What is Metformin and pioglitazone?
Metformin and pioglitazone are two diabetes medications that work together to control the blood sugar level. Metformin, pioglitazone, and diet are used in conjunction with exercise and diet to control blood sugar levels for adults who have type 2 diabetes mellitus and do not require daily insulin injections. The use of pioglitazone and metformin is not recommended for the treatment of type 1 diabetes. This medication guide does not list all possible uses of pioglitazone and metformin.
Side effects of Metformin and pioglitazone
If you experience any of the following symptoms of an allergy reaction, seek immediate medical attention: difficulty breathing, hives, swelling in your lips, face, throat, or tongue.
Metformin or pioglitazone can cause lactic acidosis. This condition is fatal. Seek emergency medical attention if you have any symptoms, even mild ones such as:
- Unusual muscle pain;
- Feeling cold
- Trouble breathing
- Feeling dizzy, fatigued, or weak?
- Stomach pain, vomiting;
- Slow or irregular heartbeat
Metformin or pioglitazone can cause severe side effects. If you experience:
- Pink or red urine; painful or difficult urination new or worsening urges to urinate.
- Changes in your vision
- Heart problems: swelling, rapid weight gain and shortness of breath.
- Liver problems: nausea, vomiting, and stomach pain. Dark urine.
- Low red blood cells (anemia), pale skin, unusual fatigue, lightheadedness, or feeling short of breath cold hands and feet.
Some of the common side effects associated with metformin or pioglitazone include:
- Headache;
- Weight gain
- Diarrhea;
- Cold symptoms include stuffy noses, sinus discomfort, sneezing, and sore throats.
There may be other side effects. For medical advice regarding side effects, contact your physician. Report them by calling the FDA at 1-800-FDA-1088.
Similar/related drugs
Metformin, Trulicity, Lantus, Tresiba, Victoza, and Levemir
Warnings
Metformin or pioglitazone should be avoided if you suffer from severe cardiac failure, severe kidney problems, active cancer of the bladder, acidosis metabolica, or ketoacidosis. (Call your doctor to get treatment.)Metformin or pioglitazone may worsen, cause, or contribute to congestive cardiac failure. If you experience shortness of breath, swelling, or rapid weight gain, even with mild exercise,You may have to stop metformin or pioglitazone temporarily if you are going to undergo an x-ray, CT scan, or any other type of test that uses a dye injected directly into your veins.You could develop lactic acidosis. Lactic acids buildup can build in your blood, potentially becoming hazardous and leading to serious health complications. If you experience unusual pain in your muscles, difficulty breathing, nausea, dizziness, or a feeling of cold, call your doctor.
Before you take this drug
This medicine should not be used if:
- Severe heart failure;
- Severe kidney disease
- Active bladder cancer
- Call your doctor if you have ketoacidosis or metabolic acidosis.
You may have to stop using metformin or pioglitazone temporarily if you are going to undergo surgery, or any type of x-ray or ct scan that uses a dye injected directly into your veins. Make sure you let your healthcare providers know that this medication is being used.
If you've ever:
- Kidney problems;
- Congestive heart failure or other heart problems
- Fluid retention;
- Diabetes can cause eye problems.
- Bladder cancer
- A stroke, a heart attack,
- Liver disease
- If you're 80 or older,
The risk of bladder cancer may be increased by taking this medication. Speak to your doctor regarding your particular risk. Lactic acidosis, or the buildup of harmful lactic acids in your bloodstream, may increase with chronic alcoholism or severe infections; always consult a healthcare provider in order to ascertain your level of risk. Metformin or pioglitazone can increase the risk of heart disease, but not managing your diabetes will also harm your heart and organs. Speak to your doctor regarding the benefits and risks of using this medication. If you're pregnant, or if you get pregnant in the future, follow your doctor’s advice about this medication. Metformin can stimulate ovulation and lead to unintended pregnancies in women not yet menopausal. Speak to your doctor regarding your risks. Metformin or pioglitazone may increase the risk of a woman breaking a bone. Speak to your doctor about ways you can maintain your bone health. Breastfeeding may be unsafe while taking this medication. Please consult your physician regarding potential risks. Anyone younger than the age of 18 is not allowed to use pioglitazone or metformin.
How to take Metformin and pioglitazone?
Reading all instructions or guides that come with your medication and adhering to all directions are crucial steps in taking any medicine effectively. Follow the directions on your prescription label. Metformin and pioglitazone should be taken with food. You can take the tablet with dinner. Do not chew or crush the tablet. You might feel shaky, hungry, irritable, or confused. If you want to treat hyperglycemia quickly, consume or drink sugary foods or drinks (crackers, fruit juices, hard candies, raisins, or regular soda). If you suffer from severe hypoglycemia, your doctor might prescribe an injection kit. Make sure that your close family members or friends are familiar with how to administer this injection. Stress, illness, surgeries, exercise, drinking alcohol, and skipping meals can all affect blood sugar levels. Before making any adjustments or making modifications to your medication or dose schedule, always consult with a medical provider first. Metformin, pioglitazone, or other medications may be part of an overall treatment plan that includes diet, physical activity, weight management, testing for blood sugar, and medical attention. You should follow your doctor’s advice. Take only the recommended amount of Vitamin B12 if you have been prescribed extra by your doctor. Keep the bottle at room temperature, away from heat and moisture. When not in use, keep the bottle closed tightly.
Details on dosage
Adult dosage for diabetes type 2:
Individualize dosage based on safety, efficacy, and previous therapy.
All doses provided as pioglitazone or metformin
Immediate-release (IR):
Initial dose: 15 mg/500 mg IR twice daily or 15 mg/850 mg IR once daily
For patients with metformin monotherapy who are not adequately controlled, you may start by giving 15 mg or 850 mg of IR twice daily (depending on the previous dose of metformin).
For patients with NYHA class I or II CHF, the initial dose is 15 mg/500mg IR (or 15 mg/850mg IR) orally, one time per day.
Maintaining dose: Titrate the dose gradually based on efficacy and safety.
Maximum dose: 45 mg of Pioglitazone per day/2550 mg of Metformin per day
Extended-release (XR):
Initial dose: 15 mg/1000mg XR, or 30 mg/1000 mg XR once daily.
For patients with inadequate control after pioglitazone monotherapy or metformin: 15 mg/1000 mg XR two times a week (depending upon the previous dose of metformin) or 30 mg/1000 mg XR once daily.
Maintaining dose: Titrate the dose gradually based on efficacy and safety.
Maximum dose: Pioglitazone 45 mg/Metformin 2000 mg per day
Comments:
Initial doses should match the current regimen as closely as possible for patients who are receiving a combination of therapy in separate tablets.
Take metformin with food and gradually increase the dose to minimize gastrointestinal effects. Doses above 2000mg may be tolerated better if taken three times per day.
After the initiation of treatment, monitor closely for any adverse effects related to fluid accumulation.
If hypoglycemia is present with concurrent use of insulin, an insulin secretagogue, or both, then the doses should be decreased.
Use: To improve the glycemic level in adult patients with type II diabetes when metformin and pioglitazone are used.
What happens if I miss the dose?
If you are almost due for the next dose, skip the missed one. Never take more than one dose at a time. Refill your prescription before it runs out.
What happens if I overdose?
Call Poison Help at 1-800-222-1222 or seek emergency medical care. Lactic acidosis can result from an overdose of metformin.
What should be avoided?
Alcohol is harmful to your health. Alcohol can cause your blood glucose to drop and increase the risk of developing lactic acidosis.
Interaction with other drug
Metformin, pioglitazone, and other drugs may affect their effectiveness or increase your risk for lactic acidosis. These include prescription, over-the-counter, and herb products. This list does not include all interactions. Inform your doctor of all medications you are currently taking and those that you will stop or start using.
