Actos : Uses, Side effects, and interactions

Overview

What is Actos?

Actos (Pioglitazone) is an antidiabetic drug prescribed with exercise and diet to control blood sugar in type 2 diabetes patients. Insulin is a hormone (chemical messenger) that helps the body convert sugar to energy. Insufficient insulin usage results in type 2 diabetes. The body’s blood sugar levels rise as a result.

Facts of Actos

• Actos is the brand or trade name for the generic drug pioglitazone Generic drugs contain similar active ingredients as trade-name drugs.
• In 1999, the FDA (Food and Drug Administration) approved the Actos drug
• In 2007, Actos ranked as the world’s best-selling antidiabetic drug
• In 2011, the health regulators in France and Germany ordered Takeda (manufacturer) to stop the drug manufacturing due to its increased risk for bladder cancer and heart diseases ¹Overview| Researched based study from Sciencedirect.com

Category of Drug

• Actos contain pioglitazone as its active ingredient.
• It belongs to the drug class called thiazolidinedione

Mode of Action

Mode of action of Actos

• Type 2 diabetes causes the cells to be insulin resistant. When the body resists the effects of insulin and is unable to absorb blood glucose, this condition is known as insulin resistance.

• Actos lowers insulin resistance and makes the cells respond to insulin. It makes the cells efficiently convert sugar into energy and thus helps in reducing the body’s blood sugar ²Mode of Action| Researched based study from Nlm.nih.gov

Dosage

Dosage of Actos

A doctor best decides for the Actos dosage considering certain factors such as

• Patient’s medical condition
• Other medications that are already in use to control blood sugar.
• A doctor initially prescribes the lower dose, i.e., 15mg once daily with or without food.
• Gradually he will adjust the dose based on the person’s need.
• However, taking the exact dose as the physician prescribes is best ³Dosage| Researched based study from Nlm.nih.gov

Uses

Uses of Actos

Fasting blood glucose

• Actos decreases the fasting blood sugar in diabetic patients
• Fasting blood sugar is the blood sample taken in the early morning without food to measure the blood sugar. In normal individuals, the fasting blood sugar must be below 100mg/dL, while in diabetic patients, the level might be much higher ⁴Uses| Researched based study from Nlm.nih.gov

Hemoglobin A1c

• Actos decreases the Hemoglobin A1c levels in type 2 diabetes patients
• An assessment of the average blood glucose over the previous three months is made by a blood test called hemoglobin A1c. ⁵Uses| Researched based study from Sciencedirect.com

Effects of Actos, when used with other medication

Actos and insulin

• Actos and insulin, when taken together, decrease the fasting blood sugar in type 2 diabetes patients.
• It also decreased the HbA1c levels ⁶Uses| Researched based study from Nlm.nih.gov

Actos and metformin

• When taken together, Actos and metformin decrease the HbA1c levels and fasting blood sugar in type 2 diabetes patients ⁷Uses| Researched based study from Nlm.nih.gov

Actos and sulfonylureas

• When taken together, Actos and sulfonylureas decrease the fasting blood sugar and HbA1c in type 2 diabetes patients ⁸Uses| Researched based study from Nlm.nih.gov

Actos uses for the non-approved condition

Non-alcoholic fatty liver disease

• Non-alcoholic fatty liver disease is a disease of excess fat builds up in the liver that can lead to liver damage.
• Additionally, it may result in insulin resistance and a subsequent rise in blood sugar.
• Actos, along with metformin, decreases the liver scarring
• It reduces insulin resistance in the body ⁹Uses| Researched based study from clinicaltrials.gov

Side effects

Side effects of Actos

Mild side effects

• Headache
• Stomach gas (flatulence)
• Sore throat
• Muscle pain
• Diarrhea
• Weight gain
• Common cold

Serious side effects

Low blood sugar-Symptoms are

• Headache
• Sweating
• Lightheadedness
• Faint
• Liver failure

Liver failure

Symptoms are :

• Nausea and vomiting
• Belly pain
• Yellowing of the skin

Bone Fracture

Symptoms are :

• Bone swelling
• Bone pain

Severe allergic reactions

Symptoms are as follow:

• Swelling in the mouth, tongue, and throat
• Difficult breathing
• Swelling of the eyelids, lips, hands, feet

Fluid buildup in part of the eye (macular edema)

Symptoms of fluid buildup in part of the eye are:

• Blurry vision

Fluid buildup in the body(edema)

Symptoms include:

• Headache
• Weight gain
• Swelling of feet and ankles

Congestive heart failure (CHF)

It is a disease in which the heart is unable to pump blood to other body parts. Symptoms of CHF include:

• Swelling of the legs and feet
• Breathing problem
• Extreme tiredness
• Weight gain

Bladder cancer( bladder tumor)

Symptoms of bladder cancer are:

• Painful urination
• Abdominal pain
• Blood in urine ¹⁰Side effects| Researched based study from Sciencedirect.com

Formulations

Formulation Types of Actos

Tablet

• Actos is available in tablet forms which come in three powers (strength) viz; 15 mg (milligrams), 30, and 45 mg.

Risk

Who should not take Actos?

Diabetic patients with the following conditions should refrain from consuming Actos

• People with Heart problems like new or worsening congestive heart failure
• People with Liver problems
• People with galactose intolerance (a condition in which the body is unable to break the milk sugar)
• People with a history of bladder cancer
• People prone to bone fractures
• Women with polycystic ovary syndrome
• Pregnant woman
• Diabetic ketoacidosis (a condition of acid buildup in the blood)
• The medicine is not for treating Type 1 diabetes.
• Nursing mothers
• Aged people (above 65 years)
• Individuals below 18 years of age ¹¹Risk| Researched based study from Sciencedirect.com

Precautions

Precautions of Actos

• Avoiding sharing the medication
• Avoiding medications that the doctor does not prescribe
• Checking blood sugar regularly and sharing the results with the doctor
• Doing blood and urine test at regular intervals
• Making an appointment with an ophthalmologist for a routine eye check-up
• Learning the symptoms of low blood sugar and high blood sugar and also learning ways to manage them
• Consulting with the doctor if the drug consumption has crossed one year ¹²Precautions| Researched based study from Nlm.nih.gov

Interactions

Interactions of Actos

Actos and rifampin

• Rifampin Is an antibiotic to kill or prevents the growth of bacteria.
• Actos and rifampin, when taken together, reduce the body’s actos level and decreases the drug’s efficiency.

Actos and topiramate

• Topiramate is a medicine to prevent and control seizures(body shaking)
• Taking Actos and topiramate together might decrease the body levels of actos
• It reduces the effect of the drug.

Actos and gemfibrozil

• Gemfibrozil is a drug to reduce the cholesterol in the body
• Actos and gemfibrozil, when taken together, increase the actos level in the body
• It also increases the time of actos retention in the body and can lead to an excessive blood sugar decrease causing lightheadedness and fainting.¹³Interactions| Researched based study from Nlm.nih.gov

Actos and diabetic medication

• Taking Actos and other diabetic medicines together might lead to an excess dip in blood sugar level, causing sweating, dizziness, and fainting.

Other medicines that may interact with Actos are as follows

• Midazolam
• Birth control pills
• Atorvastatin
• Ketoconazole
• Itraconazole
• Nifedipine
• Bosentan

Storage

Storage of Actos

• One should keep the drug in inaccessible places of reach for children and young kids.
• One should store it at temperatures between 15 to 30 degrees centigrade
• Keep it away from direct sun exposure
• Always keep it in air-tight containers .

Takeaways

Key Takeaways

• Actos must only be used for the indication prescribed by the doctor
• One must always share the medical conditions with the doctor if Actos is prescribed
• One must always ensure the dose of Actos with the doctor to prevent side effects and untoward consequences