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Actoplus Met (pioglitazone/metformin) is a medication associated with several important safety considerations and warnings. It is crucial to be aware of these potential risks and precautions while using this medication. If you have any questions or concerns, please discuss them with your healthcare provider.

• Heart Failure Risk: Actoplus Met can cause your body to retain fluids, which may lead to or worsen heart failure. If you experience symptoms such as shortness of breath, swelling in the legs or ankles, unusual fatigue, or sudden weight gain, contact your healthcare provider immediately. This medication is not recommended for patients with certain types of heart failure.

• Lactic Acidosis: Although rare, lactic acidosis is a serious condition that can occur with metformin use. This risk increases in older adults, those with kidney or liver issues, heart failure, dehydration, heavy alcohol consumption, and those undergoing surgery or imaging procedures using contrast dye. If you experience symptoms like extreme fatigue, dizziness, severe drowsiness, chills, blue or cold skin, muscle pain, difficulty breathing, slow or irregular heartbeat, or stomach pain with nausea, vomiting, or diarrhea, stop taking the medication and seek medical help immediately.

• Low Blood Sugar: Combining Actoplus Met with insulin or sulfonylureas like glipizide may increase the risk of hypoglycemia (low blood sugar). Inform your healthcare provider about all diabetes medications you are taking to ensure dosage adjustments are made as necessary.

• Liver Damage: Some individuals taking pioglitazone have experienced liver damage. Your healthcare provider will monitor your liver function through blood tests before and during treatment. Report symptoms such as loss of appetite, upper right abdominal pain, fatigue, dark urine, or yellowing of the skin or eyes to your healthcare provider promptly.

• Bladder Cancer Risk: There is inconclusive evidence regarding the increased risk of bladder cancer with pioglitazone use. If you have a history of bladder cancer, discuss the risks and benefits of this medication with your healthcare provider. Actoplus Met is not recommended for individuals currently diagnosed with bladder cancer.

• Bone Fractures: Pioglitazone may increase the risk of bone fractures, particularly in females. Discuss strategies to maintain bone health with your healthcare provider.

• Eye Problems: Some patients may develop macular edema (swelling in the eye) while taking pioglitazone. If you notice blurry vision or a decrease in visual sharpness, inform your prescriber or eye specialist promptly.

• Vitamin B12 Deficiency: Long-term use of Actoplus Met can lead to low vitamin B12 levels, which may cause anemia. Regular blood tests may be needed to monitor your vitamin B12 status. Report symptoms such as low energy, dizziness, poor appetite, or tingling and numbness in the extremities to your healthcare provider.

Contraindications: This medication should not be used in cases of:

• Certain types of heart failure.
• Severe kidney problems.
• Metabolic acidosis, including diabetic ketoacidosis.

Always consult your healthcare provider if you have any conditions that may contraindicate the use of Actoplus Met. Your provider will assess whether this medication is suitable for you based on your medical history and current health status.

Common side effects:

• nausea
• vomiting
• stomach upset
• diarrhea
• headache
• muscle pain
• metallic taste in the mouth

Less common but important to monitor:

• swelling
• weight gain
• sore throat
• tooth problems
• upper respiratory tract infections

Serious side effects:

• heart failure symptoms (shortness of breath or sudden weight gain)
• lactic acidosis (fast breathing and muscle pain)
• bladder issues (pain or blood during urination)
• liver problems (persistent nausea, dark urine, or yellowing of the skin)
• vision changes (blurry vision or macular edema)
• severe allergic reaction (rash, swelling of the face or throat, dizziness, difficulty breathing)
• high blood sugar (increased thirst and urination)
• low blood sugar (sudden sweating and dizziness)

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

• 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
• Iopromide
• Iopronic Acid
• Ioseric Acid
• Iosimide
• Iotasul
• Iothalamate
• Iotrolan
• Iotroxic Acid
• Ioxaglate
• Ioxitalamic Acid
• Ipodate
• Metrizamide
• Metrizoic Acid
• Tyropanoate Sodium

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

• Acarbose
• Aspirin
• Balofloxacin
• Besifloxacin
• Bupropion
• Capmatinib
• Chloroquine
• Chlorpropamide
• Ciprofloxacin
• Dasabuvir
• Dofetilide
• Dolutegravir
• Enoxacin
• Fleroxacin
• Flumequine
• Gatifloxacin
• Gemifloxacin
• Glimepiride
• Glipizide
• Glyburide
• Hydroxychloroquine
• Ifosfamide
• Insulin
• Insulin Aspart, Recombinant
• Insulin Bovine
• Insulin Degludec
• Insulin Detemir
• Insulin Glargine, Recombinant
• Insulin Glulisine
• Insulin Lispro, Recombinant
• Ioversol
• Lanreotide
• Levofloxacin
• Lomefloxacin
• Lumateperone
• Metformin
• Moxifloxacin
• Nadifloxacin
• Nateglinide
• Nifedipine
• Norfloxacin
• Octreotide
• Ofloxacin
• Ombitasvir
• Paritaprevir
• Pasireotide
• Pazufloxacin
• Pefloxacin
• Pioglitazone
• Piperaquine
• Pixantrone
• Prulifloxacin
• Repaglinide
• Ritonavir
• Rufloxacin
• Sitagliptin
• Sparfloxacin
• Tafenoquine
• Thioctic Acid
• Tolazamide
• Tolbutamide
• Tolvaptan
• Tosufloxacin
• Vandetanib

Interactions with low risk that usually do not require a change in therapy:

• Gemfibrozil
• Rifamycins including Rifampin
• Beta-blocker medications (such as metoprolol, Propranolol, glaucoma eye drops such as Timolol)