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​​​​​​Pioglitazone is a type of medication you might need to take if you have type 2 diabetes

What is pioglitazone?

Pioglitazone belongs to a group of drugs called thiazolidinediones, also known as glitazones. It is the only glitazone available in the UK. The brand name for pioglitazone is Actos. 

This medication is used to manage blood sugar levels. You can take it on its own or with other diabetes medications such as metformin, sulphonylureas or insulin. 

There is another medication that has both pioglitazone and metformin in one tablet, which has the brand name Competact.   

How does pioglitazone work?

Pioglitazone helps cells in your body respond better to the insulin your pancreas makes. This helps to lower blood sugar levels.

How do you take pioglitazone?

Pioglitazone is a tablet that you swallow, which comes in different strengths. You can take it with or without food. It should be taken with a drink of water and swallowed whole.   

If you take the tablet that also that also has metformin in it, you should take this with food. 

Always take this medication exactly as your healthcare professional has told you. The Patient Information Leaflet inside the box will tell you how to take it but always check with your healthcare team if you’re not sure.

Who can take pioglitazone?

Adults over the age of 18 years with type 2 diabetes can take pioglitazone.

Who can't take pioglitazone?

Some medications might not be suitable for some people, which might be because of medical conditions or other reasons:    

  • Your doctor will tell you to stop taking pioglitazone if you develop diabetic ketoacidosis, or DKA;   
  • Pioglitazone might not be suitable for you if you have heart failure, bladder cancer or blood in your urine;
  • If you have kidney disease you might not be able to take pioglitazone, but this will depend on the stage of your kidney disease;  
  • If you have liver disease you might not be able to have pioglitazone;
  • You may need to temporarily stop taking pioglitazone if you're going to have an operation;
  • You should not take pioglitazone if you are pregnant of breastfeeding. If you’re planning a pregnancy speak with a healthcare professional if you are using this medication.    

When you start a new medication always check with your healthcare team that it’s suitable for you to take.  

Your prescription

Your healthcare team should explain your prescription to you but it's important to make sure you ask if you don't feel you know enough.   

And make sure you talk to your GP or your diabetes team if you struggle to take your medication. They might be able to help by giving you a different dose. 

In England, if you need to take any medication to manage your diabetes, your prescriptions will be free. Ask your healthcare team about a prescription exemption certificate if you don't have one, to make sure you don't get charged for your medication. Prescriptions are already free for everybody in the rest of the UK, so you shouldn't pay for your medication.

Side effects of pioglitazone

Like all medications, pioglitazone can cause side effects. But when side effects are listed as common in the Patient Information Leaflet, it doesn’t mean that everyone who takes the medication will get them.   

The information about side effects is based on the likelihood of people having them. For example, if a side effect is very common then it can affect more than one in ten people, and if a side effect is very rare then it affects fewer than one in 10,000 people.   

Because medicines can affect people differently, your healthcare team will speak to you about what’s best for you and discuss any side effects. Side effects can include:

  • Increased risk of infections in the throat or lungs; 
  • Some people find that they gain weight while taking pioglitazone. Eating a healthy balanced diet and physical activity can help you manage weight gain; 
  • A serious side effect that can happen is that you can be at a higher risk of breaking a bone; 
  • A common side effect if you take pioglitazone with insulin is swelling in parts of your body, such as the legs. This is called oedema. Speak to your healthcare team if you develop swelling; 
  • There is a small increased risk of bladder cancer if you take pioglitazone. You should not take this drug if you have active bladder cancer, a history of bladder cancer or if you are being treated because of blood in your urine.

Risk of low blood sugar

Pioglitazone does not usually cause blood sugar levels to become too low, also known as hypoglycaemia or hypos, when taken on its own. However, hypos can happen when you take it with other diabetes medications such as insulin or a sulphonylurea. 

Your healthcare team may advise reducing the dose of your sulphonylurea or insulin medicine when you start taking pioglitazone to reduce the risk of hypos.   

These are not all of the side effects. You will find a full list of known side effects in the Patient Information Leaflet. This comes in the medication box. 

It’s also important that you take individual advice from your healthcare team before starting pioglitazone treatment and report any side effects to your healthcare professionals, if you experience any.  

You can also report these side effects to the Yellow Card Scheme, which is the government system used for recording side effects with medicines in the UK.   

More information and support

Still have more questions? Or is there anything you're not sure about after reading this page? Contact our helpline on 0345 123 2399. 

You can visit the NHS website for more information on pioglitazone. 

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