Actoplus Met (Pioglitazone/Metformin)

Description

Actoplus Met (pioglitazone and metformin hydrochloride) is a combination medication that is prescribed in addition to diet and exercise to treat high blood sugar in adults who have type 2 diabetes.

Actoplus Met is available in oral tablets containing 15 mg pioglitazone/500 mg of metformin HCl and 15 mg pioglitazone/850 mg metformin HCl.

Directions

Actoplus Met should be taken exactly as your doctor has advised. Any questions or concerns should be discussed with your doctor or pharmacist.

Depending on your current treatment regimen, your Actoplus Met dosage may be changed based on how well you tolerate and respond to the medication. You should not take more than pioglitazone 45 mg and metformin 2550 mg by mouth a day.

Ingredients

The active ingredients in Actoplus Met are pioglitazone, a thiazolidinedione, and metformin, a biguanide. Inactive ingredients include povidone, microcrystalline cellulose, croscarmellose sodium, magnesium stearate, hypromellose 2910, polyethylene glycol 8000, titanium dioxide, and talc.

Contraindications

Patients with New York Heart Association Class III or IV heart failure should not take Actoplus Met.

Patients who suffer from severe kidney problems should not take Actoplus Met.

Patients who have an allergy to pioglitazone, metformin, or to any of its other ingredients should avoid taking Actoplus Met.

Patients with diabetic ketoacidosis should not take Actoplus Met.

Cautions

Actoplus Met has the following FDA Boxed Warnings:

• Thiazolidinediones (a component of Actoplus Met), can cause or worsen congestive heart failure in some patients.

• After dose changes and starting treatment with Actoplus Met, patients should be monitored for signs and symptoms of heart failure. If heart failure occurs, it should be managed and Actoplus Met should be stopped or the dose should be reduced.

• Patients with symptomatic heart failure should not take Actoplus Met.

• Patients with established New York Association Class III or IV heart failure should not take Actoplus Met.

• Metformin-associated lactic acidosis can lead to death, hypothermia, low blood pressure, and resistant slow heart rates. Symptoms include general discomfort, muscle pains, breathing problems, drowsiness, and stomach pain. Lab findings may include elevated blood lactate levels, anion gap acidosis, increased lactate:pyruvate ratio, and metformin blood levels greater than 5 mcg/mL.

• The risk of lactic acidosis is increased in patients with kidney problems, who are taking certain drugs, who are at least 65 years old, who are undergoing radiological studies with contrast, who are undergoing surgery and other procedures, who have low blood oxygen, who consume excessive amounts of alcohol, or who have liver problems.

• If lactic acidosis is suspected, Actoplus Met should be stopped and treatment started.

• Before starting Actoplus Met, tell your doctor:
• About any and all prescription and nonprescription medications you take
• About any allergies you may have
• About your past medical history and current health conditions
• Your current pregnancy and breastfeeding status
• Fluid retention, which can worsen or result in congestive heart failure, can be caused by Actoplus Met. Monitoring for signs and symptoms is important.
• Lactic acidosis can be caused by Actoplus Met.
• Swelling that is dose-related can be caused by Actoplus Met.
• Low blood sugar levels can occur with the use of Actoplus Met and insulin or an insulin secretagogue; a lower insulin or insulin secretagogue dose may be required.
• Actoplus Met may cause liver failure that can be fatal.
• An increased risk of bladder cancer may be associated with Actoplus Met.
• A female’s incidence of fracture risk could be increased with Actoplus Met.
• All diabetic patients are recommended to have regular eye exams, as they are at risk of macular edema with Actoplus Met.
• Actoplus Met may decrease vitamin B12 levels.
• There is no evidence that Actoplus Met reduces the risk of macrovascular outcomes.

Side Effects

Upper respiratory tract infection, swelling, diarrhea, headache, and weight gain are side effects associated with Actoplus Met. If you experience concerning or persistent side effects, immediately call your doctor.

Reference:

Actoplus Met. Lexington, MA: Takeda Pharmaceuticals America Inc.; 2020.

About Dr. Savannah Muncy (Page Author)

Dr. Muncy (PharmD) studied science and education as an undergraduate before attending the Appalachian College of Pharmacy where she completed her PharmD in three years. She is currently using her pharmacy and healthcare expertise to write medical content for clients all around the world. She is focused on delivering the most current, accurate, and engaging information to healthcare professionals and patients. Read More....