Serious side effects
Some people may have serious side effects after taking Piodar.
Call your doctor straight away if:
- your skin or whites of your eyes turn yellow - these can be signs of a liver problem
- you put on weight quickly, your arms, legs or stomach are swollen, and you have problems breathing - these can be signs of heart failure
- there's blood in your pee and you have problems peeing or need to pee urgently - these can be signs of bladder cancer
You're also at greater risk of breaking a bone when taking Piodar, particularly if you are a woman. If you are treated for a broken bone or fracture, let your doctor know as soon as possible afterwards.
See also Warning section.
Before taking this medication, tell your doctor or pharmacist if you are allergic to Piodar or metformin; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: severe breathing problems (such as obstructive lung disease, severe asthma), blood problems (such as anemia, vitamin B12 deficiency), kidney disease, liver disease, heart disease (such as congestive heart failure, chest pain), fluid in your lungs, swelling (edema), a certain eye problem (macular edema), bladder cancer.
Before having surgery or any X-ray/scanning procedure using iodinated contrast, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). You may need to stop this medication for a short time for the surgery/procedure. Ask your doctor or dentist for instructions before your surgery/procedure.
You may experience blurred vision, dizziness, or drowsiness due to extremely low or high blood sugar. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely.
Limit alcohol while using this medication because it can increase your risk of lactic acidosis and developing low blood sugar.
High fever, "water pills" (diuretics such as hydrochlorothiazide), too much sweating, diarrhea, or vomiting may cause loss of too much body water (dehydration) and increase your risk of lactic acidosis. Stop taking this medication and tell your doctor right away if you have prolonged diarrhea or vomiting. Be sure to drink enough fluids to prevent dehydration unless your doctor directs you otherwise.
It may be harder to control your blood sugar when your body is stressed (such as due to fever, infection, injury, or surgery). Consult your doctor because increased stress may require a change in your treatment plan, medications, or blood sugar testing.
Piodar may increase the risk of bone fracture in women (usually in the upper arm, hand, or foot). See also Notes section.
Older adults may be at greater risk for side effects such as low blood sugar or lactic acidosis.
During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor. Your doctor may direct you to use insulin instead of this product during your pregnancy. Follow your doctor's instructions carefully.
This medication can cause changes in the menstrual cycle (promote ovulation) and increase the risk of becoming pregnant. Consult your doctor or pharmacist about the use of reliable birth control while using this medication.
Metformin passes into breast milk in small amounts. It is unknown if Piodar passes into breast milk. Consult your doctor before breast-feeding.
Serious Side Effects of Piodar
Contact your physician immediately if you experience any of the symptoms listed in the Warning section or any of the following serious side effects:
- Vision changes or vision loss
- Discolored, cloudy, or bloody urine
- Back or abdominal pain
Piodar comes as a tablet and is typically taken by mouth once a day, with or without meals.
Your dosage will be based on your medical condition, response to treatment, and other drugs you're taking.
Try to take Piodar around the same time each day.
Your doctor might start you on a low dose and gradually increase it.
Follow the instructions on your prescription label carefully. Don't take more or less than is prescribed.
How to use Piodar HCL
Read the Medication Guide provided by your pharmacist before you start using Piodar and each time you get a refill. If you have any questions, ask your doctor or pharmacist.
Take this medication by mouth with or without food as directed by your doctor, usually once daily. Dosage is based on your medical condition, response to treatment, and if you are taking other diabetes drugs. Your doctor will adjust your dose based on your blood sugar to find the best dose for you. Follow your doctor's directions carefully.
Take this medication regularly in order to get the most benefit from it. Remember to use it at the same time each day.
If you are already taking another diabetes drug (such as metformin or a sulfonylurea), follow your doctor's directions carefully for stopping/continuing the old drug and starting this medication. Carefully follow the medication treatment plan, meal plan, and exercise program your doctor has recommended.
Check your blood sugar regularly as directed by your doctor. Keep track of the results, and share them with your doctor. Tell your doctor if your blood sugar measurements are too high or too low. Your dosage/treatment may need to be changed. It may take up to 2 to 3 months before the full benefit of this drug takes effect.
7. Pregnancy and breastfeeding
Piodar is not generally recommended in pregnancy. It's not clear whether Piodar can harm your unborn baby.
Talk to your doctor if you're trying for a baby, or if you find out that you're pregnant while taking Piodar. They will probably prescribe insulin for you instead.
What should I avoid while taking Piodar (Actos)?
Avoid drinking alcohol. It lowers blood sugar and may interfere with your diabetes treatment.
What Other Drugs Interact with Piodar?
If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.
Piodar has no known severe interactions with other drugs.
Serious interactions of Piodar include:
Piodar has moderate interactions with at least 78 different drugs.
Piodar has minor interactions with at least 135 different drugs.
This information does not contain all possible interactions or adverse effects. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns or for more information about this medicine.
Which drugs or supplements interact with Actos (Piodar)?
- Gemfibrozil reduces the break down of Actos by certain liver enzymes, increasing blood levels and possibly side effects of Actos. The maximum dose of Actos should not exceed 15 mg daily when combined with gemfibrozil or other drugs that reduce the activity of liver enzymes that break down Actos. Conversely, rifampin increases the breakdown of Actos by the liver, reducing blood levels and possibly the effects of Actos.
What are some side effects that I need to call my doctor about right away?
WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:
- Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
- Bone pain.
- Feeling very tired or weak.
- Change in eyesight.
- Pain when passing urine or blood in urine.
- Passing urine more often.
- Low blood sugar can happen. The chance may be raised when Piodar is used with other drugs for diabetes. Signs may be dizziness, headache, feeling sleepy or weak, shaking, fast heartbeat, confusion, hunger, or sweating. Call your doctor right away if you have any of these signs. Follow what you have been told to do for low blood sugar. This may include taking glucose tablets, liquid glucose, or some fruit juices.
- Very bad and sometimes deadly liver problems have happened with Piodar. Call your doctor right away if you have signs of liver problems like dark urine, feeling tired, not hungry, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.
What are the possible side effects of Piodar (Actos)?
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Stop using Piodar and call your doctor at once if you have symptoms of liver damage: nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes).
Call your doctor at once if you have:
- shortness of breath (especially when lying down), unusual tiredness, swelling, rapid weight gain;
- pink or red urine, painful or difficult urination, new or worsening urge to urinate;
- changes in your vision; or
- sudden unusual pain in your hand, arm, or foot.
Some people taking this medicine have had bladder cancer, but it is not clear if Piodar was the actual cause.
Common side effects may include:
- muscle pain; or
- cold symptoms such as stuffy nose, sinus pain, sneezing, sore throat.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
4. How and when to take it
Doses of Piodar can vary. Follow your doctor's instructions when taking this medicine.
You'll usually take Piodar once a day. You can take it at any time, for example in the morning or in the evening. Try to take it at the same time every day.
Swallow the tablet whole, with a glass or water. Do not chew it.
You can take Piodar with or without food.
What Is Piodar (Actos)?
Piodar is the generic form of the prescription drug known by the brand name Actos.
It's used along with diet and exercise to help lower blood sugar in people who have type 2 diabetes.
When you have type 2 diabetes, your body doesn't make or use the hormone insulin normally, so it can't control the amount of sugar, or glucose, in the blood.
Piodar is in a class of drugs known as thiazolidinediones.
It lowers blood-sugar levels by making the body's cells more sensitive to insulin, allowing them to take up more glucose from your blood.
Taking Piodar, along with adopting a healthy lifestyle, can decrease your risk of developing the serious or life-threatening complications of type 2 diabetes.
These may include cardiovascular diseases, such as heart attack, stroke, and problems related to blood circulation; nerve damage; kidney disease; or eye conditions.
The drug is manufactured by Takeda Pharmaceuticals, and was approved by the Food and Drug Administration (FDA) in 1999.
As with other medications, Actos (Piodar) can cause several side effects and weight gain appears to be one of them. Clinical trials conducted before Actos was approved by the Food and Drug Administration has shown that this drug can cause an increase in body weight.
It is important to note, however, that sudden, uncontrolled weight gain may indicate congestive heart failure, a possible side effect of Actos. Weight increase of more than three to five pounds per week should be evaluated carefully for possible heart complication.