Many people not only around the world but in our own family are also suffering from diabetes. Unfortunately, diabetes can never be cured but can be managed. Generally, there are many types of diabetes but mainly three types of diabetes are considered to be of utmost important named as, Type 1 Diabetes and Type 2 Diabetes and Gestational Diabetes. In Type 1 Diabetes, the body is unable to produce insulin and needs regular shots to keep the glucose level normal. In Type 2 Diabetes, they can produce insulin but the cells in their bodies are ‘Insulin Resistant’ i.e. they do not respond properly to the hormone. As a result, the glucose gets accumulated in the blood. The third type namely Gestational Diabetes develops only in pregnant women, which disappears automatically after the delivery of the baby. Generally, such women have the risk of developing Type 2 Diabetes, approximately in coming next 15 years.

Actos i.e. Pioglitazone medicine is widely used to treat Type 2 Diabetes. Pioglitazone is a drug that reduces the amount of glucose sugar in the blood. It belongs to a class of anti-diabetic drugs named as, thiazolidinediones which is used in the treatment of Type 2 Diabetes. The other member in this class is Rosiglitazone Avandia. Another member of this class Troglitazone or Rezulin was removed from the market because of liver toxicity. Patients with Type 2 Diabetes cannot make enough insulin and the cells of their body do not respond normally to the reduced amounts of insulin that are present.

Insulin is the hormone produced by the pancreas that stimulates cells to remove glucose from the blood. Pioglitazone often is referred to as an insulin sensitizer because it attaches to the insulin receptors on cells throughout the body and causes the cells to become more sensitive and more responsive to insulin. As a result, more glucose is removed from the blood. At least some insulin must be produced by the pancreas in order for Pioglitazone to work.

Pioglitazone also lowers the level of glucose in the blood by reducing the production and secretion of the glucose into the blood by the liver. In addition Pioglitazone may alter the blood concentrations of lipids fats in the blood. Specifically, it decreases triglycerides and increases the good HDL cholesterol. Actos may also be used for other purposes that are not listed in this medication guide.

Pioglitazone received FDA approval on July 16 1999.

Generally, Pioglitazone tablets are taken orally only once daily, in doses ranging from 15 to 45 mg. Pioglitazone may be taken any time of the day with or without meals. If you miss a dose, do not double it the next day to cope up with the missed one. However, try to take the medicine as exactly prescribed by your doctor and also read the prescription label carefully to know the exact dosage. Remember, Actos cannot cure Type 2 Diabetes, but can help in managing it. Do not stop the course in between, even if you start feeling good and healthy. Consult your doctor before doing so.

For more information on the process, please consult from your doctor or your physician.

The most common side effects seen in clinical trials with Pioglitazone alone or in combination with Sulfonylureas Metformin or insulin were: upper respiratory tract infection, headache, sinusitis, muscle aches, tooth disorders, hypoglycemia, and sore throat. In addition, fluid accumulation Edema occurred in less than 5 of patients taking Pioglitazone alone. But 15 of patients taking Pioglitazone and insulin as compared with 2 and 7 of patients receiving placebo respectively. Fluid accumulation can lead to the heart failure.

Pioglitazone may cause ovulation in women who have stopped ovulating if they are pre-menopausal and insulin resistant. This may lead to pregnancy.

To date no formal studies to evaluate drug interactions of Pioglitazone with other drugs have been conducted. Nevertheless because it interacts with the liver enzymes that eliminate some other drugs there is the potential for Pioglitazone to increase the elimination of such drugs as erythromycin calcium channel blockers e.g. Cardizem, Cisapride Propulsid, Corticosteroids, Cyclosporine, Tacrolimus, Triazolam e.g. Halcion, Trimetrexate and HMG-CoA reductase inhibitors e.g. Lipitor. This would reduce their effectiveness.

Since another thiazolidinediones, anti diabetic drug has been associated with liver injury it is recommended that periodic monitoring of liver-related side effects and liver function be done in patients taking Pioglitazone. Side effects while taking Pioglitazone which may be due to liver injury include, nausea, vomiting, abdominal pain, fatigue, anorexia, loss of appetite or dark urine. Blood liver tests also are recommended during Pioglitazone therapy.

Studies in the laboratory have shown that an anti-fungal drug ketoconazole Nizoral prevents the elimination of Pioglitazone. This could lead to increased levels of Pioglitazone and Hypoglycemia, seriously reduced level of sugar in the blood. Therefore, the manufacturer of Pioglitazone recommends more frequent monitoring of blood sugar among patients taking both Pioglitazone and ketoconazole or the drugs related to ketoconazole Fluconazole Diflucan and Itraconazole Sporanox.

Since studies of Pioglitazone excluded patients with heart disease classified by the New York Heart Association NYHA, as Class III and IV more serious disease it is not known how diabetics with serious heart disease will respond to Pioglitazone, particularly since it may lead to fluid accumulation and heart failure.

Call your doctor if you have any of these unusual problems or some new problems arises, while taking this medication which may appear severe or persistent to you. Consult your doctor immediately and get treated accordingly.

Drug interactions can result in unwanted side effects or prevent a medicine from doing its job. So, keep an eye on what all medicines do you consume during the course.
Till date, no formal studies have been done to evaluate drug interactions of Pioglitazone with other drugs. However, since another thiazolidinediones that is similar to Pioglitazone may reduce the effectiveness of oral contraceptives potentially leading to pregnancy. Therefore, caution is suggested while using Pioglitazone with an oral contraceptive.

Clinical studies performed, using Pioglitazone 15-45mg did not reveal changes in blood levels for the following drugs: Glipizide, Digoxin, Warfarin or Metformin. In addition, the clotting of blood did not appear to be changed enough by Pioglitazone to require the iterations in the doses of the blood thinner Warfarin.

Healthy diet is very necessary, to achieve good results. Exercise, calorie reduction, weight loss etc. will help effectively to control the diabetes. So, to achieve this, stay in touch with your dietitian and your doctor too. In-take of alcohol during the course may prove harmful, so consult your doctor about how much quantity is safe for you to drink. It is better to avoid alcohol to get rid of any harmful interactions.

Also do inform your doctor about any other medication you may be taking in any other form. So, please consult your doctor and get more information on the interactions of the Actos medication and take precautions accordingly. If you wish to discontinue this medication, please consult your doctor before doing so.

In case of overdose call your local poison control center at 1-800-222-1222.
If the suffering patient has collapsed or is not breathing call local emergency services at 911. Canadian residents should call their local poison control center directly.

Keep all appointments with your doctor during the complete course. And never allow anyone else take your medication unless they are prescribed by their doctors themselves. Also inform your doctor if you have been the victim of any serious and major diseases. Without consulting your doctor, please do not take any OTC medications on your own, as they may interact with the current medicine and produce some life threatening results.

If you missed the dose, do take the dose immediately provided that there is ample of time in between the next dose. However if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Never double your doses to cope up with the missed dose. And in case, if you miss the two consecutive doses consult to your doctor or physician for guidance and continue further. Try your best not to miss any of your doses.

Pioglitazone is used for the treatment of Type 2 Diabetes along with a healthy diabetic diet, regular exercise, weight control, smoking reduction and careful monitoring of blood glucose. Pioglitazone may be used alone or in combination with Metformin, a drug in a different class of anti-diabetic drugs that also lowers blood glucose. Since it requires naturally-secreted insulin to be effective, Pioglitazone is not recommended in Type 1 diabetes, where the amount of insulin is very low or absent. Nevertheless, Pioglitazone is approved for treating Type 2 Diabetes in combination with insulin as well as another class of anti-diabetic drugs the Sulfonylureas.

This medicine may also be used to treat other purposes, but be sure to confirm it from your doctor.

Actos medication is sometimes prescribed for other uses also, so ask your doctor or pharmacist for more information.

Actos tablets are stored at a prescribed temperature of below 15-30°C and 59-86°C.
Keep the medicine in a light-resistant tight container and away from heat, dampness or direct light. Check Expiry date without fail. Keep all medicines away from women, newborns, children and pets. Moisture or Heat may cause the break down of the medicine. In any case, do not store the medicine in the bathroom. However, some manufacturers vary in their storage recommendations. Therefore storage conditions for each product should be clarified with your pharmacist. Dispose the outdated medicines safely.

Following precautions must be taken during consuming generic Actos:

1. Let your doctor know about your complete medical history, if you have or have ever had any severe diseases like heart failure, kidney disease, strokes, high or low blood pressure, diabetes, liver disease including cirrhosis and hepatitis, swollen ankles or feet, edema, high cholesterol or a history of alcohol abuse or any other major disease.
Also inform if you are breast feeding, had given delivery to a baby, any recent surgery or are receiving any kind of other injections etc.

2. Tell your doctor that what prescription and nonprescription medications you are taking or even any OTC like nutritional supplements, vitamins, minerals, herbal products etc. especially ketoconazole, Nizoral, oral contraceptives that you may be intaking, because there is possibility that they may interact with the Actos medication and reproduce harmful results. Also inform your doctor and pharmacist if your have ever taken Troglitazone Rezulin.

3. Inform your doctor if you consume alcohol or any alcohol containing beverages.

4. If you have to undergo any surgery, major operation or any dental procedure, inform your surgeon, dentist or doctor, that you are taking Actos medication.

5. Let your doctor or the physician know about your any kind allergies. They may be any food, medicine, Pioglitazone, Rosiglitazone, Troglitazone or any other drugs or composition.

6. Do not share the Actos with others unless they are prescribed by the doctor themselves. If the medicine is no longer in use or is outdated, discard it immediately after checking with your doctor or your pharmacist.

7. Always carry your some kind of identity that specifies your name, your medical condition, your medicine, your and health care professional’s contact number in case of emergency.

8. Do not discontinue medication on your own. Consult your doctor before doing so.

9. Keep the medication out of reach of newborns, children and pets.

10. Tell your doctor if you are pregnant, plan to become pregnant or are breast-feeding. If you conceive during the course, immediately inform your doctor.

11. Rush to your doctor immediately if any of the following symptoms occur, while using this Actos medication such as: Yellowing of the skin or whites of the eyes, Excessive tiredness, Loss of consciousness, Upset stomach, Vomiting, Stomach pain, Dark urine etc. If any other unusual symptoms, be sure to inform your doctor immediately.

12. Remember that, Pioglitazone can restart ovulation in women taking oral contraceptives or those with polycystic ovary disease. You may be at risk for pregnancy, if adequate birth control is not used. So, be sure to discuss a reliable form of birth control with your doctor. If you are already taking birth control pills, your doctor may adjust your dose accordingly.

13. Keep all the appointments with your doctor as the doctor may need to change the doses of your medications or monitor you carefully for side effects caused to you.