid in the lungs (pulmonary oedema). This has been reported in clinical trials mainly in patients who are taking Actos in combination with insulin;
- Increased risk of bone fracture in women;
- Macular oedema (an eye disorder that can affect vision);
- Altered or impaired liver function.
Tell your doctor if you notice any of the following side effects:
- Weight gain;
- Signs of hypoglycaemia which may include weakness, trembling or shaking, sweating, lightheadedness, headache, dizziness, lack of concentration, tearfulness or crying, irritability, hunger, numbness around the lips and fingers;
- Eye problems including blurred or double vision.
The above list includes the more common side effects of your medicine.
Tell your doctor as soon as possible if you notice any of the following:
- Dark urine or pale stools, yellowing of the skin or eyes, severe cramps of the stomach, nausea or vomiting, loss of weight, tiredness;
- Shortness of breath when at rest or after minimal physical activity with swelling of legs, feet and hands, rapid increase in weight;
- Blood in the urine often accompanied by pain and burning, these can be symptoms of bladder cancer.
The above list includes serious side effects, which may require medical attention. Serious side effects are rare.
Tell your doctor or pharmacist if you notice anything that is making you feel unwell. Other side effects not listed above may also occur in some people.
For further information talk to your doctor.