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Actos (Pioglitazone)

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Actos lowers blood sugar by increasing the body’s sensitivity to insulin and reducing the amount of glucose the liver releases. This allows the body to better remove excess blood sugar. The Food and Drug Administration (FDA) approved Actos in 1999.

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Also known as: Pioglitazone


Actos is an effective drug of the class thiazolidinedione (TZD) with hypoglycemic (antihyperglycemic, antidiabetic) action to treat diabetes mellitus type 2. Actos contains the active ingredient Pioglitazone Hydrochloride. Pioglitazone helps to lower blood glucose levels by increasing the sensitivity of liver, fat, and muscle cells to insulin; enables cells to remove glucose from the blood more effectively, reduces the amount of glucose produced by the liver, and preserves the functioning of the cells in the pancreas that produce insulin. Actos does not cause the body to make more insulin. Therefore, when used alone, it does not cause low blood glucose (hypoglycemia). Actos is used either alone or in combination with other anti-diabetic medications (such as insulin, metformin, or a sulfonylurea such as glyburide). Actos is not taken to treat type 1 diabetes.


The Actos dosage your doctor prescribes will depend on several factors. These include:

  • the type and severity of the condition you’re using Actos to treat
  • other medical conditions you may have, such as congestive heart failure (CHF)*
  • other medications that you’re taking to treat your type 2 diabetes
Typically, your doctor will start you on a low dosage. Then they’ll adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

* <em>Actos</em> has a<em> boxed warning</em> for CHF. This is the most serious warning from the FDA. For more information, see “FDA warning: Congestive heart failure” at the beginning of this article.

Drug forms and strengths

Actos comes as a tablet that you swallow, and you’ll usually take it once a day. Actos is available in three strengths: 15 mg, 30 mg, and 45 mg.

Dosage for type 2 diabetes

Your doctor will likely have you start taking either a 15-mg or 30-mg dose of Actos once a day. If needed, they may increase the dose by 15 mg for extra control of your blood sugar. The maximum dose of Actos is 45 mg a day.

Your starting dose will depend on if you have other health conditions, such as CHF.* And the dose will be increased over time based on how your body responds.

And in some situations where your body may be very stressed, your doctor may need to change your dose or have you stop taking Actos. So tell your doctor right away if you:

  • have a fever
  • have an infection
  • have had an accident
  • have just had or will have surgery
Never change your dosage of Actos without first talking with your doctor. And before you start taking Actos, be sure to tell them about any medical conditions you have or any other medications that you take. Your doctor will determine what the best dosage is for you.

* Actos has a boxed warning for CHF. This is the most serious warning from the Food and Drug Administration (FDA). For more information, see “FDA warning: Congestive heart failure” at the beginning of this article.

What if I miss a dose?

If you miss your dose, wait and take Actos when your next dose is due. Never take two doses in 1 day. If you have questions on when to take your next dose of Actos after you’ve missed a dose, talk with your doctor or pharmacist.

To help make sure that you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Will I need to use this drug long term?

Actos is meant to be used as a long-term treatment. If you and your doctor determine that Actos is safe and effective for you, you’ll likely take it long term.


If an overdose occurs and you are not feeling well, you should seek emergency medical attention or contact your health care provider immediately. You can experience the following symptoms of Actos overdose: signs of low blood sugar, such as extreme weakness, blurred vision, sweating, trouble speaking, tremors, stomach pain, confusion, and seizure (convulsions).


Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F) and away from excess moisture and heat. Throw away any unused medicine after the expiration date. Keep out of the reach of children.

Side effects

The most common side effects associated with Actos are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.


You should not use Actos if you are allergic to pioglitazone, or if you have:

severe or uncontrolled heart failure; or diabetic ketoacidosis (call your doctor for treatment).

This medication may increase your risk of developing bladder cancer. Talk with your doctor about your specific risk.

To make sure Actos is safe for you, tell your doctor if you have ever had:

congestive heart failure or heart disease; a heart attack or stroke; eye problems caused by diabetes; bladder cancer; or liver disease.

Actos may increase your risk of serious heart problems, but not treating your diabetes can also damage your heart and other organs. Talk to your doctor about the risks and benefits of this medicine.

Follow your doctor's instructions about using Actos if you are pregnant or you become pregnant. Controlling diabetes is very important during pregnancy, and having high blood sugar may cause complications in both the mother and the baby.

Pioglitazone may stimulate ovulation in a premenopausal woman and may increase the risk of unintended pregnancy. Talk to your doctor about your risk.

Women may be more likely to have a broken bone while using Actos. Talk with your doctor about ways to keep your bones healthy.

It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk.

Actos is not approved for use by anyone younger than 18 years old.

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