Updated 11 February 2013


Pioglitazone is an oral blood-glucose-lowering drug.


Pioglitazone is the active ingredient of Actos.

General information

Pioglitazone is an oral blood-glucose-lowering drug. It is prescribed in the treatment and management of type-2 diabetes - a disease caused by a problem in the way the body makes or uses insulin which is necessary for glucose to move from the blood to the inside of the cells - that is not adequately controlled by diet and exercise alone.

Type-2 diabetes makes up 90 per cent or more of all cases of diabetes.

Treatment with oral anti-diabetic drugs should only be started once all lifestyle and dietary measures have been tried for at least three months and have not controlled blood-glucose adequately. Once treatment with this medication is started, diet and exercise should however not be stopped.

Pioglitazone can be used on its own - and treatment is often started with one drug only - or in combination with other oral blood glucose lowering drugs.

This drug is faster-acting than most other oral antidiabetic drugs, but may take between 1 and 2 weeks to reach its full effect.

For pioglitazone to remain effective it needs to be taken regularly. This medication is best given 30 minutes before a meal to allow the insulin that is released as a result of taking this drug to cope with food. If a meal is likely to be missed the medication should not be taken.

Low blood sugar levels is a potential risk when being treated with this medication and other similar drugs - the dosage should titrated under supervision of your doctor until the right dose has been found. It is therefore recommended to start treatment with low doses.

Pioglitazone tends to encourage weight gain and weight control is of great importance.

This medication is used in general when the body is still making some insulin.

How does pioglitazone work?

Pioglitazone acts by stimulating the release of insulin from the pancreas, thereby promoting sugar uptake in the body. This ultimately lowers the level of sugar in the blood.

Fast facts

Drug schedule: schedule 3

Available as: pioglitazone is available as tablets

What does it do? pioglitazone lowers blood sugar

Overdose risk: high

Dependence risk : low

Is pioglitazone available as a generic? no

Is pioglitazone available on prescription only? yes

User information

Onset of effect: within 60 minutes

Duration of action: up to 24 hours

Dietary advice: take this medication 30 minutes before a meal

Stopping this medicine: consult your doctor before stopping this medication. Diabetes may worsen with premature discontinuation

Prolonged use: prolonged use increases the risk for adverse effects. Regular liver function tests are advised.

Special precautions

Consult your doctor before using this drug if:

  • you have liver or kidney disease
  • if you are anaemic
  • you have congestive heart failure
  • you are taking other medication

Pregnancy: avoid. It is unknown how this medication may affect your baby. Consult your doctor before using this drug, or if you are planning to fall pregnant.

Breastfeeding: avoid. It is unknown how this medication may affect your baby. Consult your doctor before use.

Porphyria: avoid. This medication may cause serious adverse effects. Consult your doctor before use.

Infants and children: this medication is not intended for use in children.

The elderly: caution is advised in the elderly as side effects may be more common.

Driving and hazardous work: caution is advised as use of this medication may lead to dizziness or light-headedness. Avoid such activities until you know how this medication affects you.

Alcohol: no special precautions need to be taken.

Possible side effects

Side effect


Consult your doctor



Only if severe

In all cases




weight gain






sore throat









tooth disorder






swelling of ankles










Drug interactions


risk of pioglitazone toxicity


reduced effect of pioglitazone

Disease interactions

Consult your doctor before using this drug if you have liver or kidney disease or congestive heart failure.

Overdose action

An overdose of this medication can be serious. Seek immediate emergency medical attention.

Recommended dosage

Adults: 15-30mg once a day with a maximum dose of 45mg/day

This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.


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