Generic Name: metformin and pioglitazone (met FOR min and PYE o GLI ta zone)
Brand Names: Actoplus Met, Actoplus Met XR
What is Actoplus Met?
Actoplus Met contains a combination of metformin and pioglitazone, two oral diabetes medicines that help control blood sugar levels.
Actoplus Met is for people with type 2 diabetes who do not use daily insulin injections.
Actoplus Met is not for treating type 1 diabetes.
You should not use Actoplus Met if you have severe or uncontrolled heart failure, kidney problems, active bladder cancer, metabolic acidosis, or diabetic ketoacidosis (call your doctor for treatment with insulin). Actoplus Met is not for treating type 1 diabetes.
Actoplus Met can cause or worsen congestive heart failure. Call your doctor at once if you have shortness of breath (even with mild exertion), swelling, or rapid weight gain.
If you need to have any type of x-ray or CT scan using a dye that is injected into your veins, you will need to temporarily stop taking Actoplus Met.
Some people develop lactic acidosis while taking metformin. Get emergency medical help if you have even mild symptoms such as: muscle pain or weakness, numb or cold feeling in your arms and legs, trouble breathing, stomach pain, nausea with vomiting, slow or uneven heart rate, dizziness, or feeling very weak or tired.
Before taking this medicine
You should not use Actoplus Met if you are allergic to metformin or pioglitazone, or if you have:
severe or uncontrolled heart failure;
active bladder cancer;
metabolic acidosis; or
diabetic ketoacidosis (call your doctor for treatment with insulin).
If you need to have any type of x-ray or CT scan using a dye that is injected into your veins, you will need to temporarily stop taking Actoplus Met. Be sure your caregivers know ahead of time that you are using this medication.
Some people taking metformin develop a serious condition called lactic acidosis. This may be more likely if you have liver or kidney disease, congestive heart failure, a severe infection, if you are dehydrated, or if you drink large amounts of alcohol. Talk with your doctor about your risk.
To make sure Actoplus Met is safe for you, tell your doctor if you have:
congestive heart failure or heart disease;
a history of bladder cancer;
a history of heart attack or stroke;
liver disease; or
if you are 80 years or older.
Actoplus Met may increase your risk of developing bladder cancer. Talk with your doctor about your specific risk.
Taking Actoplus Met may increase your risk of serious heart problems. However, not treating your diabetes can damage your heart and other organs. Talk to your doctor about the risks and benefits of treating your diabetes with this medicine.
Follow your doctor's instructions about using this medicine if you are pregnant. Blood sugar control is very important during pregnancy, and your dose needs may be different during each trimester of pregnancy.
Some women using Actoplus Met have started having menstrual periods, even after not having a period for a long time due to a medical condition. You may be able to get pregnant if your periods restart. Talk with your doctor about the need for birth control.
Women may be more likely than men to have bone fractures in the upper arm, hand, or foot while taking medicine that contains pioglitazone. Talk with your doctor if you are concerned about this possibility.
It is not known whether metformin and pioglitazone passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.
Actoplus Met should not be given to a child.
How should I take Actoplus Met?
Take Actoplus Met exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.
Take Actoplus Met with meals. Take the extended-release (XR) tablet once daily with your evening meal.
Do not crush, chew, or break an extended-release tablet. Swallow it whole.
Your blood sugar will need to be checked often, and you may need other blood tests at your doctor's office.
Low blood sugar (hypoglycemia) can happen to everyone who has diabetes. Symptoms include headache, hunger, sweating, pale skin, irritability, dizziness, feeling shaky, or trouble concentrating. Always keep a source of sugar with you in case you have low blood sugar. Sugar sources include fruit juice, hard candy, crackers, raisins, and non-diet soda. Be sure your family and close friends know how to help you in an emergency.
If you have severe hypoglycemia and cannot eat or drink, use a glucagon injection. Your doctor can prescribe a glucagon emergency injection kit and tell you how to use it.
Check your blood sugar carefully during times of stress, travel, illness, surgery or medical emergency, vigorous exercise, or if you drink alcohol or skip meals. These things can affect your glucose levels and your dose needs may also change. Do not change your Actoplus Met dosage or dosing schedule without your doctor's advice.
Use Actoplus Met regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.
If you take extra vitamin B12 while you are taking Actoplus Met, take only the amount of vitamin B12 that your doctor has prescribed.
Actoplus Met is only part of a treatment program that may also include diet, exercise, weight control, blood sugar testing, and special medical care. Follow your doctor's instructions very closely.
Store at room temperature away from moisture, heat, and light. Keep the bottle tightly closed when not in use.
Actoplus Met dosing information
Usual Adult Dose of Actoplus Met for Diabetes Type 2:
Individualize dose based on safety, efficacy, and prior therapy; asses the risk versus benefit of initiating with combination therapy versus monotherapy
Initial dose: metformin 500 mg-pioglitazone 15 mg orally twice a day OR metformin 850 mg-pioglitazone 15 mg orally once a day
Maintenance dose: Gradually titrate dose based on safety and efficacy
Maximum dose: Metformin 2550 mg-Pioglitazone 45 mg per day
Initial dose: metformin 1000 mg-pioglitazone 15 mg OR metformin 1000 mg-pioglitazone 30 mg orally once a day
Maintenance dose: Gradually titrate dose based on safety and efficacy
Maximum dose: Metformin 2000 mg-Pioglitazone 45 mg per day
-Initial doses for patients receiving combination therapy as separate tablets should be as close as possible to current regimen.
-Metformin doses above 2000 mg may be better tolerated given 3 times a day.
Use: Adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus when treatment with both pioglitazone and metformin is appropriate.
See also: Dosage Information (in more detail)
What happens if I miss a dose?
Take the missed dose as soon as you remember (be sure to take the medicine with food). Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What should I avoid while taking Actoplus Met?
Avoid drinking alcohol. It can lower your blood sugar and may increase your risk of lactic acidosis.
Actoplus Met side effects
Some people develop lactic acidosis while taking metformin. Early symptoms may get worse over time and this condition can be fatal. Get emergency medical help if you have even mild symptoms such as: muscle pain or weakness, numb or cold feeling in your arms and legs, trouble breathing, stomach pain, nausea with vomiting, fast or uneven heart rate, dizziness, or feeling very weak or tired.
Get emergency medical help if you have any of these signs of an allergic reaction to Actoplus Met: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
shortness of breath (even with mild exertion), swelling, rapid weight gain;
pink or red urine, painful or difficult urination, new or worsening urge to urinate;
pale skin, easy bruising or bleeding;
nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or
changes in your vision.
Common Actoplus Met side effects may include:
cold symptoms such as stuffy nose, sinus pain, sneezing, sore throat.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
What other drugs will affect Actoplus Met?
Tell your doctor if you use insulin. Taking Actoplus Met while you are using insulin may increase your risk of serious heart problems.
Tell your doctor about all your current medicines and any you start or stop using, especially:
an antibiotic - rifampin, trimethoprim, vancomycin; or
heart or blood pressure medication - digoxin, nifedipine, procainamide, quinidine.
You may be more likely to have hyperglycemia (high blood sugar) if you also take other drugs that can raise blood sugar, such as:
diuretics (water pills);
steroids (prednisone and others);
niacin (Advicor, Niaspan, Niacor, Simcor, Slo-Niacin, and others);
phenothiazines (Compazine and others);
thyroid medicine (Synthroid and others);
birth control pills and other hormones; and
diet pills or medicines to treat asthma, colds or allergies.
These lists are not complete and many other medicines can increase or decrease the effects of Actoplus Met on lowering your blood sugar. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here. Give a list of all your medicines to any healthcare provider who treats you.
More about ActoPlus Met (metformin / pioglitazone)
Related treatment guides
Where can I get more information?
- Your pharmacist can provide more information about Actoplus Met.
- Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Actoplus Met only for the indication prescribed.
- Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2017 Cerner Multum, Inc. Version: 11.02.
Last reviewed: December 13, 2016
Date modified: January 10, 2017