Actoplus MET, Actoplus MET XR (Pioglitazone Hcl and Metformin Hcl) Drug Information: Overdosage and Contraindications

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May 22, 2012

Actoplus MET

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Diabetes is a chronic condition associated with abnormally high levels of sugar (glucose) in the blood.
Insulin produced by the pancreas lowers blood glucose.
Absence or insufficient production of insulin causes diabetes.
The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent).
Symptoms of diabetes include increased urine output, thirst and hunger as well as fatigue.
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OVERDOSE

Pioglitazone hydrochloride

During controlled clinical trials, one case of overdose with pioglitazone was reported. A male patient took 120 mg per day for four days, then 180 mg per day for seven days. The patient denied any clinical symptoms during this period.

In the event of overdosage, appropriate supportive treatment should be initiated according to patient's clinical signs and symptoms.

Metformin hydrochloride

Overdose of metformin hydrochloride has occurred, including ingestion of amounts greater than 50 grams. Hypoglycemia was reported in approximately 10% of cases, but no causal association with metformin hydrochloride has been established. Lactic acidosis has been reported in approximately 32% of metformin overdose cases (see WARNINGS, Metformin hydrochloride). Metformin is dialyzable with a clearance of up to 170 mL/min under good hemodynamic conditions. Therefore, hemodialysis may be useful for removal of accumulated metformin from patients in whom metformin overdosage is suspected.

CONTRAINDICATIONS

Initiation of ACTOPLUS MET in patients with established New York Heart Association (NYHA) Class III or IV heart failure is contraindicated (see BOXED WARNING).

In addition, ACTOPLUS MET is contraindicated in patients with:

Renal disease or renal dysfunction (e.g., as suggested by serum creatinine levels ≥ 1.5 mg/dL [males], ≥ 1.4 mg/dL [females], or abnormal creatinine clearance) which may also result from conditions such as cardiovascular collapse (shock), acute myocardial infarction, and septicemia (see WARNINGS, Metformin hydrochloride and PRECAUTIONS, General: Metformin hydrochloride).
Known hypersensitivity to pioglitazone, metformin or any other component of ACTOPLUS MET.
Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma. Diabetic ketoacidosis should be treated with insulin.

ACTOPLUS MET should be temporarily discontinued in patients undergoing radiologic studies involving intravascular administration of iodinated contrast materials, because use of such products may result in acute alteration of renal function (see PRECAUTIONS, General: Metformin hydrochloride).

Last reviewed on RxList: 8/11/2011
This monograph has been modified to include the generic and brand name in many instances.