Pioglitazone tablets for diabetes

About pioglitazone

Insulin is a hormone which is made naturally in your body by the pancreas. It helps to control the levels of sugar (glucose) in your blood. If your body does not make enough insulin to meet its needs, or if it does not use the insulin it makes effectively, this results in the condition called diabetes (diabetes mellitus).

People with diabetes need treatment to control the amount of sugar in their blood. This is because good control of blood sugar levels reduces the risk of complications later on. Some people can control the sugar in their blood by making changes to the food they eat, but for other people, medicines are given alongside the changes in diet.

Pioglitazone works by increasing the sensitivity of your body's cells to insulin - so more glucose is taken into cells for the same amount of insulin in the bloodstream. It can be used on its own, but it is more commonly taken alongside metformin and/or other antidiabetic medicines.

Before taking pioglitazone

Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking pioglitazone it is important that your doctor knows:

• If you are pregnant or breastfeeding.

• If you have any problems with the way your liver works.

• If you have ever had bladder cancer, or if you have recently noticed any blood in your urine.

• If you have been told your heart is not working as well as it should, a condition called heart failure.

• If you have a heart condition or blood vessel disease

• If you have a rare inherited blood disorder called porphyria.

• If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.

• If you have ever had an allergic reaction to a medicine.

How to take pioglitazone

• Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about pioglitazone, and will also provide you with a full list of the side-effects which you could experience from taking it.

• Take the tablets exactly as your doctor tells you to. It is usual to take one tablet of pioglitazone daily. There are three strengths of tablet available: 15 mg, 30 mg, and 45 mg. Most people are started on the lowest strength of tablet, but your doctor will tell you which strength is right for you. Pioglitazone tablets can be taken either with or without food. Swallow the tablet with a drink of water.

• If you have been prescribed Competact® tablets, this is a combination brand of pioglitazone with a medicine called metformin. Take one tablet twice a day, after a meal.

• Try to take your doses at the same time of day each day, as this will help you to remember to take them regularly.

• If you forget to take a dose, take it as soon as you remember (unless it is nearly time for your next dose, in which case leave out the missed dose and take the next dose as normal). Do not take two doses together to make up for a forgotten dose.

Getting the most from your treatment

• If you have been given advice by your doctor about changes to your diet, stopping smoking or taking regular exercise, it is important for you to follow the advice you have been given.

• It is also important that you keep your regular doctor's and clinic appointments. This is so your progress can be monitored. Your doctor will want to do some blood tests both before and during treatment to check how well your liver is working. You will also need regular check-ups with an eye clinic and a foot clinic.

• Test your blood or urine regularly to ensure your blood sugar (glucose) levels are being controlled. Your doctor or diabetes nurse will show you how to do this. Doing this regularly is especially important if you are taking pioglitazone with another antidiabetic medicine or insulin.

• Make sure you know what it feels like if your blood sugar is low. This is known as hypoglycaemia, or a 'hypo'. Although pioglitazone is unlikely to cause low blood sugar, other medicines that you are taking for diabetes alongside it may. The first signs of hypoglycaemia are feeling shaky or anxious, sweating, looking pale, feeling hungry, having a feeling that your heart is pounding (palpitations), and feeling dizzy. If you are a driver you should take special care, as your ability to concentrate may be affected if your diabetes is not well controlled. You may be advised to check your blood sugar levels before you travel and to have a snack with you on long journeys.

• If you get unusually thirsty, pass urine more frequently, and feel very tired, you should let your doctor know. These are signs that there is too much sugar in your blood and your treatment may need adjusting.

• Drinking alcohol is not recommended. Pioglitazone and alcohol can produce low blood sugar levels and this will affect the control of your condition.

• If you are having an operation or dental treatment, tell the person carrying out the treatment that you are taking pioglitazone.

• If you buy any medicines, check with a pharmacist that they are suitable for you to take with pioglitazone.

• Taking pioglitazone can increase the risk of developing problems such as bladder cancer, bone fractures (particularly in women), and heart failure. Your doctor will talk with you about these risks, as they can depend upon a number of factors. Your doctor will also closely monitor your progress and review the need for treatment with pioglitazone on a regular basis.

Can pioglitazone cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with pioglitazone. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

Important: your doctor will discuss with you the possibility of some less common side-effects but ones, which if you experience, you must let your doctor know about straightaway. These are:

• Feeling sick (nausea) or being sick (vomiting) for no apparent reason, tummy (abdominal) pain, extreme tiredness, or dark urine. These are signs that your liver is not working as well as it should.

• Blood in your urine, or bladder problems such as pain or an increased urgency to go to the toilet. Your doctor will want to check these symptoms to make sure that your bladder is healthy.

If you experience any other symptoms which you think may be due to the tablets, speak with your doctor or pharmacist for further advice.

How to store pioglitazone

• Keep all medicines out of the reach and sight of children.

• Store in a cool, dry place, away from direct heat and light.
  

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