If you have type 2 diabetes, your doctor may recommend Actos as a treatment for your condition. It’s a prescription drug used together with diet and exercise to help improve blood sugar levels in adults with type 2 diabetes.
Actos contains the active drug pioglitazone. (An active drug is the ingredient that makes a medication work.) Pioglitazone is also the name of the generic version of this drug.
Actos belongs to the drug classification thiazolidinedione. (Drugs in the same classification work in a similar way.) It comes as tablets that you swallow.
In this article, we describe the side effects of Actos, its dosage, and more.
Like most drugs, Actos may cause mild or serious side effects. The lists below describe some of the drug’s more common side effects. These lists don’t include all possible side effects.
Keep in mind that side effects of a drug can depend on:
- your age
- other health conditions you have
- other medications you take
To find out more about the potential side effects of Actos, see this article. Your doctor or pharmacist can also tell you more about the drug’s side effects. And they can suggest ways to help reduce these effects and their symptoms.
Mild side effects
Here’s a short list of some of the mild side effects that Actos can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read the prescribing information for Actos.
Mild side effects of Actos that have been reported include:
- flatulence (gas)
- muscle aches or pains
- sore throat
- upper respiratory tract infection, such as the common cold or a sinus infection
- weight gain†‡
* This side effect was only reported in people taking Actos together with insulin.
† For more information about this side effect, see the “Side effect focus” section below.
‡ Weight gain can also be a symptom of heart failure, a serious side effect Actos may cause. For more information, see the “Side effect focus” section below.
Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.
Serious side effects
Serious side effects from Actos can occur, but they aren’t common. If you have serious side effects from Actos, call your doctor right away. But if you think you’re having a medical emergency, you should call 911 or your local emergency number.
Serious side effects of Actos that have been reported include:
- bone fractures (broken bones)
- hypoglycemia (low blood sugar)
- liver failure
- edema (fluid buildup in your body)*
- macular edema (fluid buildup in part of your eye)
- boxed warning: new or worsening congestive heart failure†
- bladder cancer†
- allergic reaction†
* Edema can also be a symptom of heart failure, a serious side effect Actos may cause. For more information, see the “Side effect focus” section below.
† For more information about this side effect, see the “Side effect focus” section below.
Side effect focus
Learn more about some of the side effects Actos may cause.
Actos has a
New or worsening congestive heart failure. In rare cases, treatment with Actos can cause new or worsening congestive heart failure. This is a known side effect of thiazolidinedione drugs, including Actos. These drugs all carry a boxed warning for this side effect.
With heart failure, your heart doesn’t pump blood well enough. This means other organs in your body may not get enough blood to work properly.
Symptoms of heart failure can include:
- edema (fluid buildup), especially in your ankles or legs
- feeling unusually tired
- quick increase in weight (such as gaining 5 or more pounds over a few days)
- shortness of breath, especially when lying down
Due to this risk, doctors typically won’t prescribe Actos to anyone who already has severe heart failure.
What might help
Before you begin taking Actos, tell your doctor if you already have heart failure. Your doctor can determine whether Actos is safe to take based on how severe your heart failure is.
If you start taking Actos, your doctor will monitor you for symptoms of heart failure. But you should contact your doctor right away if you have symptoms of this condition. They’ll likely lower your Actos dose or have you stop taking the medication. They can also prescribe treatments for your symptoms.
Treatment with Actos may increase your risk of bladder cancer. Note that reported cases of bladder cancer in people taking Actos are rare. Studies haven’t found for sure that Actos causes bladder cancer.
Because Actos may increase the risk of bladder cancer, doctors typically won’t prescribe it to those who already have this condition. If you’ve had bladder cancer in the past, your doctor may suggest a different diabetes treatment for you.
Symptoms of bladder cancer can include:
What might help
If you currently have bladder cancer or had it in the past, talk with your doctor before taking Actos. They may monitor you more closely for symptoms of bladder cancer. Or they may recommend a different medication to treat your type 2 diabetes.
If you notice symptoms of bladder cancer while taking Actos, contact your doctor right away. They’ll likely want to evaluate your symptoms.
Treatment with Actos may cause weight gain.
Actos is often used together with other drugs to treat diabetes, some of which can increase your risk of weight gain.
Weight gain can be a symptom of more serious side effects Actos may cause, including heart failure. And other side effects of Actos can lead to weight gain, including edema.
Weight gain may also be caused by type 2 diabetes, the condition Actos is used to treat.
What might help
Actos works to lower blood sugar, which can make it easier to maintain a moderate weight. And your treatment plan should include a healthy diet and exercise. This can also help with weight gain.
Weight gain can be a symptom of more serious side effects caused by Actos. If you have a quick increase in weight while taking Actos, such as gaining 5 or more pounds in a few days, contact your doctor. This may be a symptom of edema, which can lead to heart failure.
If you’re concerned about your weight while taking Actos, talk with your doctor.
Some people may have an allergic reaction to Actos.
Symptoms of a mild allergic reaction can include:
A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, typically in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.
Call your doctor right away if you have an allergic reaction to Actos. But if you think you’re having a medical emergency, call 911 or your local emergency number.
Your doctor will recommend the dosage of Actos that’s right for you. Below are commonly used dosages, but always take the dosage your doctor prescribes.
Form and strengths
Actos comes as tablets that you swallow. The tablets are available in three strengths:
- 15 milligrams (mg)
- 30 mg
- 45 mg
You’ll take Actos once a day. You may take it with or without food.
Questions about the dosage for Actos
Following are answers to a few questions you might have about the dosage for Actos. For more information about the drug’s dosage, see this article.
- What if I miss a dose of Actos? If you miss your dose of Actos, take it as soon as you remember. But if it’s nearly time for your next dose, skip the missed dose. Take your next dose at the regularly scheduled time. Do not take more than one dose of Actos to make up for a missed dose.
- Will I need to use Actos long term? If you and your doctor agree that Actos is working well for you, you’ll likely use the drug long term.
- How long does Actos take to work? Actos begins working as soon as you take a dose. But it can take up to several weeks before you notice beneficial changes in your blood sugar level.
Find answers below to some commonly asked questions about Actos.
Can you suddenly stop taking Actos? Will stopping it cause withdrawal symptoms?
Stopping Actos treatment suddenly isn’t known to cause withdrawal symptoms. But doing so can cause your blood sugar to increase. This may result in your diabetes symptoms coming back or worsening.
Before you stop taking Actos, talk with your doctor. They can work with you to come up with the best treatment plan for your type 2 diabetes. This may include making changes to the medications you take.
How does Actos compare with alternatives such as Avandia, glipizide, Victoza, and Jardiance?
Like Actos (pioglitazone), Avandia (rosiglitazone), Jardiance (empagliflozin), Victoza (liraglutide), and Glucotrol (glipizide) are all prescribed to help lower blood sugar in adults with type 2 diabetes. To learn how these drugs are alike and different, talk with your doctor or pharmacist.
Is Actos safe to take?
In general, yes. Studies have found the drug to be safe and effective for helping lower blood sugar in adults with type 2 diabetes.
Like most drugs, Actos can cause mild side effects. It can also cause some rare but serious side effects. For more information, check out the “What are the side effects of Actos?” section above. You can also talk with your doctor or pharmacist to learn more.
Does Actos cause weight loss, diarrhea, hair loss, rhabdomyolysis, or macular edema?
Actos isn’t known to cause weight loss, hair loss, or rhabdomyolysis (a condition resulting from the breakdown of muscle). But certain other drugs prescribed to treat type 2 diabetes may cause these side effects.
For more information on how often these side effects happened in studies, check out the prescribing information for Actos. You can also talk with your doctor or pharmacist to learn more.
Can Actos cause problems with kidney function, heart attack, or pancreatic cancer?
Actos isn’t known to cause problems with kidney function (such as renal failure) or pancreatic cancer. Certain other drugs prescribed to treat type 2 diabetes may cause these side effects. But they haven’t been reported with Actos.
While heart attacks have occurred in people taking Actos, the drug doesn’t cause heart attacks or make them more likely. But type 2 diabetes and high blood sugar do increase the risk of heart disease. And heart disease increases the risk of having a heart attack.
For more information on the side effects Actos may cause, check out the medication’s prescribing information. You can also talk with your doctor or pharmacist to learn more.
Is Actos used for fatty liver or PCOS treatment?
Actos isn’t approved by the Food and Drug Administration (FDA) as a treatment for fatty liver or polycystic ovary syndrome (PCOS). But the drug may be used off-label to treat these conditions. With off-label use, a drug is prescribed to treat a condition other than what it’s approved to treat.
As for PCOS, studies have shown the drug to help ease symptoms of this syndrome. But data on whether the drug’s benefits outweigh potential risks, such as weight gain, is mixed.
If you have questions about these and any other off-label uses for Actos, talk with your doctor or pharmacist.
To learn how Actos and metformin compare, check out this article. Also, talk with your doctor about which medication is recommended for your condition.
Cells in your body use sugar to make energy. Your body makes insulin, which works to keep blood sugar at a healthy level. But with type 2 diabetes, cells don’t respond to insulin as they should. This affects how much sugar the cells take up from your blood. Over time, your body may make less of its own insulin or stop making it entirely.
Without treatment, type 2 diabetes can cause some serious problems, including:
- heart disease
- nerve damage
- poor blood circulation, particularly in your feet
- vision changes or vision loss
Actos works to lower blood sugar by making your body’s cells more sensitive to insulin. This helps them use sugar to make energy, which causes your blood sugar to decrease.
* Actos is sometimes used off-label. (With off-label use, a drug is prescribed to treat a condition other than what it’s approved to treat.) For more information, see “Is Actos used for fatty liver or PCOS treatment?” in the “What are some frequently asked questions about Actos?” section above.
Before taking Actos, talk with your doctor. There are important things to discuss with them when considering this drug as a treatment option. These include your overall health and any medical conditions you have.
You should also tell your doctor and pharmacist about any medications you take. They’ll want to see if any interact with Actos before prescribing the drug for your treatment.
Taking a medication with certain vaccines, foods, and other things can affect how the medication works. These effects are called interactions.
Before taking Actos, be sure to tell your doctor about all medications you take, including prescription and over-the-counter types. Also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Actos.
Interactions with drugs or supplements
Actos can interact with several types of drugs. These drugs include:
- drugs that can increase Actos levels in your body, such as the cholesterol drug gemfibrozil (Lopid)
- drugs that can decrease Actos levels in your body, such as the antibiotic rifampin (Rimactane, Rifadin)
- the antiepileptic drug topiramate (Topamax, Trokendi XR)
- other medications used for diabetes, including insulins, such as insulin glargine (Basaglar, Lantus) and sulfonylureas, such as glipizide (Glucotrol)
This list does not contain all types of drugs that may interact with Actos. Your doctor or pharmacist can tell you more about these interactions and any others that may occur with use of Actos.
Actos has a
New or worsening congestive heart failure. Actos can cause new or worsening congestive heart failure. Due to this risk, doctors typically will not prescribe Actos if you have severe congestive heart failure. (This is a contraindication to taking Actos. A contraindication is a factor or condition that could prevent your doctor from prescribing a drug due to risk of harm.)
For more information, see the “What are the side effects of Actos?” section above.
Actos may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take Actos. Factors to consider include those in the list below.
- Bladder cancer. Taking Actos may increase your risk of bladder cancer. Due to this risk, doctors typically will not prescribe Actos if you have or have had bladder cancer.
- Irregular periods. Taking Actos may increase your chances of becoming pregnant if you’re premenopausal and your periods are irregular. If you have irregular periods, your doctor can discuss effective birth control options with you before you start taking Actos.
- Liver problems. In rare cases, Actos can cause liver problems, including liver failure. Your risk may be higher if you already have liver problems. Talk with your doctor about whether Actos is safe for you to take.
- Macular edema. While rare, macular edema can be a serious side effect of Actos. If you already have this condition, taking Actos may worsen it. Talk with your doctor about whether Actos is safe for you.
- Osteoporosis. Taking Actos can increase your risk of bone fractures. If you already have osteoporosis, you may have a higher risk of bone fractures if you take Actos. Talk with your doctor about whether Actos is safe for you to take.
- Allergic reaction. If you’ve had an allergic reaction to Actos or any of its ingredients, your doctor will likely not prescribe Actos. Ask your doctor what other medications are better options for you.
Actos and alcohol
Alcohol can cause liver damage. In rare cases, Actos can also cause liver damage. As a result, drinking alcohol while taking Actos may increase the risk of liver damage. The risk may also be higher for someone who engages in binge drinking or heavy drinking.
Whether it’s safe for you to drink alcohol depends on different factors, including your blood sugar level. Your doctor can recommend how much alcohol, if any, is safe for you to drink while taking Actos.
Pregnancy and breastfeeding
It’s not known whether it’s safe to take Actos while pregnant. But high blood sugar can increase the risk of problems during pregnancy. To learn more about the risks and benefits of taking Actos during pregnancy, talk with your doctor.
It’s also not known whether it’s safe to breastfeed while taking Actos. Talk with your doctor about the risks and benefits of taking Actos and breastfeeding. They can also discuss other ways to feed your child during treatment.
Your doctor will explain how you should take Actos. They will also explain how much to take and how often. Be sure to follow your doctor’s instructions.
Actos comes as tablets that you swallow. You’ll take Actos once each day, but there’s no best time to take your dose. Take it whenever it’s easiest for you to do so. And try to take your dose at the same time each day.
Accessible medication containers and labels
If it’s hard for you to read the label on your prescription, tell your doctor or pharmacist. Certain pharmacies may provide medication labels that:
- have large print
- use braille
- contain a code you can scan with a smartphone to change the text into audio
Your doctor or pharmacist may be able to recommend a pharmacy that offers these options if your current pharmacy doesn’t.
Also, if you’re having trouble opening your medication bottles, let your pharmacist know. They may be able to put Actos in an easy-open container. Your pharmacist might also recommend tools to help make it simpler to open the drug’s container.
Taking Actos with other drugs
If you have questions about your diabetes treatment plan, including whether you’ll take Actos with other diabetes drugs, talk with your doctor or pharmacist.
Questions about taking Actos
Here are answers to a few questions you may have about taking Actos:
- Can Actos be chewed, crushed, or split? The manufacturer of Actos hasn’t stated whether the tablets may be chewed, crushed, or split. If you have trouble swallowing pills, including Actos tablets, talk with your doctor or pharmacist.
- Should I take Actos with food? You may take Actos with or without food.
Questions for your doctor
You may have questions about Actos and your treatment plan. It’s important to discuss all your concerns with your doctor.
Here are a few tips that might help guide your discussion:
- Before your appointment, write down questions such as:
- How will Actos affect my body, mood, or lifestyle?
- Bring someone with you to your appointment if doing so will help you feel more comfortable.
- If you don’t understand something related to your condition or treatment, ask your doctor to explain it to you.
Remember, your doctor and other healthcare professionals are available to help you. And they want you to get the best care possible. So don’t be afraid to ask questions or offer feedback on your treatment.
Costs of prescription drugs can vary depending on many factors. These include what your insurance plan covers and which pharmacy you use.
Actos is available as the generic drug pioglitazone. Generics usually cost less than brand-name drugs. Talk with your doctor if you’d like to know about taking generic pioglitazone.
If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. In addition, you can visit Medicine Assistance Tool’s website to see if it has support options.
You can also check out this article to learn more about saving money on prescriptions.
Do not take more Actos than your doctor prescribes. Using more than this can lead to serious side effects.
What to do in case you take too much Actos
Call your doctor if you think you’ve taken too much Actos. You can also call 800-222-1222 to reach the American Association of Poison Control Centers or use its online resource. However, if you have severe symptoms, immediately call 911 or your local emergency number. Or go to the nearest emergency room.
If you have type 2 diabetes, your doctor may recommend treatment with Actos. Before you begin taking Actos, talk with your doctor or pharmacist. Ask questions you have about the medication to help you and your doctor decide whether to add it to your treatment plan. Here are a few suggestions to help get you started:
- What actions should I take if I have low blood sugar during Actos treatment?
- What lab tests will I need to check if Actos is working for me?
- Are there steps I can take to lower my risk of side effects from taking Actos?
To learn more about other medications used for type 2 diabetes, check out this overview of diabetes medications.
You might also consider joining the Healthline T2D community. It’s a safe space to get advice and share tips on living well with type 2 diabetes.
And you can sign up for Healthline’s diabetes newsletter.
If I have side effects while taking Actos, is it safe for me to take a lower dosage? Or will I have to switch to another diabetes medication instead?Anonymous
This will likely depend on which side effect you’re experiencing. For example, after you start taking Actos, your doctor will monitor you for signs and symptoms of heart failure, such as edema and weight gain. If you’re experiencing certain side effects from Actos, they’ll likely lower your Actos dose or have you stop taking the medication.
Tell your doctor right away if you have any side effects with Actos, and always take the dosage your doctor prescribes. Before you make any changes to your dosage, talk with your doctor. They can work with you to decide on the best treatment plan for your type 2 diabetes. This may include taking a lower dosage of Actos or switching to another medication.Tanya Kertsman, PharmDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.