Pioglitazone

• In Aotearoa New Zealand pioglitazone is available as tablets (15 mg, 30 mg and 45 mg).
• The usual starting dose is 15 mg once a day.
• Depending on your blood glucose levels, your doctor may increase your dose over a few months to 45 mg once a day.
• Always take your pioglitazone exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much to take, how often to take it and any special instructions.

• Timing: Take pioglitazone once a day, at the same time each day. Swallow your tablets with a drink of water. You can take pioglitazone with or without food.
• Avoid or limit alcohol while you are taking pioglitazone: Alcohol may affect your blood glucose control and increase your risk of side effects.
• Missed dose: If you forget to take your dose, take it as soon as you remember but if it's nearly time for your next dose, just take the next dose at the right time. Don't take double the dose.
• Keep taking pioglitazone regularly: To control your diabetes you must take pioglitazone every day. The effects of pioglitazone are not immediate. It may take 6 to 8 weeks to reach full effect. Talk to your doctor or nurse before stopping. Contact your doctor or nurse for advice if you have been unwell and missed meals.

Here are some things to know when you're taking pioglitazone.

Taking other medicines

Pioglitazone can interact with some other medicines, herbal supplements and rongoā Māori. Check with your doctor or pharmacist before starting pioglitazone and before starting any new products.

Have a sick day plan

If you're unwell with vomiting, diarrhoea or a fever or you're not eating or drinking as usual, ask your healthcare provider for advice. They may advise you to stop taking pioglitazone for a few days and start again when you’re eating and drinking as normal. Read more about diabetes sick day plan.

Increased risk of fractures

Pioglitazone can weaken your bones increasing your risk of breaking a bone, particularly if you are a woman. You may need tests to check for this before you start. If you're treated for a broken bone or fracture, let your doctor know as soon as possible afterwards.

Putting on weight

Pioglitazone may cause you to gain weight, this is mostly fluid. Lifestyle changes can be helpful in preventing weight gain, eg, making better eating choices, limiting your portion sizes, and getting more exercise. Read more about medicines and weight gain. However, if you put on weight quickly and notice swelling in your arms, legs or stomach, and have problems breathing, these can be signs of problems with your heart. Contact your doctor immediately.

Like all medicines pioglitazone can cause side effects, although not everyone gets them. If you're concerned about any symptoms you think might be related to your medicine, talk to your healthcare provider. The following information offers some guidance but doesn't include all possible side effects.

Common side effects

Tell your healthcare provider if these bother you.

• Headache.
• Sore throat, cough, runny nose, sneezing.
• Problems with your eyesight. Your eyesight may be affected for a short time when you first start pioglitazone. Don't drive, cycle or use machinery until your eyesight is back to normal. If it lasts for more than a few days, or if you are worried, tell your doctor.

Weight gain

Pioglitazone can cause some people to gain weight. Lifestyle changes can be helpful in preventing weight gain, eg, making better eating choices, limiting your portion sizes, and getting more exercise. Read more about medicines and weight gain(external link). However, if you put on weight quickly and notice swelling in your arms, legs or stomach, and have problems breathing, these can be signs of problems with your heart. Contact your doctor immediately.

Tell your healthcare provider immediately or phone Healthline free on 0800 611 116 if these occur

• Blood in your pee (urine) or problems peeing such as needing to pee more often.
• Signs of problems with your heart, such as swollen arms, ankles, legs or stomach or problems breathing.
• Signs of problems with your liver, such as yellowing of your skin or eyes, dark urine or pain in your tummy (abdomen).
• Signs of low blood glucose (hypoglycaemia) such as feeling weak, faint, dizzy or irritable. You may get a headache, tremor (shakes) or blurred vision. Pioglitazone cannot cause hypoglycaemia on its own. If you are taking pioglitazone as well as insulin and/or a sulphonylurea (gliclazide, glipizide or glibenclamide), very rarely the addition of pioglitazone may lower your blood glucose too much. If this happens, follow the instructions for treating a hypo given to you by your healthcare team. Tell your doctor or nurse if this happens. Read more about low blood glucose.

Phone 111 for an ambulance or go to your nearest accident and emergency (A&E) clinic if these occur

• Signs of an allergic reaction such as itchy skin, and rash, swollen lips or tongue, problems breathing, like a tight chest or shortness of breath.

Read more about medicines and side effects and reporting a reaction you think might be a side effect.