{"id":54762,"date":"2022-10-24T11:34:49","date_gmt":"2022-10-24T15:34:49","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=54762"},"modified":"2025-09-03T09:05:09","modified_gmt":"2025-09-03T13:05:09","slug":"pioglitazone-side-effects","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/pioglitazone-side-effects\/","title":{"rendered":"Pioglitazone side effects and how to avoid them"},"content":{"rendered":"<p><a href=\"https:\/\/www.singlecare.com\/prescription\/pioglitazone-hcl\"><span style=\"font-weight: 400;\">Pioglitazone<\/span><\/a><span style=\"font-weight: 400;\">, also prescribed as the brand-name medication <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/actos\"><span style=\"font-weight: 400;\">Actos<\/span><\/a><span style=\"font-weight: 400;\">, is a generic prescription drug that helps control <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/normal-blood-glucose-levels\/\"><span style=\"font-weight: 400;\">blood sugar levels<\/span><\/a><span style=\"font-weight: 400;\"> in people with <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/type-2-diabetes-treatment-and-medications\"><span style=\"font-weight: 400;\">Type 2 diabetes mellitus<\/span><\/a><span style=\"font-weight: 400;\">. Often combined with other glucose-lowering drugs such as <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/metformin-hcl\"><span style=\"font-weight: 400;\">metformin<\/span><\/a><span style=\"font-weight: 400;\">, pioglitazone is a <\/span><a href=\"https:\/\/www.singlecare.com\/drug-classes\/thiazolidinediones\"><span style=\"font-weight: 400;\">thiazolidinedione<\/span><\/a><span style=\"font-weight: 400;\">, one of only two drugs in that class. It works by making muscle and fat cells more <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/insulin-resistance\/\"><span style=\"font-weight: 400;\">sensitive to insulin<\/span><\/a><span style=\"font-weight: 400;\">, so these cells take in more blood glucose.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Unlike other antidiabetic drugs, pioglitazone only works when insulin is present, that is, right after eating. So low blood sugar is not a common side effect when it\u2019s taken alone, but it can contribute to low blood sugar when combined with other antidiabetic drugs. It does, however, have other notable side effects that people should be aware of.\u00a0<\/span><\/p>\n<h2 id=\"common-side-effects-of-pioglitazone\"><span style=\"font-weight: 400;\">Common side effects of pioglitazone<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">The most common side effect of <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/pioglitazone-hcl\/what-is\"><span style=\"font-weight: 400;\">pioglitazone<\/span><\/a><span style=\"font-weight: 400;\"> is infections of the upper respiratory tract. However, when combined with other diabetes drugs, the most common side effect is fluid retention and swelling. The most <\/span><a href=\"https:\/\/online.epocrates.com\/drugs\/204905\/pioglitazone\/Adverse-Reactions\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">common side effects<\/span><\/a><span style=\"font-weight: 400;\"> of pioglitazone are:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Upper respiratory tract infections<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Headache<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Stuffy sinuses<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Muscle pain<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Sore throat<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Fluid retention and swelling<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Side effects are most likely to happen when pioglitazone is combined with <\/span><a href=\"https:\/\/www.singlecare.com\/drug-classes\/sulfonylureas\"><span style=\"font-weight: 400;\">sulfonylurea<\/span><\/a><span style=\"font-weight: 400;\"> or <\/span><a href=\"https:\/\/www.singlecare.com\/drug-classes\/insulins\"><span style=\"font-weight: 400;\">insulin<\/span><\/a><span style=\"font-weight: 400;\">. Most people taking such a combination can expect to have side effects. The most common are:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Fluid retention and swelling<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Low blood sugar<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Upper respiratory tract infections<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Weight gain<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Urinary tract infections<\/span><\/li>\n<\/ul>\n<h2 id=\"serious-side-effects-of-pioglitazone\"><span style=\"font-weight: 400;\">Serious side effects of pioglitazone<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">The most serious side effects of pioglitazone are:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Congestive heart failure<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Liver dysfunction<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Diabetic macular edema<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Increased risk of bladder cancer<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Bone fractures (in women)<\/span><\/li>\n<\/ul>\n<h3 id=\"pioglitazone-and-heart-failure\"><span style=\"font-weight: 400;\">Pioglitazone and heart failure<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">The worsening of pre-existing <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/congestive-heart-failure-treatment-and-medications\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">congestive heart failure<\/span><\/a><span style=\"font-weight: 400;\"> is the most serious side effect of pioglitazone. The estimated incidence is between <\/span><a href=\"https:\/\/www.pdr.net\/drug-summary\/Actos-pioglitazone-556\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">1% and 6%<\/span><\/a><span style=\"font-weight: 400;\">, which is high enough for the FDA to include a boxed warning on the drug information sheet. As worrisome as that sounds, the risk only applies to people who already have congestive heart failure. People with severe heart failure cannot take the drug. People with mild to moderate heart failure can, but with a lot of extra monitoring. However, even those without congestive heart failure should be familiar with the warning signs. The most important is swelling. If swelling is experienced while taking pioglitazone, be sure to tell the prescriber. The <\/span><a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=d2ddc491-88a9-4063-9150-443b4fa4330c\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">risk<\/span><\/a><span style=\"font-weight: 400;\"> of congestive heart failure is higher in patients who are also taking insulin, those over 65 years of age, and those taking higher doses of pioglitazone. It is recommended that those patients with mild heart failure who need to be started on pioglitazone be given 15 mg once daily.<\/span><\/p>\n<h3 id=\"pioglitazone-and-bone-fractures\"><span style=\"font-weight: 400;\">Pioglitazone and bone fractures<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Women taking pioglitazone experience <\/span><a href=\"https:\/\/jamanetwork.com\/journals\/jamainternalmedicine\/fullarticle\/1108509\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">almost twice<\/span><\/a><span style=\"font-weight: 400;\"> as many bone fractures as other women. In one study, <\/span><a href=\"https:\/\/www.pdr.net\/drug-summary\/Actos-pioglitazone-556\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">5%<\/span><\/a><span style=\"font-weight: 400;\"> of postmenopausal women taking pioglitazone for three years had bone breaks, usually in the hands, feet, or lower legs. Men are also at an increased risk for fractures. The cause is not understood, especially since hip and spine breaks are the most common fractures in postmenopausal women. Based on the final analysis, women, especially postmenopausal women, taking pioglitazone should take measures to preserve bone health. Caution should be used in women with osteoporosis or risk factors for osteopenia. Bone density tests may sometimes be required.<\/span><\/p>\n<h2 id=\"how-soon-do-pioglitazone-side-effects-start\"><span style=\"font-weight: 400;\">How soon do pioglitazone side effects start<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Many of the side effects of pioglitazone are delayed side effects including infections, swelling, sore throat, weight gain, and most serious side effects. A few side effects\u2014headache, muscle pain, and low blood sugar can happen shortly after starting pioglitazone.\u00a0<\/span><\/p>\n<h2 id=\"how-long-do-pioglitazone-side-effects-last\"><span style=\"font-weight: 400;\">How long do pioglitazone side effects last?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Some of the mild side effects such as headaches may get better over time. Infections and related problems may recur regularly. Low blood sugar will need to be corrected, though, with either change in doses or drugs. Unfortunately, some serious side effects such as worsening heart failure, fractures, bladder cancer, or macular edema may have long-term consequences even after the drug is discontinued.<\/span><\/p>\n<h2 id=\"what-are-the-long-term-side-effects-of-pioglitazone\"><span style=\"font-weight: 400;\">What are the long-term side effects of pioglitazone?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Pioglitazone is used for as long as it works provided adverse effects are tolerable. No side effects due to long-term use have been identified. However, healthcare professionals are advised to regularly check for symptoms of heart failure. This isn\u2019t because heart failure is an effect of pioglitazone, but because the drug could worsen heart failure if it does develop.<\/span><\/p>\n<h2 id=\"pioglitazone-contraindications\"><span style=\"font-weight: 400;\">Pioglitazone contraindications<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Pioglitazone is never prescribed to people with:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Severe heart failure (Class III or IV heart failure)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Bladder cancer<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Diabetic ketoacidosis<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Any history of an allergic reaction to pioglitazone<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Pioglitazone is never used to treat Type 1 diabetes.<\/span><\/p>\n<h3 id=\"pregnancy\"><span style=\"font-weight: 400;\">Pregnancy<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Based on animal studies, there is a possibility that pioglitazone can cause birth defects. Healthcare providers are cautious and only prescribe it when necessary to pregnant women.\u00a0<\/span><\/p>\n<h3 id=\"breastfeeding\"><span style=\"font-weight: 400;\">Breastfeeding<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">No one knows if pioglitazone is present in human breast milk or if it affects a nursing infant. Still, healthcare professionals are cautious and only prescribe it when necessary to a woman who is breastfeeding.<\/span><\/p>\n<h3 id=\"children\"><span style=\"font-weight: 400;\">Children<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Pioglitazone is not FDA approved for use in children because of potentially severe side effects including heart failure.<\/span><\/p>\n<h3 id=\"seniors\"><span style=\"font-weight: 400;\">Seniors<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Pioglitazone showed no difference in effectiveness or side effects in seniors versus younger adults in clinical trials. However, healthcare professionals use pioglitazone with caution in seniors because of the risk of heart failure.<\/span><\/p>\n<h2 id=\"pioglitazone-warnings\"><span style=\"font-weight: 400;\">Pioglitazone warnings<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Pioglitazone comes with several warnings and cautions, so it\u2019s a good idea to be aware of them.<\/span><\/p>\n<h3 id=\"cautions\"><span style=\"font-weight: 400;\">Cautions<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">A <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/black-box-warning\/\"><span style=\"font-weight: 400;\">black box warning<\/span><\/a><span style=\"font-weight: 400;\"> (or \u201cboxed warning\u201d) is the FDA\u2019s way of signaling that there\u2019s a major safety risk with a certain drug. People taking a drug should be familiar with at least this one warning. Pioglitazone has a boxed warning that the drug could worsen existing heart failure. The drug is prohibited in people with severe heart failure (class III or class IV heart failure) and not recommended in people who have symptomatic heart failure.\u00a0<\/span><\/p>\n<h3 id=\"heading-15\"><span style=\"font-weight: 400;\">Cautions<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Because of the risk of worsening heart failure, pioglitazone is used cautiously in people with mild to moderate heart failure or risk factors for heart failure. These risk factors include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Insulin treatment<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Age greater than 65<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Coronary artery disease<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Excessive body weight<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Heart problems<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Other pre-existing conditions can either be worsened by pioglitazone, or these conditions could exacerbate pioglitazone\u2019s side effects. These include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">A history of bladder cancer<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Liver dysfunction<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Edema<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Osteoporosis or weak bones (osteopenia)<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Ovulation is possible in women who do not ovulate because of conditions such as polycystic ovary syndrome if they start taking pioglitazone. They may need to start using birth control.\u00a0<\/span><\/p>\n<h3 id=\"abuse-and-dependence\"><span style=\"font-weight: 400;\">Abuse and dependence<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Neither drug abuse nor physical dependence is associated with pioglitazone.\u00a0<\/span><\/p>\n<h3 id=\"overdose\"><span style=\"font-weight: 400;\">Overdose<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Call a poison control center or get medical help if too much pioglitazone is taken. An overdose may cause hypoglycemia if other antidiabetic drugs are being taken like metformin or insulin. The <a href=\"https:\/\/www.singlecare.com\/prescription\/actos\/dosage\">maximum dosage is 45 mg per day<\/a>, but the actual dosage will be individualized for each person. It\u2019s best to think of the prescribed dose as the maximum dose, especially if other drugs are being taken.\u00a0<\/span><\/p>\n<h2 id=\"pioglitazone-interactions\"><span style=\"font-weight: 400;\">Pioglitazone interactions<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Some drug interactions can undermine the safety or effectiveness of both pioglitazone and the other drugs being taken. These include:<\/span><\/p>\n<ul>\n<li><b>Antidiabetic medications.<\/b><span style=\"font-weight: 400;\"> Although pioglitazone is often prescribed with other diabetes drugs, there is a risk of low blood sugar, particularly when it\u2019s combined with insulin. Dosages of these other drugs may need to be reduced.<\/span><\/li>\n<li><b>Hormonal birth control.<\/b><span style=\"font-weight: 400;\"> Pioglitazone reduces the effectiveness of hormonal birth control. Pregnancy is more likely when the two are combined. For its part, hormonal birth control reduces the effectiveness of pioglitazone at controlling high blood sugar.<\/span><\/li>\n<li><b>Drugs that block the metabolism of pioglitazone.<\/b><span style=\"font-weight: 400;\"> Some drugs tie up the liver enzyme that breaks down pioglitazone. As a result, pioglitazone levels build up in the blood and raise the risk of side effects. Healthcare providers are very familiar with these drugs, so always let them know about taking pioglitazone when getting a new prescription.<\/span><\/li>\n<li><b>Drugs that speed up the metabolism of pioglitazone. <\/b><span style=\"font-weight: 400;\">On the other hand, some drugs speed up the liver\u2019s metabolism of pioglitazone, reducing its ability to reduce blood glucose. The effects aren\u2019t dramatic, but the dose of pioglitazone may need to go up a bit.<\/span><\/li>\n<\/ul>\n<h2 id=\"how-to-avoid-pioglitazone-side-effects\"><span style=\"font-weight: 400;\">How to avoid pioglitazone side effects<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Some of pioglitazone\u2019s side effects can be very serious, so it pays to follow a few tips to keep these problems at bay.<\/span><\/p>\n<h3 id=\"1-tell-the-prescribing-healthcare-provider-about-all-medical-conditions\"><span style=\"font-weight: 400;\">1. Tell the prescribing healthcare provider about all medical conditions<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Before starting pioglitazone, make sure the prescriber has a complete picture of your current state of health. Medical conditions the prescriber should know about include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Type 1 diabetes<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Diabetic ketoacidosis<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Heart disease<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Swelling<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Bladder cancer or a history of bladder cancer<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Swelling of the retina due to diabetes (diabetic macular edema)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Liver disease<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Osteoporosis<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Weak bones<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Pregnancy or pregnancy plans<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Breastfeeding or breastfeeding plans<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Premenopausal women should tell the prescriber if they have irregular periods or no periods at all. Pioglitazone may cause ovulation and result in pregnancy.<\/span><\/p>\n<h3 id=\"2-tell-the-prescriber-about-all-drugs-being-taken\"><span style=\"font-weight: 400;\">2. Tell the prescriber about all drugs being taken<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Drug interactions are another potential source of adverse effects. The prescriber should know about all the prescription drugs, over-the-counter medications, or dietary supplements being taken. They may seem unrelated to diabetes or diabetes drugs, but they could still cause trouble.<\/span><\/p>\n<h3 id=\"3-take-the-tablets-as-directed\"><span style=\"font-weight: 400;\">3. Take the tablets as directed<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Follow the prescriber\u2019s instructions to the letter. Not only will the prescriber give instructions about how much pioglitazone to take and when to take it, but there may also be instructions about diet and exercise.<\/span><\/p>\n<h3 id=\"4-do-not-take-two-doses-in-one-day\"><span style=\"font-weight: 400;\">4. Do not take two doses in one day<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">If a dose is missed, it can be taken on the same day it was supposed to be taken. If it\u2019s the next day, skip the missed dose. Take the next dose as scheduled.<\/span><\/p>\n<h3 id=\"5-keep-all-follow-up-appointments\"><span style=\"font-weight: 400;\">5. Keep all follow-up appointments<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Regular hemoglobin A1C tests are required to see if pioglitazone is working as it should to help control blood sugar. Other routine blood tests can also help spot possible side effects before they blow up into serious problems. The prescriber may also need to do regular eye exams.<\/span><\/p>\n<h3 id=\"6-tell-the-prescriber-about-physical-stress\"><span style=\"font-weight: 400;\">6. Tell the prescriber about physical stress<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Physical stress may require that the dosages of all diabetic medications be changed. Always tell the prescriber about any injury, surgery, accident, infection, or fever.<\/span><\/p>\n<h3 id=\"7-don-t-skip-meals\"><span style=\"font-weight: 400;\">7. Don\u2019t skip meals<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">If pioglitazone is being taken with other diabetes medications, skipping or drastically reducing meals raises the risk of low blood sugar.<\/span><\/p>\n<h3 id=\"8-regularly-check-blood-sugar-levels\"><span style=\"font-weight: 400;\">8. Regularly check blood sugar levels<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Another way to avoid low blood sugar is to regularly check blood sugar levels so that you can react or adjust sugar intake when levels are trending too low.<\/span><\/p>\n<h3 id=\"9-avoid-alcohol\"><span style=\"font-weight: 400;\">9. Avoid alcohol<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Drinking can both cause and prolong low blood sugar. It may need to be avoided altogether, but get medical advice from the prescriber about how much alcohol is okay and how much is too much.<\/span><\/p>\n<h2 id=\"how-to-treat-side-effects-of-pioglitazone\"><span style=\"font-weight: 400;\">How to treat side effects of pioglitazone<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">While all drugs have side effects, some of pioglitazone\u2019s side effects can be worrisome. When taking pioglitazone, it\u2019s important to know what to look for and what to do.<\/span><\/p>\n<h3 id=\"low-blood-sugar\"><span style=\"font-weight: 400;\">Low blood sugar<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Low blood sugar should be handled when symptoms first appear or show up on a blood sugar test. The first signs of trouble are hunger, sweating, shaking, confusion, and trouble thinking or focusing. As it gets worse, sleepiness, tiredness, fatigue, and confusion set in. Follow the instructions given by the prescriber. If low blood sugar seems to happen a lot, talk to the prescribing healthcare provider.<\/span><\/p>\n<h3 id=\"swelling\"><span style=\"font-weight: 400;\">Swelling<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Sit down and prop up the body part that is swelling. Because swelling may be a sign of heart failure, contact the prescriber.\u00a0<\/span><\/p>\n<h3 id=\"fractures\"><span style=\"font-weight: 400;\">Fractures<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Women past menopause should tell the prescriber about any broken bones, particularly in the hands or feet.\u00a0<\/span><\/p>\n<h3 id=\"retina-problems\"><span style=\"font-weight: 400;\">Retina problems<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Contact the prescriber immediately if any vision changes, such as blurred vision, are experienced.<\/span><\/p>\n<h3 id=\"bladder-problems\"><span style=\"font-weight: 400;\">Bladder problems<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Contact the prescriber immediately if any signs of bladder problems are noticed. These could be the early symptoms of bladder cancer and include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Blood in the urine<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Red or discolored urine<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Urinating more frequently<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Painful urination<\/span><\/li>\n<\/ul>\n<h3 id=\"liver-problems\"><span style=\"font-weight: 400;\">Liver problems<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Pioglitazone can hurt the liver. The only way to know is with a blood test, so contact the prescriber if any of the signs of liver damage are noticed, especially:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Stomach pain<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Excessive tiredness<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Nausea<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Vomiting<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Loss of appetite<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Dark urine<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Yellowing of the skin or eyes<\/span><\/li>\n<\/ul>\n<h3 id=\"heart-failure\"><span style=\"font-weight: 400;\">Heart failure<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Get immediate medical care if any of the following symptoms are noticed:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Swelling<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Rapid weight gain<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Shortness of breath or trouble breathing, especially when lying down<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Unexplained tiredness<\/span><\/li>\n<\/ul>\n<h2 id=\"sources\"><span style=\"font-weight: 400;\">Sources<\/span><\/h2>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/online.epocrates.com\/drugs\/204901\/pioglitazone\/Adult-Dosing\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Pioglitazone<\/span><\/a><span style=\"font-weight: 400;\">, Epocrates<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.pdr.net\/drug-summary\/Actos-pioglitazone-556\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Pioglitazone drug summary<\/span><\/a><span style=\"font-weight: 400;\">, Prescriber\u2019s Digital Reference<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=1f259863-21fd-4d62-b094-4eff845944df\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Pioglitazone hydrochloride tablet<\/span><\/a><span style=\"font-weight: 400;\">, U.S. National Library of Medicine<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/jamanetwork.com\/journals\/jamainternalmedicine\/fullarticle\/1108509\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Thiazolidinediones and fractures in men and women<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><i><span style=\"font-weight: 400;\">JAMA<\/span><\/i><\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Pioglitazone, also prescribed as the brand-name medication Actos, is a generic prescription drug that helps control blood sugar levels in people with Type 2 diabetes mellitus. Often combined with other glucose-lowering drugs such as metformin, pioglitazone is a thiazolidinedione, one of only two drugs in that class. It works by making muscle and fat cells [&hellip;]<\/p>\n","protected":false},"author":15,"featured_media":54764,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4589],"tags":[10298,12752],"coauthors":[8861],"class_list":["post-54762","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drug-info","tag-diabetes","tag-medication-side-effects","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Pioglitazone side effects and how to avoid them | SingleCare<\/title>\n<meta name=\"description\" content=\"Heart failure and bone fractures are common pioglitazone side effects. 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