Take Actos exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose of Actos with a full glass of water.

Actos should be taken once a day with or without meals.

It is important to take Actos regularly to get the most benefit.

Your doctor may want you to have blood or urine tests or other medical evaluations during treatment with Actos to monitor blood sugar levels, liver function, or other factors.

Usually, liver function is monitored with blood tests at the start of treatment, every two months for the first year of treatment, and periodically thereafter during treatment with pioglitazone. Notify your doctor immediately if you develop nausea, vomiting, abdominal pain, unusual fatigue, loss of appetite, yellow skin or eyes, or dark urine. These symptoms may be early signs of liver problems.

Although pioglitazone does not usually cause hypoglycemia (low blood sugar), hypoglycemia may result from skipped meals, excessive exercise, or alcohol consumption. Know the signs and symptoms of hypoglycemia, which include headache, drowsiness, weakness, dizziness, fast heartbeat, sweating, tremor, and nausea. Carry a piece of non-dietetic hard candy or glucose tablets with you to treat episodes of low blood sugar.

If you miss a Actos dose
Take it as soon as you remember. If you miss a dose on one day, skip it and go back to your regular schedule. Do not double your dose the following day.

If this fails to bring your blood sugar under control, the dose can be increased to a maximum of 45 milligrams a day. If your blood sugar still remains high, the doctor may add a second medication.

When Actos is added to other diabetes medications, your doctor may need to lower their dosage if you develop low blood sugar. If you are taking insulin, the dose should be lowered when blood sugar readings fall below 100.

Actos Storage instructions:
Store at room temperature in a tight container, away from moisture and humidity.

Actos Preparations: Tablets: Actos 15 mg, Actos 30 mg, Actos 45 mg.

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Actos may reduce the effectiveness of birth control pills containing ethinyl estradiol and norethindrone. Additional measures may be necessary to prevent pregnancy while taking Actos. Talk to your doctor about the use of birth control.

Do not take over-the-counter or prescription cough, cold, allergy, pain, or weight-loss medications during treatment with Actos without first talking to your doctor.

If Actos is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Actos with the following:

• Ketoconazole (Nizoral)
• Midazolam (Versed)

There may be an increased risk of fluid retention (oedema) if non-steroidal anti-inflammatory drugs (NSAIDs) such as diclofenac or ibuprofen are taken with this medicine.

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