Actoplus Met XR

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Take metformin and pioglitazone with meals. Take the extended-release (XR) tablet once daily with your evening meal.

Do not crush, chew, or break an extended-release tablet. Swallow it whole.

Your blood sugar will need to be checked often, and you may need other blood tests at your doctor's office.

Low blood sugar (hypoglycemia) can happen to everyone who has diabetes. Symptoms include headache, hunger, sweating, pale skin, irritability, dizziness, feeling shaky, or trouble concentrating. Always keep a source of sugar with you in case you have low blood sugar. Sugar sources include fruit juice, hard candy, crackers, raisins, and non-diet soda. Be sure your family and close friends know how to help you in an emergency.

If you have severe hypoglycemia and cannot eat or drink, use a glucagon injection. Your doctor can prescribe a glucagon emergency injection kit and tell you how to use it.

Check your blood sugar carefully during times of stress, travel, illness, surgery or medical emergency, vigorous exercise, or if you drink alcohol or skip meals. These things can affect your glucose levels and your dose needs may also change. Do not change your medication dose or schedule without your doctor's advice.

Use metformin and pioglitazone regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

If you take extra vitamin B12 while you are taking metformin and pioglitazone, take only the amount of vitamin B12 that your doctor has prescribed.

Metformin and pioglitazone is only part of a treatment program that may also include diet, exercise, weight control, blood sugar testing, and special medical care. Follow your doctor's instructions very closely.

Store at room temperature away from moisture, heat, and light. Keep the bottle tightly closed when not in use.

Take the missed dose as soon as you remember (be sure to take the medicine with food). Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Pioglitazone and metformin combination is used with proper diet and exercise to treat high blood sugar levels caused by type 2 diabetes. Pioglitazone works by helping your body use insulin better. Metformin reduces the absorption of sugar from the stomach, reduces the release of stored sugar from the liver, and helps your body use sugar better. This medicine does not help patients who have insulin-dependent or type 1 diabetes.

This medicine is available only with your doctor's prescription.

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Upset stomach or throwing up.
• Loose stools (diarrhea).
• Gas.
• Headache.
• Signs of a common cold.
• Weight gain.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• acetazolamide (Diamox)
• amiloride (Midamor, in Moduretic)
• angiotensin-converting enzyme (ACE) inhibitors such as benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), and trandolapril (Mavik)
• atorvastatin (Lipitor)
• beta-blockers such as atenolol (Tenormin), labetalol (Normodyne), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), and propranolol (Inderal)
• calcium channel blockers such as amlodipine (Norvasc), diltiazem (Cardizem, Dilacor, Tiazac, others), felodipine (Plendil), isradipine (DynaCirc), nicardipine (Cardene), nifedipine (Adalat, Procardia), nimodipine (Nimotop), nisoldipine (Sular), and verapamil (Calan, Isoptin, Verelan)
• cimetidine (Tagamet)
• digoxin (Lanoxin)
• diuretics ('water pills')
• furosemide (Lasix)
• gemfibrozil (Lopid)
• hormonal contraceptives (birth control pills, patches, rings, implants, and injections) or hormone replacement therapy
• insulin or other medications to treat diabetes
• isoniazid
• ketoconazole (Nizoral)
• medications for asthma and colds
• medications for mental illness and nausea
• medications for thyroid disease
• midazolam (Versed)
• morphine (MS Contin, others)
• nifedipine (Procardia)
• oral steroids such as dexamethasone (Decadron, Dexone), methylprednisolone (Medrol), and prednisone (Deltasone)
• phenytoin (Dilantin, Phenytek)
• procainamide (Procanbid)
• quinidine
• quinine
• ranitidine (Zantac)
• rifampin (Rifadin, Rifater, in Rifamate)
• topiramate (Topamax)
• triamterene (Dyazide, Maxzide, others)
• trimethoprim (Primsol)
• vancomycin (Vancocin)
• zonisamide (Zonegran)

This is not a complete list of Actoplus Met XR drug interactions. Ask your doctor or pharmacist for more information.

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of Actoplus Met XR, there are no specific foods that you must exclude from your diet when receiving this medication.

Take Actoplus Met XR exactly as prescribed.

This medication comes in tablet form and is taken one or two times a day, with food.

If you miss a dose, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of Actoplus Met XR at the same time.

Do not chew, divide, or break Actoplus Met XR. Swallow Actoplus Met XR tablets whole.

If you take too much Actoplus Met XR, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

If Actoplus Met XR is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

• Store Actoplus Met XR at room temperature.
• Keep this and all medicines out of the reach of children.