Special information on Actos

The effects of Actos during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, tell your doctor immediately. He may switch you to insulin during your pregnancy, since normal blood sugar levels are very important for the developing baby.

It is not known whether Actos appears in breast milk. For safety s sake, do not use Actos doses while breastfeeding.

In very rare cases, a drug similar to Actos has proven toxic to the liver. The manufacturer therefore recommends that your doctor check your liver function before you begin Actos, then every 2 months for the first year of therapy and periodically thereafter. If you experience symptoms of liver problems such as jaundice (yellowing of the skin and eyes), nausea, vomiting, abdominal pain, fatigue, loss of appetite, or dark urine, report them to your doctor immediately. You will probably have to stop using Actos. Because Actos works by improving the body s response to its own supply of insulin, it is not for type 1 diabetics, who are unable to produce any insulin at all.

For the same reason, Actos can t be used to treat the condition known as diabetic ketoacidosis (excessively high sugar levels due to the lack of insulin).
In rare instances, Actos causes swelling and fluid retention that can lead to congestive heart failure. If you already have this problem, you should avoid Actos. If you develop symptoms that signal the problem--such as shortness of breath, fatigue, or weight gain--you should check with your doctor immediately; the drug will probably have to be discontinued. The problem is more likely when Actos is taken in combination with insulin.

Actos, by itself, will not cause excessively low blood sugar (hypoglycemia). However, when you combine Actos with insulin injections or Actos with oral diabetes drugs, the chance of hypoglycemia increases. If you begin to feel symptoms of hypoglycemia--shaking, sweating, agitation, clammy skin, or blurred vision--take some fast-acting sugar, such as 4 to 6 ounces of fruit juice. Let your doctor know about the incident; you may need a lower dose of insulin or oral medication. To make sure that your blood sugar levels stay within the normal range, get regular tests of your blood sugar and glycosylated hemoglobin (a long-term measurement of blood sugar).

Contact your doctor during periods of stress due to fever, infection, injury, surgery, and the like.Your dosage of diabetes medicines may need to be changed.