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This medication has several important safety considerations that should be reviewed carefully. Below are key risks and necessary precautions associated with its use:

• Heart Failure and Swelling: Pioglitazone, a component of Duetact, can cause or worsen heart failure by promoting fluid retention, leading to swelling around the heart. Patients with heart failure or related conditions should discuss risks with their healthcare provider before starting this medication. Immediate medical attention is recommended if symptoms such as shortness of breath, unusual fatigue, swelling in the body, or sudden weight gain occur. This medication is generally not advisable for individuals with moderate to severe heart failure.

• Low Blood Sugar (Hypoglycemia): Glimepiride in Duetact can significantly lower blood sugar levels, potentially leading to hypoglycemia. Symptoms include shakiness, anxiety, rapid heartbeat, sweating, confusion, and intense hunger. Patients should be aware of how to manage low blood sugar and keep fast-acting sugars readily available. Risk factors include skipping meals, irregular eating schedules, alcohol consumption, intense exercise, and concurrent use of other diabetic medications. Special caution is advised for older adults and individuals with kidney or liver issues.

• Liver Issues: There have been rare reports of liver problems in patients using pioglitazone. Regular liver function tests may be recommended, and any signs of liver distress, such as extreme fatigue, weight loss, stomach discomfort, dark urine, or jaundice, should be reported immediately.

• Bone Fracture Risk: Females taking pioglitazone may have a higher likelihood of experiencing bone fractures, particularly in the arms and feet. Healthcare providers should evaluate bone health before initiating therapy.

• Vision Changes: Some individuals have reported vision problems while taking medications similar to pioglitazone. Regular eye examinations are encouraged, especially since diabetes itself can impact vision. Any changes in vision such as cloudiness or blurriness should be promptly discussed with a healthcare provider.

• Risk of Anemia: There is a potential for developing low red blood cell count, especially in patients with specific genetic conditions. Symptoms like weakness, fatigue, or dizziness should be communicated to a healthcare provider.

• Severe Allergic Reactions: Patients with a history of allergies to sulfa drugs should be cautious, as Duetact can cause serious allergic reactions. Symptoms include rash, skin peeling, swelling, breathing difficulties, and dizziness. Immediate medical attention is required if these occur, and the medication should be discontinued.

In case of an overdose, seek emergency medical assistance immediately. Always consult with your healthcare provider about any concerns or if you are part of a special population, such as pregnant individuals or those with pre-existing conditions, to ensure safe use of this medication.

Common side effects:

• Headaches
• Dizziness
• Diarrhea
• Nausea
• Muscle pain
• Sore throat
• Tooth problems
• Shakiness
• Anxiety
• Fast heartbeat
• Sweating
• Feeling very hungry
• Cough
• Runny nose
• Weight gain
• Swelling of the legs and feet
• Pain while urinating
• Increased frequency of urination

Less common but important to monitor:

• Vision problems
• Changes in mood or mental state
• Hallucinations
• Confusion
• Seizures
• Signs of infection
• Persistent sore throat
• Fever
• High blood sugar

Serious side effects:

• Worsening heart failure
• Difficulty breathing
• Unusual swelling
• Sudden weight gain
• Serious liver problems
• Fatigue
• Loss of appetite
• Dark urine
• Yellowing of the skin and eyes
• Severe allergic reactions
• Rash
• Blisters
• Difficulty breathing
• Swelling of the face, tongue, or throat

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

• Gemfibrozil
• Rifamycins including Rifampin

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

• Acarbose
• Insulin
• Metformin
• Beta-blockers (such as Metoprolol, Propranolol, Timolol)