Remember to follow any advice you have been given about your diet and taking exercise.

Make sure you know how to recognise the symptoms of low blood sugar. These include feeling shaky or anxious, sweating, looking pale, feeling hungry, and having palpitations.

If you get any of the following symptoms, contact your doctor immediately - being sick, abdominal pain, feeling unusually tired, dark urine, or jaundice.

About pioglitazone

Type of medicine An antidiabetic medicine
Used for Type 2 diabetes mellitus
Also called Actos®; Glidipion®; Glizofar®; Competact® (a combination of pioglitazone with metformin)
Available as Tablets

Insulin is a hormone which is made naturally in your body by the pancreas. It helps to control the levels of sugar in your blood. If your body does not make enough insulin to meet its needs, or if it does not use the insulin it makes effectively, this results in the condition called diabetes mellitus (sugar diabetes).

People with diabetes need treatment to control the amount of glucose (sugar) in their blood. This is because good control of blood sugar levels reduces the risk of complications later on. Some people can control the sugar in their blood by making changes to the food they eat, but for other people, medicines are given alongside the changes in diet.

Pioglitazone works by increasing the sensitivity of your body's cells to insulin (so more glucose is taken into cells for the same amount of insulin in the bloodstream). It can be used on its own, but it is more commonly taken alongside metformin and/or another antidiabetic medicines.

Before taking pioglitazone

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking pioglitazone it is important that your doctor or pharmacist knows:

  • If you are pregnant, trying for a baby or breast-feeding.
  • If you have any problems with your liver.
  • If you have ever had bladder cancer, or if you have recently noticed any blood in your urine.
  • If you have heart failure (this is a condition where your heart is not working as well as it should).
  • If you have heart or blood vessel disease
  • If you have porphyria. This is a rare inherited blood disorder.
  • If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
  • If you have ever had an allergic reaction to a medicine.

How to take pioglitazone

  • Before you start this treatment, read the manufacturer's printed information leaflet from inside your pack. The leaflet will give you more information about the specific brand of pioglitazone you have been given, and a full list of side-effects which you may experience from taking it.
  • Take the tablets exactly as your doctor tells you to. It is usual to take one tablet of pioglitazone daily, although there are several strengths of tablet. Most brands of pioglitazone tablets may be taken before or after meals. However, if you are taking Competact®, this is a combination tablet of pioglitazone with metformin, and should be taken twice daily after a meal.
  • Try to take your doses at the same time of day each day, as this will help you to remember to take them.
  • If you forget to take a dose, take it as soon as you remember. If you do not remember until the following day, skip the missed dose. Do not take two doses together to make up for a forgotten dose.

Getting the most from your treatment

  • If you have been given advice by your doctor about changes to your diet, stopping smoking or taking regular exercise, it is important for you to follow the advice you have been given.
  • It is also important that you keep your regular doctor's and clinic appointments. This is so your progress can be monitored. Your doctor will want to do some blood tests before and during this treatment to check how well your liver is working. You will also need regular check-ups with an eye clinic and a foot clinic.
  • Test your blood or urine regularly to ensure your blood sugar levels are being controlled. This is especially important if you are taking pioglitazone with another antidiabetic medicine or insulin.
  • Treatment with pioglitazone is often long-term unless you experience an adverse effect. Continue to take the tablets unless you are advised otherwise.
  • Drinking alcohol is not recommended with this medicine. Pioglitazone and alcohol may produce low blood sugar levels and this will affect the control of your condition.
  • If you are having an operation or dental treatment, tell the person carrying out the treatment that you are taking pioglitazone.
  • Make sure you know what it feels like if your blood sugar is too low. This is known as hypoglycaemia, or a 'hypo'. The first signs of hypoglycaemia are: feeling shaky or anxious, sweating, looking pale, feeling hungry, and having palpitations (a feeling that your heart is pounding). If these happen you should eat or drink something containing sugar or have a snack straightaway. Let your doctor know if this happens to you, as your doses may need adjusting.
  • If you are a driver you should take special care, as your ability to concentrate may be affected if your diabetes is not well controlled.
  • If you buy any medicines, check with a pharmacist that they are suitable to take with pioglitazone.

Can pioglitazone cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

Common pioglitazone side-effects - these affect less than 1 in 10 people who take this medicine What can I do if I experience this?
Eyesight problems Let your doctor know about this or make an appointment with your eye clinic
Putting on weight Try to maintain a balanced diet and check your weight regularly. If you feel you are gaining weight without actually eating more, discuss this with your doctor
Aches and pains, flu-like symptoms, chest infections, reduced sense of touch, flatulence (wind), a greater risk of broken bones, difficulties sleeping If any of these become troublesome, speak with your doctor

Important: your doctor will discuss with you the possibility of unwanted side-effects that you must let your doctor know about. Contact your doctor straightaway if you experience any of the following:

  • Feeling or being sick for no apparent reason, abdominal pain, tiredness, dark urine, or jaundice (yellowing of your skin or the whites of your eyes). These are signs that your liver is not working as it should.
  • Blood in your urine, or bladder problems such as pain or an increased urgency to go to the toilet. This is because there is a small increased risk of bladder cancer in people taking pioglitazone and your doctor will want to check these symptoms. 

If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.

How to store pioglitazone

  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.