Actazone Special Precautions

Bladder Cancer: Do not use Pioglitazone in patients with active bladder cancer.
Use Pioglitazone with caution in patients with a prior history of bladder cancer. The benefits of blood sugar control with Pioglitazone should be weighed against the unknown risks for cancer recurrence.
General: Pioglitazone exerts its antihyperglycemic effect only in the presence of insulin. Therefore, Pioglitazone should not be used in patients with type 1 diabetes or for the treatment of diabetic keto-acidosis.
Hyperglycemia: Patients receiving Pioglitazone in combination with insulin or oral hypoglycemic agents may be at risk for hypoglycemia, and a reduction in the dose or the concomitant agent may be necessary.
Ovulation: In pre-menopausal anovulatory patients with insulin resistance, treatment with thiazolidinediones, including Pioglitazone may result in resumption of ovulation. As a consequence of their improved insulin sensitivity, these patients may be at risk for pregnancy if adequate contraception is not used.
Hematological: Pioglitazone may cause decreases in hemoglobin and hematocrit. Across all clinical studies, mean hemoglobin values declined by 2% to 4% in Pioglitazone treated patients. These changes primarily occurred within the first 4 to 12 weeks of therapy and remained relatively constant thereafter.
These changes may be related to increased plasma volume and have not been associated with any significant haematologic clinical effects.