Clinical information
Common uses
- type 2 diabetes, alongside diet and exercise
Common side effects
- upper respiratory tract infection
- swelling (oedema)
- diarrhoea
- headache
- weight gain
Cautions
- boxed warning: can cause or worsen heart failure
- boxed warning: lactic acidosis, rare but can be fatal
- possible bladder cancer risk with pioglitazone
- not for type 1 diabetes or ketoacidosis
Interactions
- gemfibrozil — dose must be limited
- rifampin — lowers pioglitazone levels
- topiramate and carbonic anhydrase inhibitors — lactic acidosis risk
- cimetidine, ranolazine, dolutegravir — raise metformin levels
- alcohol — avoid excess
- insulin or sulfonylureas — low blood sugar risk
Pregnancy: limited data — no clear risk seen with metformin
Reference information, not medical advice — always follow your doctor or pharmacist. Source: DailyMed, dailymed.nlm.nih.gov, pioglitazone HCl and metformin HCl label, setid 237d8fa2-633c-4c29-84d3-f1b413610dc3 (accessed 2026-08-16)