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Precautions

Do NOT use Actoplus Met if:

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• you possess a severe infection, low blood oxygen levels, kidney or liver problems, or high blood ketone or acid levels (eg, diabetic ketoacidosis), otherwise you are severely dehydrated
• you have experienced a stroke or even a recent cardiac event, or you have been in shock

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• you happen to be four decades old or even more and have not had a kidney function test

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• you will be having surgical procedures or certain lab procedures
• you have a reputation liver problems, including jaundice (yellowing of the skin or eyes), during therapy with a similar medicine called troglitazone.

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Some medical ailments may talk with Actoplus Met. Tell your doctor or pharmacist when you have any health concerns, particularly when any from the following sign up for you:

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• in case you possess a reputation heart disease (eg, heart failure), abnormal liver function tests, lung or breathing problems, thyrois issues, stomach or bowel obstruction (eg, paralysis, blockage), adrenal or pituitary problems, eye or vision problems (eg, macular degeneration), bladder cancer, or lactic acidosis

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• if you have fluid retention or swelling problems, vomiting, diarrhea, bad health or nutrition, low blood calcium or vitamin B₁₂ levels, or anemia, or if you're dehydrated
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Some medicines may talk with Actoplus Met. Tell your doctor if you might be taking some other medicines, especially any from the following:

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• Calcium channel blockers (eg, nifedipine), corticosteroids (eg, prednisone), diuretics (eg, furosemide, hydrochlorothiazide), estrogen, hormonal contraceptives (eg, contraception pills), insulin, isoniazid, nicotinic acid, oral antidiabetics (eg, glipizide), phenothiazines (eg, chlorpromazine), phenytoin, sympathomimetics (eg, albuterol, pseudoephedrine), or thyroid hormones (eg, levothyroxine) since the likelihood of high or low blood glucose levels could be increased

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• Amiloride, cimetidine, digoxin, gemfibrozil, morphine, procainamide, quinidine, quinine, ranitidine, triamterene, trimethoprim, or vancomycin because they may increase the probability of Actoplus Met's negative effects

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• Rifampin given it may decrease Actoplus Met's effectiveness, producing high blood glucose
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This may not be an entire list of all interactions that may occur. Ask your health care provider if Actoplus Met may interact to medicines which you take. Check with your doctor before you begin, stop, or change the dose of any medicine.

Important safety information:

• Actoplus Met could potentially cause dizziness. This effect might be worse if you get it with alcohol or certain medicines. Use Actoplus Met with caution. Do not drive or perform other possibly unsafe tasks unless you understand how you answer it.
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• Actoplus Met won't usually cause low blood glucose. Low blood sugar levels may be more likely to occur should you skip lunch, exercise heavily, or are drinking alcoholic beverages. It may also be a little more likely if you take Actoplus Met together with certain other medicines for diabetes (eg, sulfonylureas, insulin). It is really a good plan to transport a reliable supply of glucose (eg, tablets or gel) to take care of low blood sugar levels. If this is not available, you should eat or drink a simple way to obtain sugar like white sugar, honey, candy, orange juice, or non-diet soda. This will raise the blood glucose level quickly. Tell your physician right away should this happen. To prevent low blood glucose, eat meals as well daily , nor skip meals.
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• Actoplus Met may commonly cause stomach upset, indigestion, nausea, or diarrhea at the start of treatment. If you develop unusual or unexpected stomach problems, or if you develop stomach problems later during treatment, contact your doctor immediately. This could possibly be a sign of lactic acidosis.

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• Lab tests, including kidney and liver function, fasting blood glucose, hemoglobin A_1c, blood counts, and eye examinations, could possibly be performed when you use Actoplus Met. These tests could be used to monitor your trouble or look for negative effects. Be sure to keep all doctor and lab appointments.

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