Actoplus Met (Pioglitazone/Metformin)

Do’s

• Before starting Actoplus Met, read the Medication Guide provided by your pharmacist and ask your healthcare provider any questions you may have.
• The dosage of Actoplus Met is based on your medical condition, response to treatment, and other medications you may be taking. Inform your healthcare provider about all the products you use, including prescription drugs, nonprescription drugs, and herbal products.
• Your healthcare provider may direct you to start this medication at a low dose and gradually increase your dose to reduce the risk of side effects, such as upset stomach. Follow their instructions carefully regarding dosage adjustments.
• Take Actoplus Met by mouth as directed by your healthcare provider, usually once or twice daily with meals to decrease stomach upset. 
• Drink plenty of fluids while taking this medication unless otherwise directed by your healthcare provider.
• Take this medication regularly at the same time(s) each day in order to get the most benefit from it. Remember to use it consistently to achieve the best results.
• If you are already taking another diabetes medication, follow your healthcare provider's directions carefully for stopping/continuing the old drug and starting Actoplus Met
• Regularly check your blood sugar as directed by your healthcare provider and keep track of the results. Share the results with your healthcare provider and inform them if your blood sugar measurements are too high or too low. Your dosage or treatment may need to be adjusted based on these measurements.
• It may take up to 2 to 3 months before the full benefit of Actoplus Met takes effect. Continue using it as directed and follow up with your healthcare provider regarding its effectiveness.

Common Side Effects:

• Upper respiratory tract infection
• Edema
• Diarrhea
• Headache
• Muscle pain
• Weight gain 

Serious side effects have been reported with Actoplus Met. Discuss any concerns with a healthcare provider and be aware of potential serious side effects.

Monitor for any side effects while taking Actoplus Met and communicate any concerns with a healthcare provider. If you experience any unexpected or concerning symptoms, seek medical advice promptly.

Liver tests (serum alanine and aspartate aminotransferases, alkaline phosphatase, and total bilirubin) should be obtained prior to initiating Actoplus Met. Patients who have liver test abnormalities prior to initiation of Actoplus Met or who are found to have abnormal liver tests while taking Actoplus Met should be managed as described under Warnings and Precautions.

Assess renal function prior to initiation of Actoplus Met and periodically thereafter. Discontinue Actoplus Met if the patient's estimated glomerular filtration rate (eGFR) later falls below 30 mL/min/1.73 m2.

After initiation of Actoplus Met or with a dose increase, monitor patients carefully for adverse reactions related to fluid retention such as weight gain, edema, and signs and symptoms of congestive heart failure.

Use Actoplus Met with caution in patients with liver disease. There are postmarketing reports of liver failure with pioglitazone, and clinical trials have generally excluded patients with serum ALT >2.5 times the upper limit of the reference range.

Be aware that pioglitazone, one of the ingredients in Actoplus Met, has been associated with an increased risk of bladder cancer when used for more than one year. Patients should discuss any concerns with their healthcare provider

Consult a healthcare provider before taking Actoplus Met, changing any diet, or commencing or discontinuing any course of treatment. Additionally, discuss any existing medical conditions or concerns with a healthcare provider before starting Actoplus Met.

These warnings and precautions should be considered before initiating treatment with Actoplus Met.