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Pioglitazone, a medication used to manage type 2 diabetes, carries certain risks and precautions that you should be aware of before use. Discuss any concerns with your healthcare provider to ensure safety and efficacy.

• Heart Failure Risk: Pioglitazone can exacerbate or lead to heart failure due to fluid retention. If you experience symptoms such as shortness of breath, fatigue, swelling in the ankles or feet, or sudden weight gain, contact your healthcare provider immediately. This medication is not recommended for individuals with moderate to severe heart failure.

• Low Blood Sugar: While pioglitazone alone rarely causes low blood sugar, using it in combination with other diabetes medications like insulin or sulfonylureas (e.g., glipizide, glimepiride) may increase this risk. Be aware of symptoms like shakiness, hunger, sweating, confusion, or rapid heartbeat, and inform your doctor if they occur, as you might need an adjustment in your medication dosage.

• Liver Concerns: Though uncommon, there have been instances of liver problems in individuals taking pioglitazone. If you notice signs such as extreme fatigue, weight loss, abdominal discomfort, dark urine, or jaundice, seek medical advice promptly. Regular liver function tests may be recommended during treatment.

• Bladder Cancer: There is a potential link between pioglitazone and bladder cancer. It is not advised for patients with active bladder cancer. Inform your doctor of any history of bladder cancer, and report symptoms like blood in urine or painful urination without delay.

• Bone Fracture Risk: Female patients using pioglitazone may have a higher likelihood of fractures, particularly in the arms and feet. Your healthcare provider may evaluate your bone health before starting treatment to ensure this medication is suitable for you.

• Eye Problems: Pioglitazone may cause fluid accumulation in the eye, potentially leading to macular edema. Regular eye examinations are important, especially since diabetes itself can affect vision. Report any changes in vision, such as blurriness or dimness, to your healthcare provider.

In case of an overdose, seek emergency medical attention immediately. Always keep your healthcare provider informed about all medications you are taking, including over-the-counter drugs and supplements, to prevent harmful interactions.

Common side effects:

• swelling
• upper respiratory tract infections
• headaches
• sinus infections
• pain in the arms and legs
• sore throat
• muscle pain
• back pain
• chest pain
• weight gain

Serious side effects:

• worsening heart failure
• serious liver problems
• low blood sugar
• very serious allergic reaction

Interactions with high risk of serious adverse effects and should be avoided:

• Acarbose
• Metformin
• Insulin
• Chloroquine
• Chlorpropamide
• Ciprofloxacin
• Enoxacin
• Fleroxacin
• Flumequine
• Gatifloxacin
• Gemifloxacin
• Glimepiride
• Glipizide
• Glyburide
• Hydroxychloroquine
• Ifosfamide
• Insulin Aspart, Recombinant
• Insulin Bovine
• Insulin Degludec
• Insulin Detemir
• Insulin Glargine, Recombinant
• Insulin Glulisine
• Insulin Lispro, Recombinant
• Lanreotide
• Levofloxacin
• Lomefloxacin
• Lumateperone
• Nateglinide
• Nifedipine
• Norfloxacin
• Octreotide
• Ofloxacin
• Pasireotide
• Pazufloxacin
• Pefloxacin
• Piperaquine
• Pixantrone
• Prulifloxacin
• Repaglinide
• Rufloxacin
• Sparfloxacin
• Thioctic Acid
• Tolazamide
• Tolbutamide
• Tolvaptan
• Tosufloxacin

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Acebutolol
• Atenolol
• Atorvastatin
• Betaxolol
• Bisoprolol
• Bitter Melon
• Carteolol
• Carvedilol
• Celiprolol
• Clopidogrel
• Esmolol
• Fenugreek
• Glucomannan
• Guar Gum
• Ketoconazole
• Labetalol
• Levobunolol
• Metipranolol
• Metoprolol
• Nadolol
• Nebivolol
• Nilotinib
• Oxprenolol
• Penbutolol
• Pindolol
• Practolol
• Propranolol
• Psyllium
• Rifampin
• Sotalol
• Timolol
• Topiramate