Pioglitazone

What is pioglitazone?

Pioglitazone is a prescription medicine used to help manage type 2 diabetes. It belongs to a group of drugs called thiazolidinediones (also known as glitazones), which work by improving the body’s sensitivity to insulin. It is available under brand names such as Actos, or in combination with metformin as Competact[1]. 

What is pioglitazone used to treat?

Pioglitazone is used to lower blood sugar in adults with type 2 diabetes, particularly when other medications have not worked well enough or are not suitable. It may be prescribed in the following situations[1]: 

• On its own (monotherapy) 

• In combination with metformin, sulfonylureas, or insulin 

How does pioglitazone work?

Pioglitazone helps regulate blood sugar by[1]: 

• Increasing your body’s sensitivity to insulin 

• Enhancing the uptake of glucose from the blood into the cells 

• Reducing the amount of glucose produced by the liver 

Who can take pioglitazone?

Pioglitazone can be taken by adults with type 2 diabetes, especially if they cannot tolerate or do not respond well to metformin. However, you should speak to your doctor first if you[1]: 

• Have or have had heart failure 

• Have bladder cancer or unexplained blood in the urine 

• Have liver disease or diabetic ketoacidosis 

• Have other conditions caused by diabetes 

• Have osteoporosis or osteopenia 

• Are pregnant or breastfeeding 

Please tell your doctor or pharmacist about any conditions you may have or medication you take before you start treatment, and always follow the instructions in the Patient Information Leaflet[2].  

What is the typical dosage of pioglitazone?

Pioglitazone comes in 15mg, 30mg, and 45mg tablets. The dose will vary depending on your response to treatment[1]: 

• Starting dose: Usually 15mg or 30mg, once daily 

• Your doctor may adjust the dose depending on how well your blood sugar is controlled up to a maximum of 45mg once a day 

• Treatment is typically reviewed after 3 to 6 months, and you will have regular blood sugar checks 

How do you take pioglitazone?

To get the best results, you should take pioglitazone as advised by your doctor[1]: 

• Take once daily, with or without food 

• Swallow the tablet whole with water 

• Try to take it at the same time each day 

• Follow any diet and exercise advice given to you 

Can you stop taking pioglitazone?

Do not stop taking pioglitazone unless advised to do so by your doctor or pharmacist. Stopping suddenly may cause your blood sugar levels to rise. Your healthcare provider may gradually adjust your medication if needed[1]. 

What do you do if you take too much pioglitazone?

If you think you've taken too much, seek medical advice straight away. Signs of overdose may include symptoms of low blood sugar (hypoglycaemia), especially if taken with other diabetes medicines. Call 111 or go to A&E and take the medicine packaging with you[1]. 

What do you do if you forget to take pioglitazone?

If you miss a dose[1]: 

• Take it as soon as you remember 

• If it’s nearly time for your next dose, skip the missed one 

• Do not take a double dose to make up for a forgotten tablet 

How do you store pioglitazone?

Store in the packaging it came in, at room temperature in a dry place out of reach of children[1]. 

What medicines can’t you take with pioglitazone?

Pioglitazone may interact with other medicines, so always check with your doctor or pharmacist. Be cautious if you are taking[1]: 

• Other diabetes medicines, including insulin 

• Birth control pills (pioglitazone may reduce their effectiveness) 

• Diuretics, NSAIDs (e.g. ibuprofen), or steroids (may increase fluid retention) 

• Gemfibrozil (can increase levels of pioglitazone) 

• Rifampicin (may reduce its effectiveness) 

Always inform your doctor or pharmacist about all medications and supplements you take before you start a new medicine, and follow the instructions in the Patient Information Leaflet[2]. 

What are the side effects of pioglitazone?

Pioglitazone may cause side effects, some of which require medical attention. Common side effects include[1]: 

• Weight gain 

• Fluid retention (swelling in the legs or ankles) 

• Increased risk of bone fractures 

• Bladder issues, such as blood in the urine 

• Sinus, throat, or chest infections 

• Eye problems 

• Pins and needles 

Serious side effects include[1]: 

• Signs of heart failure (e.g. breathlessness, swelling) 

• Liver problems (e.g. dark urine, yellowing of the skin or eyes) 

• Symptoms of bladder cancer (e.g. blood in urine, painful urination) 

Pioglitazone does not cause low blood sugar or hypoglycaemia on its own, but they can occur when you take it with other diabetes medicines like insulin or gliclazide[1]. 

You should contact your GP if you experience any of these symptoms. In rare cases, the medicine may cause a serious allergic reaction (anaphylaxis). You should call 999 or visit A&E immediately if you believe this is happening[1]. 

Symptoms of anaphylaxis include[1]:  

• Difficulty breathing  

• Tightness in throat and chest  

• Swelling of the tongue or throat  

• Feeling faint or dizzy  

• Blue/grey skin or lips  

• Loss of consciousness 

If you experience any side effects, including those not listed, you are encouraged to report them via the Yellow Card Scheme or contact your doctor, pharmacist, or nurse. This information is intended as a summary for general awareness and does not replace professional medical advice. 

The information provided in the side effects section is not a comprehensive list of all possible side effects associated with this medication. For a complete list of side effects, please refer to the Patient Information Leaflet (PIL) provided with your medication or consult your healthcare professional[2]. 

Frequently asked questions about pioglitazone

How long does pioglitazone take to work? 
It may take several weeks to see the full effects. Treatment is reviewed after 3 to 6 months[1]. 

Can I take pioglitazone with metformin? 
Yes, pioglitazone is often used alongside metformin[1].  

Does pioglitazone cause weight gain? 
Yes, weight gain is a common side effect[1]. 

Can pioglitazone cause low blood sugar? 
Not usually on its own, but the risk increases when combined with other diabetes medicines[1]. 

Is pioglitazone safe during pregnancy? 
No, it is not recommended during pregnancy or breastfeeding[1]. 

Can pioglitazone cause cancer? 
There is a small increased risk of bladder cancer with long-term use[1]. 

Can I drink alcohol while taking it? 
Alcohol can affect your blood sugar. Speak to your doctor or pharmacist for advice[1]. 

For the official NHS guide to pioglitazone, visit their website.