Patient Medication Information: uses, side effects, how to take - Pioglitazone (Accel Pharma)
ABOUT THIS MEDICATION
What Pioglitazone is used for:
Your doctor has prescribed Pioglitazone to treat your type 2 diabetes, as an addition to diet and exercise, in order to improve your blood sugar control. Pioglitazone may be used alone or in combination with a sulfonylurea or metformin.
What Is Type 2 Diabetes?
Insulin is a hormone that the body makes to help use food for energy. There are two types of diabetes: in type 1 diabetes, the body stops producing insulin. In type 2 diabetes, the body does not respond to insulin as well as it should, and/or cannot make enough insulin on its own. When this happens, glucose (sugar) builds up in the blood. This can lead to serious medical problems, including kidney damage, eye damage, nerve damage, heart disease, or stroke. The main goal of diabetes treatment is to lower blood sugar to a normal level.
How Is Type 2 Diabetes Usually Controlled?
Treatment of type 2 diabetes must always include proper diet, exercise and weight control under the guidance of your physician.
What Pioglitazone does:
Pioglitazone is a member of a class of drugs that are insulin-sensitizing agents. Pioglitazone helps your body respond better to its own insulin, thereby reducing blood sugar levels in the body. Because Pioglitazone does not cause your body to produce more insulin, it rarely causes hypoglycemia (low blood sugar) when used alone. Even if you are taking Pioglitazone, you should still exercise and follow the recommended nutritional plan for your diabetes.
When Pioglitazone should not be used:
Pioglitazone should not be used by patients who:
- have serious liver damage
- have or have had heart problems or heart failure
are pregnant
- are allergic to pioglitazone hydrochloride or any other ingredients of Pioglitazone.
- have or have had bladder cancer
- have blood or a red color in their urine
What the medicinal ingredient is:
Pioglitazone Hydrochloride
What the nonmedicinal ingredients are:
Lactose monohydrate, hydroxypropylcellulose, carmellose calcium, magnesium stearate.
What dosage forms it comes in:
Pioglitazone is available as tablets of 15 mg, 30 mg or 45 mg.
WARNINGS AND PRECAUTIONS
Because Pioglitazone works only in the presence of insulin, it should not be used if you have type 1 diabetes (when the pancreas does not produce insulin).
Serious side effects with Pioglitazone include:
- heart failure. Symptoms of heart failure include shortness of breath, weakness, tiredness, swelling (edema), or unusual weight gain
- liver problems. Symptoms of liver problems include tiredness, lack of appetite, dark urine, yellowing of the skin or the white part of the eye
- bladder cancer. Symptoms of bladder cancer include blood or a red color in your urine, an increased need to urinate, or pain while you urinate
Pioglitazone is not approved for use with metformin and a sulfonylurea, therefore Pioglitazone should not be taken with metformin and a sulfonylurea.
Pioglitazone is not approved for use with insulin therapy, therefore, Pioglitazone should not be taken with insulin.
If you are taking Pioglitazone with a sulfonylurea, you may develop low blood sugar. Make sure to ask your doctor, pharmacist, or diabetes educator what to do if your blood sugar is low. Teach your friends, coworkers, and family members what they can do to help you if you have low blood sugar.
Consult your doctor promptly during periods of stress, such as fever, trauma, infection or surgery, since your medication requirements may change during these times.
Fractures, usually in the hand, upper arm or foot, have been seen with Pioglitazone use in women. Talk to your doctor about the risk of fracture.
Before or while taking Pioglitazone, talk to your doctor or pharmacist if you:
- have liver disease. Pioglitazone is not recommended in patients with liver disease.
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are planning to become pregnant. Only insulin should be
used during pregnancy to maintain blood glucose levels as close to normal as possible.
- are breastfeeding
are a woman who has not reached menopause but have no
menstrual periods. You may become pregnant unless you use an effective method of birth control. Pioglitazone, like other drugs in this class, may cause women with insulin resistance to ovulate again.
- have edema (water retention)
Pioglitazone should not be used in children under 18 years of age.
INTERACTIONS WITH THIS MEDICATION
Drugs that interact with Pioglitazone include:
Oral Contraception. Women using oral birth control pills should check with their doctor about the possible need to adjust the dose or use alternative methods of contraception when taking Pioglitazone. Women should also inform their doctors of any changes in their monthly cycle.
Pioglitazone may also interact with some other drugs such as gemfibrozil, rifampicin, nifedipine and atorvastatin calcium. Tell your doctor if you are taking these medicines.
PROPER USE OF THIS MEDICATION
Usual dose: Pioglitazone should be taken once daily without regard to meals. The initial dose is 15 or 30 mg once daily. Do not exceed 45 mg once daily.
Take your Pioglitazone each day, as instructed by your doctor or pharmacist. Pioglitazone can help you control your blood glucose levels only if you take it regularly. Pioglitazone should generally be taken at the same time each day at whatever time you find most convenient to remember.
Your doctor has prescribed Pioglitazone specifically for you. Do not give your medicine to anyone else, even if they have a similar condition.
Overdose:
In case of drug overdose, contact a health care practitioner, hospital emergency department or regional Poison Control Centre immediately, even if there are no symptoms.
In the event of overdosage, consult your doctor or pharmacist, or contact a poison control centre immediately.
Missed Dose: If you miss a dose of Pioglitazone, do not take a double dose to make up for the missed dose. Take your dose at the regular time on the following day.
Monitoring:
Fasting blood glucose: Test your blood sugar levels with your personal glucose meter as often as your doctor recommends.
- Glycosylated hemoglobin (HbA1c): This blood test is done periodically to determine the average control of your blood sugar levels.
- Liver Enzymes: Your doctor may recommend a blood test to monitor your liver function before you start Pioglitazone and may repeat this test occasionally while you take Pioglitazone.
- Eye: should be checked regularly. Rarely, some patients have experienced vision changes due to swelling in the back of the eye while taking pioglitazone hydrochloride.
SIDE EFFECTS AND WHAT TO DO ABOUT THEM
The following side effects have been commonly reported with pioglitazone (could affect up to 1 in 10 patients):
- Edema (fluid retention or swelling) which could lead to heart failure. If you notice swelling in extremities (arms and legs, hands and feet), unusually rapid increase in weight, tiredness, trouble breathing or shortness of breath, call your doctor. These symptoms, although not specific, may signal heart problems or heart failure.
Low blood sugar (hypoglycemia) if you are taking Pioglitazone in combination with another diabetes medicine (e.g., metformin or a sulfonylurea). Dizziness, lack of energy, drowsiness, headache, trembling, sweating, or hunger may mean that your blood sugar is too low. This can happen if you skip meals, drink alcohol, use another medicine that lowers blood sugar, exercise (particularly hard or long), or if you have certain medical problems. Call your doctor if you feel that your symptoms of low blood sugar are uncomfortable. If you are using Pioglitazone by itself, there is less risk of having low blood sugar.
- Increased weight. Tell your doctor if you gain a lot of weight in a short period of time.
The following side effects have been reported rarely with pioglitazone hydrochloride (could affect up to 1 in 1000 patients):
- Liver problems. If you experience nausea, vomiting, stomach pain, lack of appetite, tiredness, dark urine, or yellowing of the skin, stop taking Pioglitazone and call your doctor right away.
- Breakthrough bleeding (unexpected vaginal bleeding or spotting) while using oral contraceptives, or generally, if you experience any symptoms that persist or become troublesome, these should be discussed with your doctor.
- Blurred vision due to swelling (or fluid) in the back of the eye.
- Fractures, usually in the hand, upper arm or foot, have been seen with Pioglitazone use in women. Talk to your doctor about the risk of fracture.
- Bladder cancer. If you experience blood or a red colour in your urine, an increased need to urinate, or pain while you urinate, stop taking Pioglitazone and call your doctor right away.
The following side effects have been reported very rarely with pioglitazone hydrochloride (could affect up to 1 in 10,000 patients):
- Heart failure or pulmonary edema (fluid accumulation in the lungs). Symptoms of heart failure include shortness of breath, getting tired easily after light physical activity such as walking, waking up short of breath at night and swollen ankles or feet. IMPORTANT: PLEASE READ
Symptoms of fluid in the lungs are breathlessness, which may be very severe and usually worsens on lying down. Stop taking Pioglitazone and call your doctor right away if you experience these symptoms.
- Anemia (low red blood cell count) which may make you feel very weak or tired.
- Swelling of the face, lips, mouth, tongue or throat (which may cause difficulty in swallowing or breathing); hives or rash (which may be itchy). Stop taking Pioglitazone and call your doctor right away if you experience these symptoms.
| SERIOUS SIDE EFFECTS, HOW OFTEN THEY HAPPEN AND WHAT TO DO ABOUT THEM | ||||
| Symptom / effect | Talk with your doctor or pharmacist | Stop taking drug and seek immediat e emergenc y medical attention | ||
Only if severe | In all cases | |||
| Common | Fluid retention or swelling in extremities (arms and legs, hands and feet) | ✓ | ||
Common (when Pioglitazone is taken with other antidiabetic medicines) | Low blood sugar (hypoglycemia): Dizziness, lack of energy, drowsiness, headache, trembling, sweating, huger | ✓ | ||
| Rare | Liver problems: nausea, vomiting, stomach pain, lack of appetite, tiredness, dark urine, or yellowing of the skin | ✓ | ||
| Rare | Blurred vision or decreased vision [which may be due to swelling (or fluid) in the back of the eye]. | ✓ | ||
| Rare | Fractures, usually in the hand, upper arm or foot, in women. | ✓ | ||
| Rare | Bladder cancer: blood or red colour in urine, increased need to urinate, pain while you urinate | ✓ | ||
| SERIOUS SIDE EFFECTS, HOW OFTEN THEY HAPPEN AND WHAT TO DO ABOUT THEM | ||||
| Symptom / effect | Talk with your doctor or pharmacist | Stop taking drug and seek immediat e emergenc y medical attention | ||
Only if severe | In all cases | |||
| Very Rare | Heart failure or fluid in the lungs (pulmonary edema): trouble breathing or shortness of breath, getting tired easily after light physical activity, unusual tiredness, waking up short of breath at night, swollen ankles or feet, unusually rapid increase in weight | ✓ | ||
| Very Rare | Allergic reactions: swelling of the face, lips, mouth, tongue or throat (may cause difficulty in swallowing or breathing), hives or rash | ✓ | ||
This is not a complete list of side effects. For any unexpected effects while taking Pioglitazone, contact your doctor or pharmacist.
HOW TO STORE Pioglitazone
Store Pioglitazone in its bottle with the cap tightly closed at room temperature (15° - 30°C). Protect from light and humidity.
REPORTING SUSPECTED SIDE EFFECTS
You can report any suspected adverse reactions associated with the use of health products to the Canada Vigilance Program by one of the following 3 ways:
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- Report online at www.healthcanada.gc.ca/medeffect
- Call toll-free at 1-866-234-2345
Complete a Canada Vigilance Reporting Form and:
- Fax toll-free to 1-866-678-6789, or
Mail to: Canada Vigilance Program Health Canada
Postal Locator 0701E Ottawa, Ontario
K1A 0K9
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Postage paid labels, Canada Vigilance Reporting Form and the adverse reaction reporting guidelines are available on the MedEffect™ Canada Web site at www.healthcanada.gc.ca/medeffect.
NOTE: Should you require information related to the management of side effects, contact your health professional. The Canada Vigilance Program does not provide medical advice.
MORE INFORMATION
This document plus the full product monograph, prepared for health professionals can be found at
http://www.accelpharma.com
or by contacting the sponsor, Accel Pharma Inc. at: 1-877-827-1306
Last revised: December 5, 2013
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