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Actos Warnings and Precautions

There are several Actos warnings and precautions to be aware of before starting the medication. For example, side effects (such as fluid retention, high blood sugar, or increased liver enzymes) may occur while taking this drug. Also, certain people should not take the diabetes medication, such as those who are allergic to any components of Actos.

Actos: What Should I Tell My Healthcare Provider?

Prior to taking Actos® (pioglitazone hydrochloride), you should talk with your healthcare provider if you have:
  • Heart problems of any kind, especially congestive heart failure (CHF)
  • Liver problems, including liver failure or cirrhosis
  • An upcoming surgery
  • Any allergies, including allergies to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Having problems getting pregnant
  • Breastfeeding
  • Premenopausal without regular menstrual periods.
Also, tell your healthcare provider about all other medicines you may be taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Some Actos Precautions and Warnings

Some precautions and warnings with Actos to be aware of include:
  • Actos can cause fluid retention (gaining of water weight, known medically as edema). For most people, this is not dangerous. However, fluid retention can be serious in people with congestive heart failure (CHF). It is possible for fluid retention to lead to heart failure even in people who have no history of heart failure or any other heart disease. There may be an increased risk of edema or heart failure for people taking both Actos and insulin.
If you notice any of the following symptoms, contact your healthcare provider: unexplained weight gain (three to five pounds in a week); swelling of the ankles, feet, or legs; cough; and shortness of breath (see Symptoms of Congestive Heart Failure for more signs and symptoms).
  • Actos cannot be used to treat type 1 diabetes or diabetic ketoacidosis (a life-threatening condition that may occur with uncontrolled diabetes). These conditions need to be treated with insulin (see Actos and Type 1 Diabetes).
  • Taking Actos with other medications for diabetes can increase your risk of low blood sugar (hypoglycemia) (see Actos and Blood Sugar).
  • There have been reports of Actos causing macular edema (a condition of the eye). Tell your healthcare provider if you have any vision changes.


  • Actos may increase the risk of fractures (broken bones) in women. These fractures are typically different than those seen in postmenopausal women with osteoporosis. In a recent study, women taking Actos were more likely to have broken bones, especially in the upper arm, hand, lower leg, ankle, or foot.
  • Actos can cause weight gain. In studies, people taking Actos gained about 2 to 12 pounds on average (see Actos and Weight Gain). Talk to your healthcare provider about rapid weight gain, as this may be a sign of fluid retention.
  • If you are a premenopausal woman who has infertility problems (due to lack of ovulation), Actos may increase your for chance of ovulation (and pregnancy). Talk to your healthcare provider about birth control options if you would like to avoid pregnancy while taking Actos.
  • Actos may cause increased liver enzymes. Very rarely, this has led to liver damage. It is recommended that liver enzymes be checked in all people before starting Actos and should be checked again periodically. Liver enzymes are checked using a blood test. Actos should not be started in people with high liver enzymes. Actos should be stopped if liver enzymes increase and continue to stay high, as this may be a sign of liver damage. 


  • Studies suggest that Actos may increase the risk of bladder cancer, particularly in people who have taken the medication for one year or longer. You should not take Actos if you have bladder cancer. Additionally, Actos should be used very cautiously in people who have had bladder cancer in the past.

Current recommendations suggest that you should continue your treatment, unless instructed otherwise by your healthcare provider, and to discuss any concerns you may have with your healthcare provider.

  • Actos can interact with certain medications (see Actos Drug Interactions).
  • Actos is considered a pregnancy Category C medication. This means that Actos may not be safe to use during pregnancy. Talk to your healthcare provider about the risks or benefits of using Actos during pregnancy (see Actos and Pregnancy for more information).
  • It is not known if Actos passes through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, be sure to talk with your healthcare provider about this.
Diabetes Tips for Seniors

Actos Drug Info

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