METFORMIN; PIOGLITAZONE helps to treat type 2 diabetes. It helps to control blood sugar. Treatment is combined with diet and exercise.

They need to know if you have any of these conditions:

• become easily dehydrated
• diabetic ketoacidosis
• heart disease
• if you frequently drink alcohol containing drinks
• kidney disease
• liver disease
• polycystic ovary syndrome
• serious infection or injury
• swelling of the arms, legs, or feet
• undergoing surgery or certain x-ray procedures with injectable contrast agents
• vomiting
• an unusual or allergic reaction to metformin, pioglitazone, medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

Take this medicine by mouth with a glass of water. Take this medicine with food. Take your doses at regular intervals. Do not take your medicine more often than directed. Do not stop taking except on your doctor's advice.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

Do not take this medicine with any of the following medications:

• dofetilide
• gatifloxacin
• certain contrast medicines given before X-rays, CT scans, MRI, or other procedures

This medicine may also interact with the following medications:

• atorvastatin
• digoxin
• diuretics
• female hormones, like estrogens or progestins and birth control pills
• gemfibrozil
• insulin
• isoniazid
• ketoconazole
• medicines for blood pressure, heart disease, irregular heart beat
• midazolam
• morphine
• niacin
• phenothiazines like chlorpromazine, mesoridazine, prochlorperazine, thioridazine
• phenytoin
• procainamide
• quinidine
• quinine
• ranitidine
• rifampin
• steroid medicines like prednisone or cortisone
• thyroid hormones
• trimethoprim
• vancomycin

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

Visit your doctor or health care professional for regular checks on your progress. Learn how to check your blood sugar. Tell your doctor or health care professional if your blood sugar is high, you might need to change the dose of your medicine.

If you are sick or exercising more than usual, you might need to change the dose of your medicine. Do not skip meals. Ask your doctor or health care professional if you should avoid alcohol.

If you have symptoms of low blood sugar, eat or drink something containing sugar at once and contact your doctor or health care professional.

Make sure family members know that you can choke if you eat or drink when you develop serious symptoms of low blood sugar, like seizures or unconsciousness. They must get medical help at once.

Wear a medical identification bracelet or chain to say you have diabetes, and carry a card that lists all your medications.

Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
• breathing problems
• dark urine
• dizziness
• feeling faint or lightheaded, falls
• fever, chills, sore throat
• low blood sugar (ask your doctor or healthcare professional for a list of these symptoms)
• muscle aches, pains
• slow or irregular heartbeat
• stomach pain
• swelling of the hands, legs, or feet
• unusually weak or tired
• yellowing of the eyes or skin

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• diarrhea
• headache
• stomach gas, heartburn
• nausea
• problems with teeth

This list may not describe all possible side effects.

Keep out of the reach of children.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Protect from moisture and light. Throw away any unused medicine after the expiration date.