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7 were randomized to actoplus met 15 850 mg, pioglitazone 15 mg, or metformin 850 mg twice daily.

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Thiazolidinediones.including pioglitazone and rosiglitazone.cause or exacerbate buy cheap actoplus met heart failure in some patients Monitor carefully after initiation or dose increases for signs and symptoms of heart failure (including excessive.rapid weight gain. dyspnea. and/or edema). if these signs or symptoms develop.manage heart failure according current standards of care. consider discontinuing or reducing dose Not recommended in patients with symptomatic heart failure. initiation of these drugs in patients with established NYHA class III or IV heart failure is contraindicated.

Symptoms of high blood sugar (hyperglycemia) include thirst.increased urination.confusion.drowsiness.flushing.rapid breathing.or fruity breath odor. If these symptoms occur.tell your doctor right away. Your dosage may need to be increased.

Table 12. Weight Changes (kg) Buy norvasc online without prescription from Baseline During Double-Blind Clinical Trial with ACTOPLUS MET in Patients with Inadequate Glycemic Control on Diet and Exercise.

Discuss potential for unintended pregnancy with premenopausal women as therapy with metformin/pioglitazone.may result in ovulation in some anovulatory women.

Patients receiving ACTOPLUS MET in combination with insulin or other antidiabetic medications (particularly insulin secretagogues such as sulfonylureas) may be at risk for hypoglycemia. A reduction in the dose of the concomitant antidiabetic medication may be necessary to reduce the risk of buy cheap actoplus met [see DOSAGE AND ADMINISTRATION ]. Hypoglycemia can also occur when caloric intake is deficient or when strenuous exercise is not compensated by caloric supplement. Elderly.debilitated.or malnourished patients.and those with adrenal or pituitary insufficiency or alcohol intoxication are particularly susceptible to hypoglycemic effects. Hypoglycemia may be difficult to recognize in the elderly.and in people who are taking beta-adrenergic blocking drugs.

Lactic acidosis should be suspected in any diabetic patient with metabolic acidosis lacking evidence of ketoacidosis (ketonuria and ketonemia).

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