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Side Effects of Pioglitazone (Actos)


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Side Effects of Pioglitazone (Actos)

Pioglitazone, available as Actos, is an oral diabetes medicine that helps to control blood sugar levels. It is used with diet and exercise to improve blood sugar (glucose) control in adults with type 2 diabetes.

Before Starting Actos Treatment

Consult with your doctor before taking Actos if you have or had:


  • Heart failure
  • Type 1 (“juvenile”) diabetes
  • Diabetic ketoacidosis
  • Macular edema (diabetic eye disease that causes swelling in the back of the eye)
  • Liver problems
  • Cancer of the bladder
  • Known allergy to Actos


(The Actos label reported by the FDA).


In addition, inform your doctor if you are pregnant or plan to become pregnant because it is unknown if Actos will harm your unborn baby. Discuss with your doctor what is the best way to control your blood glucose levels while pregnant or are a premenopausal woman who does not have regular periods. You should not take Actos while breastfeeding because it is unknown if Actos excretes into your milk. It can possibly harm your baby. Talk to your doctor about the best way to control your blood glucose levels while breastfeeding.

Serious Side Effects

The FDA lists the severe side effects of Actos. Actos may cause hypoglycemia, causing low blood sugar levels to become dangerous. Symptoms of low blood sugar include lightheadedness, dizziness, shakiness, or hunger. These symptoms can occur if you use another lowering blood sugar medicine, if you skip meals, or have other medical conditions.


Actos can cause fluid retention, leading to swelling and weight gain. Extra body fluid can worsen heart problems or cause heart failure. Immediately contact your doctor if you have any of the following symptoms of heart failure: swelling or fluid retention, especially in the ankles or legs, shortness of breath or trouble breathing (especially when you lie down), unusual fast weight gain, and unusual tiredness.


You may also experience liver problems while taking Actos. Inform your doctor immediately if you have:


  • Nausea or vomiting
  • Stomach pain
  • Unusual or unexplained tiredness
  • Loss of appetite
  • Dark urine
  • Jaundice (yellowing of your skin or the whites of your eyes)


While taking Actos, there is an increased risk of having bladder cancer. Do not take Actos if you are receiving treatment for bladder cancer. These are the symptoms of bladder cancer: blood or a red color in your urine, an increased need to urinate, and pain while you urinate. Tell your doctor immediately if you experience any of these symptoms.


In some women, fractures may occur, usually in the hand, upper arm, or foot.


Macular edema (diabetic eye disease with swelling in the back of the eye) is associated with Actos usage. Tell your doctor right away if you have any changes in your vision.


In addition, ovulation can occur when premenopausal women with irregular periods take Actos. This can increase your chance of getting pregnant.

Common Side Effects

Most common side effects of pioglitazone include cold-like symptoms (upper respiratory tract infection), headache, sinus infection, muscle pain and sore throat (The Actos label listed by the FDA).

About Pharmacogenetic Testing

Actos is metabolized by primarily CYP2C8 in the body. Some individuals with genetic variations in CYP2C8 have reduced plasma levels that can lead to lack of desired response. Identification of such individuals with pharmacogenetic testing may empower healthcare providers to individualize Actos treatment.

Know Your Risk with the Rxight® Genetic Test

The state-of-the-art Rxight® test provides an analysis of how your body metabolizes over 200 prescription and over-the-counter (OTC) medications. This process is called “single nucleotide polymorphism” (SNP) genotyping. The genes from your unique genetic profile determine how you metabolize medications. With your results from the Rxight® genetic test, your prescriber will be able to understand what medicines are best for you and which are not. With this information, your prescriber will be able to create a treatment plan with the best medications and their optimal dosages that don’t develop adverse drug reactions.


To learn more about Rxight® and what it can do for you, give us a call at 1-888-888-1932 or email us at support@Rxight.com.


Contributors to this Article:
Michael Sapko, MD, PhD; and Deborah Kallick, PhD, Medicinal Chemistry

Read more about Rxight® Genetic Testing Labs