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What Are the Most Common Pioglitazone Side Effects?

By C. K. Lanz
Updated: May 17, 2024

The most common pioglitazone side effects include cold-like symptoms, muscle pain, and sinus infection. Sore throat and headaches have also been experienced by patients taking this medication. Liver problems, increased broken bones in women, and hypoglycemia may also occur in those taking this medication. Macular edema, heart failure, and a slight increase in bladder cancer risk are also associated with pioglitazone. Additionally, premenopausal women who are not ovulating may experience an increased risk of pregnancy while taking this drug.

Pioglitazone is a thiazolidinedione marketed in the United States under the brand name Actos® that is used to treat type 2 diabetes. It increases the body’s sensitivity to insulin and thus helps control the amount of sugar in a patient’s blood. It is a tablet typically taken once a day with or without food. This medication is not an effective treatment for type 1 diabetes or for diabetic ketoacidosis.

Most patients who take pioglitazone begin with a small dose that is gradually increased until the most effective and tolerable amount for the individual is determined. The most common pioglitazone side effects include cold-like symptoms, sinus infection, and muscle pain. Many patients also experience sore throat and headaches. These side effects often fade as the body adjusts to the medication, but patients may consult their doctors if symptoms persist and are uncomfortable.

There are a series of serious pioglitazone side effects. Female patients may experience an increase in broken bones and fractures, typically in the feet, hands, and upper arms. This medication can also cause premenopausal women who are not ovulating to ovulate, thus increasing their risk of pregnancy. Such patients often consider birth control options while taking pioglitazone.

All patients taking pioglitazone are at an increased risk of developing low blood sugar, or hypoglycemia. This risk increases if the patient skips meals or is taking an additional medication that lowers blood sugar. Hypoglycemia can cause people to feel dizzy, shake, or feel hungry. In most cases, these symptoms stop when the patient eats something that contains sugar, like candy or juice.

Hyperglycemia, or high blood sugar, is another possible side effect of pioglitazone. Symptoms include blurred vision, weakness, and extreme hunger or thirst. If hypoglycemia and hyperglycemia are left untreated, symptoms can worsen, resulting in unconsciousness.

Those who have experienced a cardiac event like heart failure may find that pioglitazone causes or worsens their problem. Patients experiencing quick weight gain, shortness of breath, and swelling should consult their doctors immediately. Liver problems are also associated with this drug and can cause dark urine, jaundice, and nausea. In some patients, pioglitazone caused or worsened their macular edema, an eye disease characterized by swelling at the back of the eye.

The United States Food and Drug Administration has linked pioglitazone with an increased risk in developing bladder cancer, and France and Germany have suspended its sale. This applies to patients taking high doses of this medication or being treated for more than a year. Individuals with active bladder cancer or a prior history of the disease should avoid pioglitazone, but patients should not stop taking their medications without consulting their doctors.

Like any medication, the risks of pioglitazone side effects should be balanced against the benefits of the drug. Patients should be forthcoming with their doctors about any drug allergies or prescription medications or vitamins they are taking in addition to pioglitazone. Previous or current medical conditions, including heart failure, should also be discussed when considering possible pioglitazone side effects.

WiseGeek is dedicated to providing accurate and trustworthy information. We carefully select reputable sources and employ a rigorous fact-checking process to maintain the highest standards. To learn more about our commitment to accuracy, read our editorial process.
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