Pioglitazone

The usual starting dose for adults is 15 mg or 30 mg taken once daily. Diet and exercise programs should be continued while taking pioglitazone. Your doctor may decide to increase the dose of pioglitazone to 45 mg daily if lower doses do not sufficiently reduce your blood sugar levels. The use and dose of pioglitazone for children must be determined by their doctor.

Pioglitazone may be taken with or without food, and should be taken daily and at regular intervals as prescribed by the doctor so that blood levels of the medication always remain in an effective range.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without talking to your doctor.

It is important to take Pioglitazone exactly as prescribed by your doctor. If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Pioglitazone at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may cause headaches; it may cause muscle pain; it could cause water retention and swelling; it may cause a sore throat; it may cause weight gain, mostly with prolonged use. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

Pioglitazone is no longer being manufactured for sale in Canada. For brands that may still be available, search under pioglitazone. This article is being kept available for reference purposes only. If you are using Pioglitazone, speak with your doctor or pharmacist for information about your treatment options.

Do not take Pioglitazone if you:

• are allergic to pioglitazone or any ingredients of Pioglitazone
• are pregnant
• have been diagnosed with any stage of heart failure
• have blood or a red colour in your urine
• have or have had bladder cancer
• have reduced liver function

There may be an interaction between pioglitazone and any of the following:

• Abiraterone acetate
• acetylsalicylic acid (Asa)
• androgens (e.g., testosterone)
• atypical antipsychotics (e.g., Clozapine, Olanzapine, Quetiapine, Risperidone)
• barbiturates (e.g., Phenobarbital, secobarbital)
• birth control pills
• Celecoxib
• chloroquine
• Clopidogrel
• corticosteroids (e.g., Dexamethasone, Hydrocortisone, Prednisone)
• Dabrafenib
• Deferasirox
• diabetes medications (e.g., chlorpropamide, glipizide, glyburide, insulin, metformin, pioglitazone)
• Disopyramide
• diuretics (water pills; e.g., Furosemide, Hydrochlorothiazide, triamterene)
• estrogens (e.g., conjugated estrogen, Estradiol, ethinyl estradiol)
• Everolimus
• Gemfibrozil
• Glucagon
• HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
• hydroxychloroquine
• Lanreotide
• Leflunomide
• mifepristone
• monoamine oxidase inhibitors (M.O.S. e.g., Moclobemide, Phenelzine, Rasagiline, Selegiline, Tranylcypromine)
• Niacin
• Nilotinib
• Octreotide
• Pasireotide
• pentamidine
• Pegvisomant
• Pregabalin
• progestins (e.g., Dienogest, Levonorgestrel, medroxyprogesterone, Norethindrone)
• quinine
• quinolone antibiotics (e.g., ciprofloxacin, Norfloxacin, Ofloxacin)
• rifampin
• selective serotonin reuptake inhibitors (SSRIs; e.g., Citalopram, Fluoxetine, Paroxetine, Sertraline)
• somatostatin acetate
• Somatropin
• sulfonamide antibiotics ("sulfas"; e.g., sulfisoxazole, sulfamethoxazole)
• Sunitinib
• Tacrolimus
• Topiramate
• Trimethoprim

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Pioglitazone. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin taking a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take Pioglitazone.

Bladder: Taking pioglitazone may increase the risk of developing bladder cancer. If you have risk factors for bladder cancer, such as age, smoking, or someone in your family has had bladder cancer you may be more likely to develop this disease. Do not use Pioglitazone if you have or have had bladder cancer.

If you experience symptoms such as blood or red colour in your urine, an urgent need to urinate, pain while urinating, or pain in the back or lower abdomen, talk to your doctor right away.

Fractures: Pioglitazone has been associated with an increased incidence of bone fracture for female patients. You and your doctor should consider the risk of fractures. Talk to your doctor if you have any concerns.

Heart failure: Pioglitazone can cause fluid buildup in the body, which may lead to Congestive Heart Failure. Pioglitazone should not be used by anyone who has any degree of heart failure, or anyone who is at risk of heart failure (including people with swelling due to fluid buildup). If you develop fluid buildup or swelling, shortness of breath, fatigue, or excessive weight gain while taking Pioglitazone, you should consult your doctor immediately.

Liver: Although liver problems have not been observed with pioglitazone, another similar medication has caused liver problems in a small number of people. You should report any signs of liver problems (abdominal or stomach pain, dark urine, loss of appetite, nausea or vomiting, unusual tiredness or weakness, or yellow eyes or skin) to your doctor at once.

Use with other diabetes medications: Pioglitazone should not be used with insulin. It should not be used in combination (i.e., triple therapy) with both metformin and a sulfonylurea (e.g., glyburide, glicazide); however, it may be used with either metformin or a sulfonylurea.

Vision: Pioglitazone may cause fluid to build up in the eye (macular edema) causing vision changes. If you experience any change to your vision, contact your doctor.

Pregnancy: Pioglitazone has not been studied for use by pregnant women. Pioglitazone should not be used during pregnancy. In general, blood sugar should be controlled during pregnancy by using insulin injections. If you become pregnant while taking Pioglitazone, contact your doctor immediately.

Breast-feeding: It is not known if pioglitazone passes into breast milk. If you are a breast-feeding mother and are taking Pioglitazone, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Pioglitazone have not been established for children.

This medication is typically used only once a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. It must be used regularly and continuously to maintain its beneficial effects. Be sure to keep an adequate supply on hand. Like all individuals with diabetes, you should monitor your blood sugar levels regularly using the appropriate device. If you remember missing a dose within 12 hours of the time it is usually taken, take it as soon as you remember, then take the next dose at the regularly scheduled time. If the dose is missed by more than 12 hours, skip the missed dose. Do not double the next dose to catch up. This medication may be taken with or without food.