What is Pioglitazone: Uses, Warnings & Interactions

Updated May 14, 2025  •  Published Dec 30, 2020

Pioglitazone is a prescription generic oral antidiabetic used in adults with Type 2 diabetes. Healthcare professionals use it only after several other types of drugs have failed to control blood sugar levels. It belongs to a class of diabetes drugs called thiazolidinediones. These drugs work by increasing insulin sensitivity in muscle, fat, and liver cells. They’re also associated with serious side effects. People taking pioglitazone should be familiar with the clinical signs of these adverse effects and get medical help when needed.

Pioglitazone overview

BRAND NAMES:

  • Actos

Generic Names:

  • Pioglitazone Hcl

Uses:

  • Treats Type 2 diabetes.

Therapeutic Classes:

  • Thiazolidinedione antidiabetic, glitazone, PPAR-gamma receptor agonist

Forms:

  • Tablet

How it’s taken:

  • By mouth

What is Pioglitazone used for?

Pioglitazone lowers blood sugar levels in adults with Type 2 diabetes.

What form(s) does Pioglitazone come in

  • Tablet

    • 15 mg

    • 30 mg

    • 45 mg

What are common Pioglitazone doses?

  • For Type 2 diabetes: 15–45 mg tablet taken once daily

Common Pioglitazone prescriptions

  • Pioglitazone HCl
    15mg tablet

  • Pioglitazone HCl
    30mg tablet

  • Pioglitazone HCl
    45mg tablet

How to take Pioglitazone

  • Take your medicine as directed. The prescriber may need to change the dose until blood sugar reaches target levels.

  • Please read the Medication Guide that is included with this drug.

  • Take pioglitazone tablets only once per day.

  • Tablets can be taken with food or on an empty stomach.

  • Swallow the tablet with a glass of water.

  • Store the medicine in the original container at room temperature protected from light. Keep the tablets dry.

What to do if you miss a dose of Pioglitazone

  • Skip a missed dose unless the doctor instructs otherwise.

  • Take the next prescribed dose at its regular time.

  • Do not take two doses to make up for a missed dose.

Pioglitazone contraindications

  • This medicine is not right for everyone. 

  • Do not use it if you have:

    • Severe heart failure

    • Had an allergic reaction to pioglitazone

  • Pioglitazone should never be used to treat Type 1 diabetes or diabetic ketoacidosis

Pioglitazone warnings

  • Tell any doctor or other healthcare provider who treats you that you are using this medicine.

  • Pioglitazone requires regular blood tests and doctor’s visits to monitor therapy. Keep all appointments.

  • Before taking pioglitazone doses, make sure the prescriber knows about all your medical conditions, particularly:

    • Kidney problems

    • Liver problems

    • Heart failure

    • Swelling of the center of the retina due to diabetes (macular edema)

    • A history of bladder cancer

  • Premenopausal women should tell the doctor if they don’t have periods or if their periods are irregular. Pioglitazone can induce ovulation and increase the risk of pregnancy in women with irregular periods or no periods at all.

  • Tell the doctor if you are being treated for bladder cancer. Pioglitazone should not be used in people who are being treated for bladder cancer.

  • Pioglitazone can cause serious problems including:

    • Heart failure

    • Fluid retention, edema, and weight gain

    • Liver problems

    • Low blood sugar

    • Increased risk of bladder cancer

    • Increased risk of bone fractures, particularly in women

  • Your dose may need to be modified in certain situations. Get medical help during periods of stress such as illness, fever, injury, or surgery.

  • Get immediate medical help if you have clinical signs of heart failure such as swollen ankles and feet, trouble breathing, shortness of breath, and unusual tiredness.

  • Stop taking pioglitazone and get immediate medical help if you notice signs of liver damage such as dark urine, abdominal pain, nausea, vomiting, and yellowing of the skin and eyes.

Pioglitazone interactions

  • Before starting pioglitazone, tell the prescriber about all the drugs and supplements you take, particularly:

    • Diabetes drugs called insulin secretagogues

    • Gemfibrozil, rifampin, topiramate

  • Tell other doctors or healthcare professionals about pioglitazone before they prescribe new medications.

Pioglitazone side effects

Serious side effects

Talk to a doctor if you notice any signs or symptoms of a possible serious side effect including:

  • Swelling in the ankles and feet, shortness of breath or trouble breathing particularly when lying down, racing heartbeats, unusual tiredness or fatigue

  • Nausea, vomiting, fatigue, stomach pain, decreased appetite, dark urine, yellow skin or eyes

  • Red urine, blood in the urine, increased frequency of urination, painful urination

  • Lightheadedness, dizziness, shaking, hunger

  • Sweating, fast or pounding heartbeat, faintness, confusion

  • Vision changes

  • Bone fractures

  • Allergic reaction: Itching, hives, swelling in your face or mouth, trouble breathing

Less serious side effects

  • Cough, runny or stuffy nose, sneezing, or sore throat

  • Weight gain

  • Headache

  • Sinus infection

  • Muscle pain

  • Sore throat

Find more information about pioglitazone side effects here.

Sources:

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