ActoPlus Met

Before taking this medicine

Do not take ActoPlus Met if you have severe kidney impairment (eGFR below 30 mL/min), acute or chronic metabolic acidosis (including diabetic ketoacidosis), or a history of a serious allergic reaction to pioglitazone, metformin or any other ingredient. Do not start treatment if you have established NYHA Class III or IV heart failure. Do not use it if you have active bladder cancer, and avoid use if you have liver impairment. ActoPlus Met can cause fluid retention and swelling, which may cause or worsen heart failure. Extra caution and monitoring are needed in people with NYHA Class I or II heart failure and those using insulin. Using it with insulin or medicines that stimulate insulin release can also increase the risk of low blood sugar. Tell your prescriber if you have a history of bladder cancer. Liver failure, sometimes fatal, has been reported; treatment should be interrupted if liver injury is detected. It should not be restarted if liver injury is confirmed and no other cause is found. Other precautions include an increased risk of fractures in women, reports of swelling at the back of the eye (macular edema), and reduced vitamin B12 levels. Regular eye examinations are recommended, and sudden vision changes need prompt assessment. Blood counts should be checked annually and vitamin B12 levels every two to three years. Kidney function should be assessed more often in older adults. Premenopausal women should be aware of the possibility of unintended pregnancy. Safety and effectiveness in children have not been established.