Source: OpenFDA label data · Not medical advice · For personal tracking only
Important warning themes extracted from the FDA label. Review the full label warnings below for source wording.
WARNING: CONGESTIVE HEART FAILURE and LACTIC ACIDOSIS See full prescribing information for complete boxed warning.
Congestive Heart Failure Thiazolidinediones, including pioglitazone, which is a component of pioglitazone and metformin hydrochloride tablets, cause or exacerbate congestive heart failure in some patients.
(5.1) After initiation of pioglitazone and metformin hydrochloride tablets, and after dose increases, monitor patients carefully for signs and symptoms of heart failure (e.g., excessive, rapid weight gain, dyspnea, and/or edema) If congestive heart failure develops while taking pioglitazone and metformin hydrochloride tablets, consider discontinuation of pioglitazone and metformin hydrochloride tablets or dosage reduction of pioglitazone in pioglitazone and metformin hydrochloride tablets (5.1) Pioglitazone and metformin hydrochloride tablets are not recommended in patients with symptomatic heart failure.
These may signal more serious reactions and may require prompt medical attention.
Frequently reflected in adverse reaction or label text.
Pain, cramping, or aching in the stomach or belly area.
Show full FDA warning text
Source label wording. This may be long, technical, or formatted for the original package label.
WARNING: CONGESTIVE HEART FAILURE and LACTIC ACIDOSIS See full prescribing information for complete boxed warning. Congestive Heart Failure
Thiazolidinediones, including pioglitazone, which is a component of pioglitazone and metformin hydrochloride tablets, cause or exacerbate congestive heart failure in some patients. (5.1)
After initiation of pioglitazone and metformin hydrochloride tablets, and after dose increases, monitor patients carefully for signs and symptoms of heart failure (e.g., excessive, rapid weight gain, dyspnea, and/or edema)
If congestive heart failure develops while taking pioglitazone and metformin hydrochloride tablets, consider discontinuation of pioglitazone and metformin hydrochloride tablets or dosage reduction of pioglitazone in pioglitazone and metformin hydrochloride tablets
Show FDA label use text
Technical label wording. It may be incomplete, repetitive, or written for clinicians.
Show FDA label dosage text
Not dosing guidance. Follow your clinician, pharmacist, or product label.
(5.1)
Pioglitazone and metformin hydrochloride tablets are not recommended in patients with symptomatic heart failure. (5.1)
Initiation of pioglitazone and metformin hydrochloride tablets in patients with established New York Heart Association (NYHA) Class III or IV heart failure is contraindicated. (4, 5.1) Lactic Acidosis
Postmarketing cases of metformin-associated lactic acidosis have resulted in death, hypothermia, hypotension, and resistant bradyarrhythmias
Symptoms included malaise, myalgias, respiratory distress, somnolence, and abdominal pain
Laboratory abnormalities included elevated blood lactate levels, anion gap acidosis, increased lactate:pyruvate ratio
and metformin plasma levels generally greater than 5 mcg/mL. (5.2)
Risk factors include renal impairment, concomitant use of certain drugs, age ≥65 years old, radiological studies with contrast, surgery and other procedures, hypoxic states, excessive alcohol intake, and hepatic impairment
Steps to reduce the risk of and manage metformin-associated lactic acidosis in these high-risk groups are provided in the Full Prescribing Information
(5.2)
If lactic acidosis is suspected, discontinue pioglitazone and metformin hydrochloride tablets and institute general supportive measures in a hospital setting
Prompt hemodialysis is recommended
(5.2) WARNING: CONGESTIVE HEART FAILURE AND LACTIC ACIDOSIS Congestive Heart Failure
Thiazolidinediones, including pioglitazone, which is a component of pioglitazone and metformin hydrochloride tablets, cause or exacerbate congestive heart failure in some patients [see Warnings and Precautions (5.1)]
If congestive heart failure develops while taking pioglitazone and metformin hydrochloride tablets, consider discontinuation of pioglitazone and metformin hydrochloride tablets or dosage reduction of pioglitazone in pioglitazone and metformin hydrochloride tablets [see Warnings and Precautions (5.1)]
Pioglitazone and metformin hydrochloride tablets are not recommended in patients with symptomatic heart failure [see Warnings and Precautions (5.1)]