What should I discuss with my healthcare provider before taking metformin and pioglitazone?
Some people have developed a life-threatening condition called lactic acidosis while taking metformin and pioglitazone. Get emergency medical help if you have any of these symptoms of lactic acidosis: weakness, increasing sleepiness, slow heart rate, cold feeling, muscle pain, shortness of breath, stomach pain, feeling light-headed, and fainting. You may be more likely to develop lactic acidosis if you have congestive heart failure. Do not use metformin and pioglitazone if you have kidney disease, or if you are in a state of diabetic ketoacidosis (call your doctor for treatment with insulin). If you have certain conditions, you may need a dose adjustment or special tests to safely take this medication. Before taking metformin and pioglitazone, tell your doctor if you have: • congestive heart failure or heart disease; • a history of heart attack or stroke; • liver disease; or • eye problems caused by diabetes. If you need to have any type of x-ray or CT scan using a dye that is injected
