Pioglitazone / Metformin

Actoplus Met is an FDA-approved combination medication used to treat diabetes mellitus type 2. It contains a combination of two drugs, pioglitazone and metformin. It comes in the form of tablets with 15mg/500mg and 15mg/850 strengths. You should take it once or twice daily with food to decrease the chances of gastrointestinal side effects. This medication is not recommended for patients with type 1 diabetes or diabetic ketoacidosis. For safe and efficient use of the medication, you should talk to your physician or medical provider before using it and discuss with them the potential risks & benefits related to the use of Actoplus Met. If you want to buy Actoplus Met at coupon offer, you can obtain it from reputable and trusted sources to ensure authenticity and affordability.

Actoplus Met is a combination medication approved by the FDA that contains pioglitazone and metformin. Pioglitazone belongs to the thiazolidinedione class and is used to improve insulin sensitivity in people with type 2 diabetes. On the other hand, Metformin, a biguanide, decreases glucose production in the liver & enhances the body’s response to insulin. Together, these two active ingredients help manage blood sugar levels effectively when lifestyle modifications alone are insufficient.

Actoplus Met is available as tablets with various strengths, commonly in combinations such as 15 mg/500 mg and 15 mg/850 mg of pioglitazone and metformin, respectively. It should be taken with meals to reduce the risk of gastrointestinal side effects. The medication is prescribed for adults diagnosed with type 2 diabetes and is not recommended for people with type 1 diabetes/diabetic ketoacidosis. It works by improving insulin utilization and decreasing hepatic glucose production, promoting better glycemic control.

Commonly occurring side effects of Actoplus Met may include nausea, diarrhea, and weight gain. Severe but rare side effects include lactic acidosis and heart failure; medical advice should be sought if unusual symptoms occur. Patients with kidney or liver impairment should take precautions, and regular monitoring of blood sugar levels is advised. In case of a missed dose, take it as soon as remembered, but avoid double doses. An overdose requires immediate medical attention. Store Actoplus Met at a controlled room temperature, away from moisture and heat. Always follow the healthcare provider’s guidance for optimal results and safe use.

It is used to treat:

• Type 2 diabetes mellitus in adults who do not use daily insulin injections

[Important warnings: Actoplus Met is not intended for use in patients with type 1 diabetes.]

What Are the Forms & Strengths of Actoplus Met?

It comes in the form of tablets with the following form:

• 15mg of pioglitazone and 500mg of metformin hydrochloride
• 15mg of pioglitazone and 850mg of metformin hydrochloride

What Is the Recommended Dosage of Actoplus Met?

The recommended dosage of Actoplus Met tablets depends on the severity of the patient’s condition, age, and response to treatment, as well as the strength and duration of the medicine. The dosage mentioned below applies to everyone. If your doctor has recommended that you use a different dose than the one given here, you should follow their instructions and avoid making dosage alterations without talking to them first.

Dosage for Diabetes Type 2

Immediate-release

• Initial dosage: 15mg/500mg twice daily or 15mg/850mg once daily. 
• Maintenance dosage: Gradually increase the dosage based on the patient’s tolerability and the medication‘s safety and efficacy. 
• Maximum dosage: Pioglitazone 45mg/Metformin 2550mg

Extended-release

• Initial dosage: 15 mg/1000 mg or 30 mg/1000 mg XR orally once daily
• Maintenance dosage: Gradually titrate dosage based on the safety and efficacy of the drug and the patient’s response to the treatment. 
• Maximum dosage: Pioglitazone 45mg/Metformin 2000mg daily

[Note: Remember, the above recommendations may vary from individual to individual. Discuss them with your doctor, and they will make changes to your dosage accordingly.]

• Before taking Actoplus Met tablets for the first time and each time you get a refill, refer to the patient information leaflet and medication guide. Talk to your doctor if you have difficulty understanding any part of the leaflet.
• For safe and efficient use of the medication, you should take Actoplus Met exactly as your doctor has prescribed, preferably with meals. Take the Actoplus Met extended-release tablet once daily with your daily evening meals.
• The typical initial dose is 15 or 30 mg, but your doctor may adjust it based on the severity of your condition and how well your body responds to the medication.
• You should swallow the tablets as a whole without crushing, breaking, or chewing them, as it can release all the drugs at once.
• Some users may experience hypoglycemia while being treated with this medication and feel very hungry, irritable, anxious, shaky, or dizzy. To quickly treat hypoglycemia, they should eat or drink a fast-acting sugar source, such as hard candy, crackers, non-diet soda, and raisins.
• Your doctor will most likely prescribe a glucagon injection kit in case you have signs and symptoms of severe hypoglycemia. Ensure your family and close friends know how to give you this injection in an emergency.
• Your blood glucose levels may be influenced by stress, illness, exercise, alcohol use, or skipping meals. Ask your doctor before making alterations to your dose or medication schedule.
• This medication is only a part of the complete treatment program that may also include exercise, diet, weight control, blood sugar testing, and special medical care. Depending on how well your body naturally manages blood glucose levels, your doctor may prescribe you to use Actoplus Met on itself or with other antidiabetic medicines.
• You should follow your doctor’s instructions very closely. Do not make dosage alterations without consulting them first, as it can cause harm.
• If you are taking extra Vitamin B12 while you are using Actoplus Met, you should take only the amount of vitamin B12 that your doctor has recommended.
• Tell your doctor if your condition does not get improve or if it worsens.

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

Actoplus Met is a combination medication containing two active ingredients, metformin hydrochloride and pioglitazone, prescribed mainly to manage blood glucose levels in users with diabetes type 2. Pioglitazone belongs to a class of medicines known as thiazolidinediones, which increase the body’s sensitivity to insulin. This helps the body cells use glucose more effectively, thereby reducing blood glucose levels in the bloodstream.

On the other hand, metformin hydrochloride is a biguanide that functions by reducing the amount of glucose made by the liver & increasing the muscle sensitivity of muscle cells to insulin. Together, these two medications provide a comprehensive approach to managing blood sugar levels, improving glycemic control, and helping to prevent and manage complications associated with diabetes. Actoplus Met is typically taken with meals to enhance its effectiveness & decrease the risk of gastrointestinal side effects.

Common mild side effects of Actoplus Met: Similar to other medicines used to treat diabetes mellitus type 2, Actoplus Met can cause certain temporary side effects in some people using it. These side effects are usually temporary and do not typically require medical intervention. These symptoms usually resolve on their own within a couple of days or weeks, but if they persist or become bothersome, let your doctor know. Common side effects of the drug include:

• Weight gain: Many people using Actoplus Met have reported a significant weight gain primarily due to the pioglitazone component. Pioglitazone can cause the body to retain extra fluid and increase fat storage, leading to extra weight gain. To prevent this, you should monitor your weight regularly, follow a healthy and balanced diet, engage in regular physical activity, and discuss any significant weight changes with your doctor. In some cases, adjusting your dosage or medication might be necessary. 
• Headache: Headache is one of the top most commonly reported temporary side effects of Actoplus Me,t but the exact mechanism behind why this happens is not entirely understood. To manage headaches, you should ensure consistent blood sugar management through constant monitoring, staying hydrated throughout the day, following a well-balanced diet, and sticking to prescribed dosages. If the headache persists or becomes bothersome, you should tell your doctor. 
• Diarrhea: This is a common gastrointestinal side effect associated with the use of Actoplus Met, especially during the initial weeks of starting treatment with it. This primarily occurs due to the Metformin component, which can affect the gastrointestinal tract and cause loose stools. You should take the medication with meals or a milky drink to reduce this side effect. Additionally, starting the medication with a lower dose & gradually increasing it, as advised by a licensed healthcare professional, can help improve tolerance. If diarrhea persists, it may lead to dehydration, so maintaining adequate fluid intake is crucial. 
• Cold symptoms: Upper respiratory tract infections presenting as stuffy nose, sore throat, sneezing, and Sinus pain have been reported in patients using Actoplus Met. While the exact cause behind this is not entirely clear, it is essential to monitor these symptoms. While over-the-counter medicines may alleviate the discomfort, consulting a healthcare professional before taking any additional medicines is essential to avoid potential drug interactions. If your symptoms persist or become bothersome, seek medical advice. 
• Nausea and vomiting: These are possible side effects of Actoplus Met, which are often related to the metformin component. These side effects are most likely to occur during the initial days of being treated with the drug and are likely to subside as your body adjusts to it. If the symptoms are severe or do not improve over time, you should talk to a healthcare professional. They may adjust your medication dosage or suggest an alternative treatment. 

• Muscle pain: Though less common, some users may experience muscle pain while using Actoplus Met. Severe muscle pain, a rare but serious side effect of metformin, may be a sign of lactic acidosis. If you experience unexplained muscle pain, especially if accompanied by weakness or fatigue, seek immediate medical attention. 
• Tooth problems: While not commonly reported, some people may experience dental issues. You should maintain good oral hygiene and regularly visit your dentist to have oral check-ups. If you notice any new or worsening symptoms of tooth-related issues, discuss them with your doctor or healthcare provider. 
• Unusual muscle pain: This can be an indication of lactic acidosis, a rare but adverse condition linked with the accumulation of metformin. Lactic acidosis occurs when there is a lactate build-up in the bloodstream faster than it can be removed, leading to reduced pH levels. To prevent this, you should adhere to the prescribed dosage and avoid consuming alcohol while being treated with this medication. If muscle pain occurs, you should seek immediate medical attention. 
• Feeling cold: Feeling cold, especially in the extremities, may also indicate lactic acidosis, which is caused by poor circulation and reduced oxygen delivery to tissues due to an acid-base imbalance. You should monitor your symptoms closely, and if you feel cold, especially in the extremities, report them to your physician or healthcare provider immediately. 
• Difficulty breathing can be a sign of fluid retention or heart failure, especially related to the pioglitazone component. This ingredient can potentially cause the body to retain fluid, cause swelling, and cause respiratory issues. To help detect it early, you should monitor your symptoms and watch for unusual swelling. If breathing difficulties develop, immediately contact a healthcare provider. 
• Dizziness, lightheadedness, fatigue, or weakness: These symptoms may be associated with hypoglycemia or lactic acidosis. Hypoglycemia may occur if you skip meals or if there is an imbalance in the medication use. To prevent these symptoms, you should regularly monitor your blood glucose levels and maintain consistent meal patterns. If these symptoms occur, seek medical advice. 
• Stomach pain: This is common during the initial days of starting treatment with metformin, which occurs due to metformin’s effect on the gastrointestinal tract. To reduce these symptoms, you may take Actoplus Met with meals or a milky drink. If symptoms persist, contact your healthcare practitioner. 
• Slow or irregular heart rate: This can be a symptom of lactic acidosis, which affects the heart’s electrical activity due to an imbalance in the pH levels of the blood. If you experience cardiac symptoms, seek medical advice. 

Serious side effects of Actoplus Met: Rarely Actoplus Met can cause severe side effects in some people using it to treat diabetes mellitus type 2. Your doctor has prescribed you this medication after determining that the benefits of pioglitazone/metformin justify the risks associated with its use. Severe symptoms require immediate medical attention and can become life-threatening in some cases if not treated promptly. If you experience any of the symptoms given below, you should seek medical attention.

• Severe allergic reactions: Actoplus Met can cause allergic reactions, which can become serious in some cases. Patients with a known hypersensitivity to pioglitazone, metformin, or any other inactive ingredient present in the product should not take it. If you are unaware of what ingredients the medication contains, consult your pharmacist or healthcare professional. However, if you develop signs & symptoms of an allergic reaction, you should discontinue using the medication and seek medical attention immediately. Its symptoms may include racing heart, breathing problems, fever, general feeling of illness, swollen lymph nodes, swelling under the skin, hives, nausea, vomiting, stomach cramps, joint pain, dizziness, or lightheadedness. 
• Heart failure: This medication can increase your chance of heart failure, especially if you also use insulin. Let your doctor or healthcare provider know immediately if you experience signs & symptoms of heart failure, such as shortness of breath, trouble breathing, swelling under the skin of ankles, feet, or legs, unusual fatigue, or unusually fast weight gain. 
• Lactic acidosis: This medication can cause a rare but potentially serious condition known as lactic acidosis, lactic acid buildup in your blood, which may be serious. Discontinue using Actoplus Met and seek immediate medical attention if you have any of the following symptoms of lactic acidosis: 
  • A general feeling of illness
  • Muscle pain
  • Drowsiness
  • Trouble breathing
  • Abdominal pain
• Vitamin B12 deficiency: This medication can cause low levels of vitamin B12 in your blood, which may cause anemia. Your medical provider will likely recommend you use lab tests to check for anemia and B12 levels. Immediately tell your doctor if you have cold hands or feet, unusual weakness, fatigue, abnormal heartbeat, pale or yellowish skin, dizziness, and shortness of breath. 

• Low blood sugar: When you use this medication with insulin or other medicines that decrease your blood sugar by increasing your body’s insulin levels, it can cause hypoglycemia. The doses of other medications may need to be changed when you use them with metformin/pioglitazone. Immediately call your physician or healthcare provider if you have any of the following symptoms of low blood sugar: 
  • Headache
  • Hunger
  • Crankiness
  • Anxiety
  • Slurred speech
  • Blurred vision
  • Rapid heartbeat
  • Shakiness or feeling jittery
  • Seizures
• Edema: This medication can lead to the build-up of fluid in the body, especially if you take a higher dose. Immediately inform your doctor or healthcare provider if you have swelling in your legs, ankles, or feet or if you have unexplained weight gain. 
• Fractures or osteoporosis: Actoplus Met can increase the risk of breaking a bone, usually in the feet, arm, or hand, especially in female patients. Discuss with your physician or medical provider to learn how to keep your bones healthy. To prevent fractures, avoid engaging in hazardous activities while using this medication. 
• Liver damage: Hepatoxicity or liver damage may occur while using pioglitazone/metformin. Call your doctor or healthcare provider immediately if you have any of the following symptoms or hepatic damage such as fever, stomach or belly pain, nausea or vomiting, itching, weakness, loss of appetite, unusual fatigue, itching, dark-colored urine, light-colored stool, or jaundice. 
• Bladder cancer: You have an increased risk of developing bladder cancer if you take Actoplus Met. Immediately get in touch with your doctor or healthcare provider if you have red pee or blood in your urine, pain during urination, and frequent urination. 
• Macular edema: Pioglitazone and metformin can increase the risk of fluid buildup in certain parts of the eye. Although you may not have any symptoms, you should keep regular eye appointments with an ophthalmologist. If your vision changes, immediately inform your doctor or healthcare provider. 

[Note: Remember, the above list may not cover all possible side effects of Actoplus Met. Always consult with your doctor or healthcare provider for medical advice about side effects.]

• You should not use Actoplus Met if you are suffering from severe heart failure, severe renal disease, active bladder cancer, metabolic acidosis, or ketoacidosis.
• This medication may cause or worsen congestive heart failure. Immediately call your doctor if you experience shortness of breath, rapid weight gain, or swelling.
• If you need any type of x-ray or CT scan using a dye that is to be injected into your veins, your doctor or healthcare practitioner may ask you to temporarily discontinue using Actoplus Met.
• While using Actoplus Met, it is possible for some users to develop a dangerous build-up of acid in their bloodstream, known as lactic acidosis. Call a licensed healthcare provider or seek immediate medical assistance if you have unusual muscle pain, stomach pain, trouble breathing, dizziness, fatigue, or coldness.

What Are the FDA Boxed Warning for Actoplus Met?

A black box warning for Actoplus Met has been issued by the FDA. It highlights the potential conditions caused by its active ingredients- pioglitazone and metformin. The key points of the boxed warning may include:

• Congestive Heart Failure

Actoplus Met, which contains pioglitazone, may cause or worsen heart failure. Patients should be monitored closely by their medical providers for signs such as rapid weight gain, shortness of breath, or swelling, especially after starting or increasing the dose. If heart failure develops, consider reducing the dose or stopping the medication. Actoplus Met is not recommended for patients with symptomatic heart failure and is contraindicated in those with NYHA Class III or IV heart failure.

• Lactic Acidosis

Metformin, an active ingredient in Actoplus Met, can lead to lactic acidosis, a rare but serious condition. Risk factors include sepsis, dehydration, alcohol use, liver or kidney problems, and acute heart failure. Symptoms may include tiredness, muscle pain, trouble breathing, drowsiness, and stomach discomfort. Blood tests may show low pH, high anion gap, and elevated lactate levels. If suspected, stop Actoplus Met and seek immediate medical care.

• Before using Actoplus Met, your doctor will most likely recommend that you undergo certain tests, such as those that check for liver issues. These tests are essential to determine whether they should prescribe this medication to patients with certain conditions. Hence, you should share your medical and family history with your doctor, especially if you have or have ever had hepatic issues, heart failure, diabetes type 1, or diabetic ketoacidosis in the past.
• You should also tell your doctor if you have ever had bladder cancer or macular edema, a diabetic optic disease that causes swelling in the back of the eye.
• Patients who have type 1 diabetes and a history of diabetic ketoacidosis should not use Actoplus Met. Additionally, this medication is not indicated for use in patients who are less than 18 years of age. Patients who have liver problems or heart failure should be watched carefully in case these medical conditions become worse while using Actoplus.
• Pioglitazone, an active ingredient in Actoplus Met, is known to increase the chances of pregnancy in some people and can also harm the unborn fetus. If you do not plan to become pregnant while using this drug, you should discuss effective contraceptive methods with your doctor. If you plan to become pregnant or suspect a pregnancy, inform your doctor before using Actoplus Met.
• Actoplus Met is also known to pass into the breastmilk and can affect the nursing infant. Hence, let your doctor know if you are breastfeeding an infant or plan to breastfeed.
• Certain medications, supplements, and vitamins can interact with this medication and cause issues.

It is contraindicated for use in patients who have:

• Severe heart failure, as pioglitazone, one of its active ingredients, can cause or worsen heart failure.
• Severe kidney disease, as this medication, can cause lactic acidosis, especially in patients with severe renal impairment.
• Active bladder cancer
• Metabolic acidosis or ketoacidosis as these conditions can be exacerbated by the medication.

To get the most out of Actoplus Met, you should stay consistent with the dosage and try to take it at the same time each day to help you remember to use it. However, if you miss a dose, ask your doctor or follow the instructions given below.

• If you have missed a dose of Actoplus Met, you should take it as soon as you think of it unless it is almost time to take your next dose. In such cases, you may skip the dose and continue taking your medication according to the regular scheduled dose.
• If you often forget to take your medicine on time, you can set a reminder on your mobile phone or mark your calendar to remind you to do so.
• If you are still unsure when to take your next dose, you should talk to your doctor or healthcare provider.

[Note: If you have missed a dose of Actoplus Met and are unsure about when to take the next one, consult your doctor or pharmacist immediately.]

You should not take Actoplus Met more than the prescribed dose, in large quantities, or more frequently than recommended, as it can cause an overdose. Its symptoms may include confusion, sweating, shakiness, and loss of consciousness. It can cause lactic acidosis and congestive heart failure. If you experience adverse signs and symptoms of an overdose, such as difficulty breathing or seizures, seek prompt medical attention by calling a healthcare professional or 911. You can also go to the nearest medical care centre.

[Note: If you suspect you or someone else has consumed Actoplus Met more than the prescribed dose, seek medical assistance right away or call the Poison Help line at 1-800-222-1222.]

• You should keep Actoplus Met in a tightly closed container, in a cool & dry place, at a controlled room temperature, to protect against direct exposure to sunlight, moisture, and excess heat, which can harm it.
• Do not keep the tablets in the bathroom or other places with high humidity.
• You should keep all medications, including Actoplus Met, in a safe place, away from the sight and reach of children and pets.
• If your doctor no longer prescribes Actoplus Met tablets or has passed its expiration date, you should dispose of them safely in a manner that does not let children, animals, or other people consume them.

[Note: Discuss with your medical provider or pharmacist about the proper disposal of any unused drug and any queries you may have regarding its storage.]

Certain medications may interact with Actoplus Met tablets and affect how they work or cause unwanted side effects. To prevent and manage such interactions, you should tell your doctor, healthcare provider, or doctor about all medications you use or plan to use, including all prescription medicines, over-the-counter drugs, herbs, and vitamin supplements. This information is also essential to identify and prevent potential drug interactions. Some of the main interactions of Actoplus Met may include

• Potent CYP2C8 inhibitors: Inhibitors of CYP2C8, such as gemfibrozil, can significantly increase the risk of exposure and half-life of pioglitazone, an active ingredient in the product. Therefore, the maximum recommended dosage of Actoplus Met is 15 mg of pioglitazone and 850mg of metformin once daily when used in combination with gemfibrozil or other strong CYP2C8 inhibitors.
• Carbonic anhydrase inhibitors: Topiramate or other carbonic anhydrase inhibitors, including acetazolamide, zonisamide, or dichlorphenamide, frequently cause a reduction in serum bicarbonate and induce non-anion gap, hyperchloremic metabolic acidosis. Concomitant use of these medications with Actoplus Met may increase the risk for lactic acidosis. A licensed healthcare professional should closely monitor such patients. 
• Drugs that decrease metformin clearance: Concomitant use of medications that may interfere with common renal tubular transport systems involved in the elimination of metformin from the kidneys, such as organic cationic transporters 2 such as vandetanib, ranolazine, cimetidine, and dolutegravir. This interaction could increase systemic exposure to metformin and may also increase the risk of lactic acidosis. Before using these medications along with Actoplus Met, you should discuss the risks and benefits of using them together. 
• Medications affecting glycemic control: Certain medications tend to cause high blood sugar levels in the bloodstream and may cause loss of glycemic control. These medications include thiazides and other diuretics, phenothiazines, thyroid medicines, corticosteroids, estrogens, oral contraceptives, nicotinic acid, calcium channel blockers, isoniazid, and sympathomimetics. When such medicines are administered to an individual receiving Actoplus Met, they should be closely monitored for loss of control over blood glucose. When such medications are discontinued in a patient using Actoplus Met, they should be monitored closely for signs and symptoms of hypoglycemia. 
• Topiramate: With concomitant use of Actoplus Met with topiramate, a decrease in pioglitazone exposure and its active metabolites were observed. However, the exact reason behind this is unknown. However, when you use Actoplus Met with topiramate, you should be closely monitored by a healthcare practitioner.

What Are the Other Actoplus Met Interactions?

Apart from medicines, certain substances, herbs, supplements, and beverages may interact with Actoplus Met and affect how it works. To prevent such interactions, you should discuss with your doctor if you have any concerns or queries. If your doctor determines that there are some potential interactions between this drug and certain substances, they may suggest you make certain dietary and lifestyle changes.

• Alcohol: Alcohol may potentiate the effect of metformin, an active ingredient in Actoplus Met, on lactate metabolism. You should not consume alcohol in large amounts while receiving treatment with Actoplus Met. 
• Insulin: Use of insulin secretagogues or insulin may increase the risk of hypoglycemia. If a patient experiences signs & symptoms of severe low blood sugar while being treated with this medication along with insulin, the dosage of the insulin should be reduced.

[Note: The above list of interactions is not a complete list, and there could be other drugs that interact with Actoplus Met. Tell your doctor about any prescription, non-prescription, over-the-counter medicines, and herbal products you are using.]

While Actoplus Met is an effective medication used to treat diabetes mellitus type 2, it may not be suitable for everyone to use due to allergies or other contraindications. If you are looking for alternatives to this medication, you should not use it without talking to your healthcare provider or pharmacist first. Based on multiple factors such as your condition, age, and other factors, they will help you determine the medication that is most suitable for you. Some of the most effective alternatives for this medication may include:

• Mounjaro
• Semaglutide
• Tirzepatide
• Januvia (sitagliptin)
• Victoza

[Note: Your doctor will help you determine which alternative is most suitable for you. Do not use any of these alternatives without talking with your healthcare provider first. Taking them by yourself may cause unwanted side effects.]

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