METFORMIN-PIOGLITAZONE

Pioglitazone can cause heart failure or make existing heart problems worse. You shouldn’t use this drug if you have symptoms of heart failure. Symptoms include:

• fast weight gain
• shortness of breath or trouble breathing, especially when you lay down
• swelling or fluid retention in your arms or legs
• unusual tiredness

Metformin may cause lactic acidosis. Although it is rare, if it happens it may requires treatment in the hospital. In this condition, lactic acid builds up in your blood. Lactic acidosis is fatal in about half of people who develop it.  You should stop taking metformin and call your doctor right away or go to the emergency room if you have signs of lactic acidosis. Symptoms include:

• tiredness
• weakness
• unusual muscle pain
• trouble breathing
• unusual sleepiness
• stomach pains, nausea, or vomiting
• dizziness or lightheadedness
• slow or irregular heart rate

Your risk of lactic acidosis may be higher if you drink a lot of alcohol or have the following conditions:

• sepsis, a dangerous complication of an infection
• dehydration
• liver problems
• kidney problems
• congestive heart failure

Common side effects include diarrhea, nausea, upset stomach, cold-like symptoms (upper respiratory tract infection), swelling in your legs, ankles, and feet, headache, and weight gain. These side effects usually happen during the first few weeks of treatment. Taking this drug with food may lower your risk of side effects.

Precautions

Tell your doctor if you have heart failure, kidney problems, bladder cancer, liver problems, or the diabetic eye disease macular edema. You should also tell your doctor if you drink a lot of alcohol. This drug may not be safe for you to take.

Interactions

Metformin/pioglitazone can interact with other medications, herbs, or vitamins you might be taking. That’s why your doctor should manage all of your medications carefully. If you’re curious about how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

If you take too much metformin/pioglitazone, you may experience low blood sugar. Symptoms include:

• mood changes, such as irritability, impatience, anger, stubbornness, or sadness
• confusion
• lightheadedness
• dizziness
• sleepiness
• blurred vision
• tingling or numbness in your lips or tongue
• headaches
• weakness
• tiredness
• lack of coordination
• nightmares or crying out during your sleep
• seizures
• loss of consciousness

If you think that you’ve taken too much of this medication or have symptoms of low blood sugar, treat your low blood sugar.

• For mild hypoglycemia (55–70 mg/dL), treatment is 15–20 grams of glucose (a type of sugar). You need to eat or drink one of the following:
• 3–4 glucose tablets
• a tube of glucose gel
• ½ cup of juice or regular, non-diet soda
• 1 cup of nonfat or 1% cow’s milk
• 1 tablespoon of sugar, honey, or corn syrup
• 8–10 pieces of hard candy, such as lifesavers
• Test your blood sugar 15 minutes after you treat the low sugar reaction. If your blood sugar is still low, then repeat the above treatment.
• Once your blood sugar is back in the normal range, eat a small snack if your next planned meal or snack is more than 1 hour later.

If your symptoms continue to worsen, call your doctor or go to the emergency room right away.

Available brands:

• Pioplus
• Tri-Senza
• Prialta-Met
• Actosmet