Drug Name
Actoplus Met (Pioglitazone/Metformin)

Drug Uses
Actoplus Met is used for treating type 2 diabetes. It is used along with diet and exercise. It may be used alone or with other antidiabetic medicines.

How to use
Use Actoplus Met as directed by your doctor. Check the label on the medicine for exact dosing instructions.
An extra patient leaflet is available with Actoplus Met . Talk to your pharmacist if you have questions about this information.
Take Actoplus Met by mouth with meals.
Take Actoplus Met on a regular schedule to get the most benefit from it. Taking Actoplus Met at the same times each day will help you remember to take it.
Continue to take Actoplus Met even if you feel well. Do not miss any doses.

Drug Class and Mechanism
Actoplus Met is a biguanide and thiazolidinedione antidiabetic combination. It works by decreasing the amount of sugar the liver produces and the intestines absorb. It also helps to make your body more sensitive to the insulin that you naturally produce.

Missed Dose
If you miss a dose of Actoplus Met , take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Storage
Store this medicine at room temperature at 77 degrees F (25 degrees C) in a tightly-closed container, away from heat, moisture, and light. Brief storage between 59 and 86 degrees F (15 and 30 degrees C) is permitted.

Warnings/Precautions
Do NOT use Actoplus Met if:

• you are allergic to any ingredient in Actoplus Met
• you have type 1 diabetes
• you have moderate to severe heart failure
• you have a severe infection, low blood oxygen levels, kidney or liver problems, or high blood ketone or acid levels (eg, diabetic ketoacidosis), or you are severely dehydrated
• you have had a stroke or a recent heart attack, or you are in shock
• you are 80 years old or more and have not had a kidney function test
• you will be having surgery or certain lab procedures
• you have a history of liver problems, including jaundice (yellowing of the skin or eyes), during therapy with a similar medicine called troglitazone

Contact your doctor or health care provider right away if any of these apply to you.

Some medical conditions may interact with Actoplus Met . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have a history of heart problems (eg, heart failure), abnormal liver function tests, lung or breathing problems, thyroid problems, stomach or bowel problems (eg, paralysis, blockage), adrenal or pituitary problems, eye or vision problems (eg, macular degeneration), bladder cancer, or lactic acidosis
• if you have fluid retention or swelling problems, vomiting, diarrhea, poor health or nutrition, low blood calcium or vitamin B12 levels, or anemia, or if you are dehydrated
• if you have an infection, fever, recent injury, or moderate to severe burns
• if you have a history of bone fracture, weak bones (eg, osteoporosis), or low calcium intake
• if you drink alcohol or have a history of alcohol abuse
• if you will be having surgery or certain lab procedures
• if you take a beta-blocker (eg, propranolol)

Some MEDICINES MAY INTERACT with Actoplus Met . Tell your health care provider if you are taking any other medicines, especially any of the following:

• Amiloride, cimetidine, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamterene, trimethoprim, or vancomycin because they may increase the risk of Actoplus Met 's side effects
• Calcium channel blockers (eg, nifedipine), corticosteroids (eg, prednisone), diuretics (eg, furosemide, hydrochlorothiazide), estrogen, hormonal contraceptives (eg, birth control pills), insulin, isoniazid, nicotinic acid, oral antidiabetics (eg, glipizide), phenothiazines (eg, chlorpromazine), phenytoin, sympathomimetics (eg, albuterol, pseudoephedrine), or thyroid hormones (eg, levothyroxine) because the risk of high or low blood sugar may be increased
• Gemfibrozil because it may increase the risk of Actoplus Met 's side effects
• Rifampin because it may decrease Actoplus Met 's effectiveness, resulting in high blood sugar
• Anticoagulants (eg, warfarin) because their effectiveness may be decreased or the risk of their side effects may be increased by Actoplus Met

Possible Side Effects
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

• Cold-like symptoms; diarrhea; headache; indigestion; mild weight gain; nausea; stomach upset.

Seek medical attention right away if any of these SEVERE side effects occur:

• Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blurred vision or other vision changes; bone pain; chest pain or discomfort; dark urine; difficult or painful urination; dizziness or lightheadedness; fainting; fast or difficult breathing; feeling of being unusually cold; general feeling of being unwell; muscle pain or weakness; pale stools; persistent loss of appetite; severe or persistent headache, nausea, or vomiting; shortness of breath; slow or irregular heartbeat; sudden unexplained weight gain; swelling of the hands, ankles, or feet; unusual stomach pain or discomfort; unusual drowsiness; unusual tiredness or weakness; yellowing of the eyes or skin.

More Information
If you have any questions about Actoplus Met , please talk with your doctor, pharmacist, or other health care provider.
Actoplus Met is to be used only by the patient for whom it is prescribed. Do not share it with other people.
If your symptoms do not improve or if they become worse, check with your doctor.
If using Actoplus Met for an extended period of time, obtain refills before your supply runs out.