Pioglitazone and metformin

Generic name: Pioglitazone And Metformin
Drug class: Antidiabetic combinations

Usage of Pioglitazone and metformin

Pioglitazone and metformin combination is used with proper diet and exercise to treat high blood sugar levels caused by type 2 diabetes. Pioglitazone works by helping your body use insulin better. Metformin reduces the absorption of sugar from the stomach, reduces the release of stored sugar from the liver, and helps your body use sugar better. This medicine does not help patients who have insulin-dependent or type 1 diabetes.

This medicine is available only with your doctor's prescription.

Pioglitazone and metformin side effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Bladder pain

bloody or cloudy urine

difficult, burning, or painful urination

frequent urge to urinate

lower back or side pain

swelling of the face, fingers, feet, or lower legs

weight gain

Less common

Pain or swelling in the arms or legs without any injury

pale skin

troubled breathing with exertion

unusual bleeding or bruising

unusual tiredness or weakness

Rare

Anxiety

blurred vision

chills

cold sweats

confusion

cool, pale skin

decreased appetite

depression

diarrhea

dizziness

fast heartbeat

fast, shallow breathing

general feeling of discomfort

headache

increased hunger

loss of consciousness

muscle pain or cramping

nausea

nightmares

seizures

shakiness

sleepiness

slurred speech

stomach discomfort

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Body aches or pain

cough

ear congestion

fever

loss of voice

runny or stuffy nose

sneezing

sore throat

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Before taking Pioglitazone and metformin

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of pioglitazone and metformin combination in the pediatric population. Use is not recommended in children. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of pioglitazone and metformin combination in the elderly. However, elderly patients are more likely to have age-related kidney problems, which may require caution and an adjustment in the dose for patients receiving pioglitazone and metformin combination.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Acetrizoic Acid

Diatrizoate

Ethiodized Oil

Iobenzamic Acid

Iobitridol

Iocarmic Acid

Iocetamic Acid

Iodamide

Iodipamide

Iodixanol

Iodohippuric Acid

Iodopyracet

Iodoxamic Acid

Ioglicic Acid

Ioglycamic Acid

Iohexol

Iomeprol

Iopamidol

Iopanoic Acid

Iopentol

Iophendylate

Iopronic Acid

Ioseric Acid

Iosimide

Iotasul

Iothalamate

Iotrolan

Iotroxic Acid

Ioxaglate

Ioxitalamic Acid

Ipodate

Metrizamide

Metrizoic Acid

Tyropanoate Sodium

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Abiraterone Acetate

Acarbose

Acetazolamide

Alogliptin

Aspirin

Bexagliflozin

Bictegravir

Chlorothiazide

Chlorpropamide

Chlorthalidone

Cimetidine

Ciprofloxacin

Dasabuvir

Delafloxacin

Dichlorphenamide

Dofetilide

Dolutegravir

Dorzolamide

Enoxacin

Fedratinib

Fexinidazole

Furosemide

Gatifloxacin

Gemfibrozil

Gemifloxacin

Glimepiride

Glipizide

Glyburide

Grepafloxacin

Hydrochlorothiazide

Hydroflumethiazide

Hydroxychloroquine

Ifosfamide

Indapamide

Insulin

Insulin Aspart, Recombinant

Insulin Bovine

Insulin Degludec

Insulin Detemir

Insulin Glargine, Recombinant

Insulin Glulisine

Insulin Lispro, Recombinant

Iopromide

Ioversol

Isavuconazole

Lanreotide

Levofloxacin

Levoketoconazole

Liraglutide

Lomefloxacin

Metformin

Methazolamide

Metolazone

Moxifloxacin

Nateglinide

Nifedipine

Norfloxacin

Octreotide

Ofloxacin

Ombitasvir

Paritaprevir

Pasireotide

Phenobarbital

Pioglitazone

Piperaquine

Pixantrone

Polythiazide

Pramlintide

Primidone

Ranolazine

Repaglinide

Semaglutide

Sitagliptin

Somatrogon-ghla

Sotagliflozin

Sparfloxacin

Tafenoquine

Thioctic Acid

Tolazamide

Tolbutamide

Tolvaptan

Topiramate

Triamterene

Trovafloxacin

Vandetanib

Zonisamide

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Acebutolol

Atenolol

Atorvastatin

Betaxolol

Bisoprolol

Bitter Melon

Carteolol

Carvedilol

Celiprolol

Clopidogrel

Colesevelam

Esmolol

Fenugreek

Glucomannan

Guar Gum

Isocarboxazid

Ketoconazole

Labetalol

Levobunolol

Linezolid

Methylene Blue

Metipranolol

Metoprolol

Nadolol

Nebivolol

Nilotinib

Oxprenolol

Ozanimod

Patiromer

Penbutolol

Phenelzine

Pindolol

Practolol

Procarbazine

Propranolol

Psyllium

Rasagiline

Rifampin

Safinamide

Selegiline

Sotalol

Timolol

Tirzepatide

Tranylcypromine

Verapamil

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Relate drugs

How to use Pioglitazone and metformin

Carefully follow the special diet your doctor gave you. This is the most important part of controlling your diabetes and will help the medicine work properly. Exercise regularly and test for sugar in your blood or urine as directed.

This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor if you have any questions.

This medicine should be taken with meals to help reduce the unwanted stomach effects that may occur during the first few weeks.

Swallow the medicine whole. Do not crush, break, or chew it.

Part of the extended-release tablet may pass into your stool (bowel movement). This is normal and nothing to worry about.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For type 2 diabetes:

For oral dosage form (extended-release tablets):

Adults—At first, 1 tablet one or two times a day with food. Your doctor may adjust your dose as needed and tolerated. However, the dose is usually not more than 45 milligrams (mg) of pioglitazone and 2000 mg of metformin per day.

Children—Use and dose must be determined by your doctor.

For oral dosage form (tablets):

Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Warnings

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to decide if you should continue to use it. Blood and urine tests may be needed to check for unwanted effects.

If you are rapidly gaining weight, having shortness of breath, chest pain or discomfort, extreme tiredness or weakness, irregular breathing, irregular heartbeat, or excessive swelling of the hands, wrist, ankles, or feet, check with your doctor right away. These may be symptoms of heart problems or fluid retention (too much water in the body).

Let your doctor or dentist know you are taking this medicine. Your doctor may advise you to stop taking this medicine before you have major surgery or diagnostic tests, especially tests that use a contrast dye.

Under certain conditions, too much metformin can cause a serious condition called lactic acidosis. The symptoms of lactic acidosis are severe and appear quickly. Lactic acidosis usually occurs when other serious health problems are present, such as a heart attack or kidney failure. The symptoms of lactic acidosis include: abdominal or stomach discomfort, decreased appetite, diarrhea, fast or shallow breathing, a general feeling of discomfort, muscle pain or cramping, and unusual sleepiness, tiredness, or weakness. If you have more than one of these symptoms together, you should get immediate emergency medical help.

Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellow eyes or skin. These could be symptoms of a serious liver problem.

Check with your doctor right away if blurred vision, decreased vision, or any other change in vision occurs while you are taking this medicine. Your doctor may want you to have your eyes checked by an ophthalmologist (eye doctor).

This medicine may increase the risk for bone fractures in women. Ask your doctor about ways to keep your bones strong to help prevent fractures.

This medicine may increase your risk for bladder cancer if you take it for more than 12 months. Tell your doctor right away if you have blood in the urine, a frequent, strong, or increased urge to urinate, painful urination, or pain in the back, lower abdomen, or stomach.

This medicine can cause hypoglycemia (low blood sugar). Low blood sugar can also occur if you delay or miss a meal or snack, exercise more than usual, drink alcohol, or cannot eat because of nausea or vomiting or take certain medicines. Low blood sugar must be treated before it causes you to pass out (unconsciousness). People feel different symptoms with low blood sugar. It is important that you learn which symptoms you have in order to treat it quickly. Talk to your doctor about the best way to treat low blood sugar.

Hyperglycemia (high blood sugar) may occur if you do not take enough or skip a dose of your medicine, overeat or do not follow your meal plan, have a fever or infection, or do not exercise as much as usual. High blood sugar can be very serious and must be treated right away. It is important that you learn which symptoms you have in order to treat it quickly. Talk to your doctor about the best way to treat high blood sugar.

There may be a time when you need emergency help for a problem caused by your diabetes. You need to be prepared for these emergencies. It is a good idea to wear a medical identification (ID) bracelet or neck chain at all times. Also, carry an ID card in your wallet or purse that says you have diabetes with a list of all your medicines.

This medicine may cause some women who do not have regular monthly periods to ovulate. This can increase the chance of pregnancy. If you are a woman of childbearing potential, you should discuss birth control options with your doctor.

Limit how much alcohol you drink while using this medicine. Heavy alcohol use can increase your risk for lactic acidosis.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

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