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Actoplus Met
Actoplus Met is a combination oral medication containing pioglitazone and metformin used to treat type 2 diabetes mellitus. It helps control blood sugar levels by addressing insulin resistance and improving the body’s ability to use insulin effectively. Pioglitazone belongs to the class of thiazolidinediones (TZDs), which work by increasing insulin sensitivity, while metformin is a biguanide that decreases the liver's glucose production and improves the body's utilization of glucose. Actoplus Met is used along with diet and exercise to help patients better manage their blood sugar levels.
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Frequently Asked Questions
How long does it take for Actoplus Met to start working?
Blood sugar levels may start to improve within several days to a week after starting Actoplus Met, but full effects on blood sugar control may take a few weeks.
Can I take Actoplus Met if I have kidney disease?
No, Actoplus Met should not be used in patients with severe kidney disease, as it increases the risk of lactic acidosis. Your doctor may prescribe a different medication if you have kidney problems.
Does Actoplus Met cause weight gain?
Weight gain is a potential side effect due to the pioglitazone component. However, this varies between patients and may not occur in all cases.
Can Actoplus Met be used with other diabetes medications?
Yes, Actoplus Met can be used with other diabetes medications if prescribed by your healthcare provider. However, you should monitor your blood sugar closely to avoid hypoglycemia (low blood sugar).
What should I do if I miss a dose of Actoplus Met?
If you miss a dose, take it as soon as you remember. If it’s close to your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not double up on doses.
Comprehensive Drug Guide
How Does Actoplus Met Work?
- Pioglitazone: Increases the body’s sensitivity to insulin by acting on fat cells, muscle cells, and liver cells, allowing them to use insulin more effectively and lowering blood sugar levels.
- Metformin: Decreases the amount of glucose produced by the liver and improves the body’s sensitivity to insulin, helping the body use glucose more efficiently.
Common Dosages
- 15 mg pioglitazone / 500 mg metformin
- 15 mg pioglitazone / 850 mg metformin
- 15 mg pioglitazone / 1000 mg metformin
Typical Dosing
- The usual starting dose is one tablet twice daily with meals, typically starting at the lower dose to minimize gastrointestinal side effects.
- The dose may be adjusted based on the patient’s blood sugar levels, response to treatment, and tolerance.
Typical Dosing
FDA Approved Indications
- Type 2 diabetes mellitus to improve glycemic control in adults, especially in cases where single-agent therapy with pioglitazone or metformin alone has not been adequate.
Who Shouldn't Take Actoplus Met?
- Severe kidney disease or renal impairment.
- Metabolic acidosis, including diabetic ketoacidosis.
- A history of heart failure (especially when pioglitazone is contraindicated).
- Known hypersensitivity to pioglitazone, metformin, or any of the ingredients in the formulation.
Advice From The Pharmacist
- Take Actoplus Met with meals to reduce gastrointestinal side effects like nausea, vomiting, or diarrhea.
- Avoid excessive alcohol consumption, as it can increase the risk of lactic acidosis, a rare but serious side effect of metformin.
- Regularly monitor your blood sugar levels as directed by your healthcare provider.
- If you experience symptoms of fluid retention (such as swelling, rapid weight gain, or shortness of breath), contact your doctor immediately.
- Be aware of the signs of low blood sugar (hypoglycemia), such as dizziness, sweating, shakiness, or confusion, especially if taken with other diabetes medications.
Side Effects of Actoplus Met
Common Side Effects
- Nausea, vomiting, or diarrhea (often related to metformin)
- Headache
- Upper respiratory tract infections
- Weight gain (due to pioglitazone)
Uncommon/Severe Side Effects
- Lactic acidosis, a rare but serious condition associated with metformin use, which may present with muscle pain, weakness, trouble breathing, stomach pain, or unusual tiredness.
- Heart failure or worsening of heart failure symptoms (pioglitazone).
- Liver problems: Symptoms like dark urine, yellowing of the skin (jaundice), or severe stomach pain should be reported immediately.
Risks and Warnings of Actoplus Met
- Lactic acidosis: Metformin can cause a rare but life-threatening condition called lactic acidosis, especially in patients with kidney problems, those who consume alcohol excessively, or those with severe dehydration. Symptoms include difficulty breathing, stomach pain, and feeling very weak.
- Heart failure: Pioglitazone may cause or worsen heart failure. It should be used cautiously in patients with a history of heart failure or those at risk of developing it.
- Bone fractures: Pioglitazone has been associated with an increased risk of fractures, particularly in women.
- Bladder cancer: Some studies suggest that long-term use of pioglitazone may increase the risk of bladder cancer.
Interactions with Actoplus Met
Common Drug Interactions
- Diuretics: Taking diuretics with Actoplus Met may increase the risk of dehydration and kidney problems.
- Insulin: Combining Actoplus Met with insulin may increase the risk of low blood sugar (hypoglycemia).
- Carbonic anhydrase inhibitors (such as acetazolamide): These drugs may increase the risk of lactic acidosis when taken with metformin.
- Oral contraceptives: Some studies suggest that pioglitazone may reduce the effectiveness of hormonal contraceptives, requiring backup methods of contraception.
Alternatives to Actoplus Met
- Januvia (sitagliptin): A DPP-4 inhibitor used to manage blood sugar in type 2 diabetes.
- Byetta (exenatide): A GLP-1 receptor agonist used for type 2 diabetes management.
- Glucophage (metformin): Metformin alone is a common first-line treatment for type 2 diabetes.
- Farxiga (dapagliflozin): An SGLT2 inhibitor that works by increasing glucose excretion through the urine.
- Sulfonylureas: Such as glipizide, which increases insulin production from the pancreas.