Actos interactions: Alcohol, medications, and other factors

Before you start treatment with Actos, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Actos interacts with supplements, herbs, or vitamins, see the “Actos and other interactions” section below.)

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with Actos. Keep in mind that this table doesn’t include all drugs that may interact with Actos. Some of these interactions are described in detail just below in “Drug interactions in depth.”

In some cases, factors or conditions could prevent your doctor from prescribing Actos due to the risk of harm. These are known as contraindications. Actos contraindications include:

Having severe heart failure

Doctors typically won’t prescribe Actos for people with heart failure that’s classified as New York Heart Association Class III or IV. These are more severe stages of heart failure. With Class III heart failure, you have symptoms that restrict your physical activity. With Class IV heart failure, you have symptoms even when you’re resting.

Actos can worsen heart failure. In fact, Actos has a boxed warning about the risk of heart failure. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see “Boxed warning” at the beginning of this article.

If you have heart failure, talk with your doctor before taking Actos. If you have Class III or IV heart failure, your doctor will likely prescribe a treatment other than Actos for your condition.

Having had an allergic reaction to Actos or any of its ingredients

If you’ve had an allergic reaction to Actos or any of its ingredients, your doctor will likely not prescribe Actos. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Note: Before you start treatment with Actos, it’s important to tell your doctor if these contraindications apply to you. They can determine whether to prescribe Actos.

There aren’t any known interactions between Actos and alcohol. However, your doctor may advise you to limit alcohol consumption during Actos treatment. This is because Actos and alcohol can both sometimes cause hypoglycemia. As a result, drinking alcohol while taking Actos can raise your risk of this side effect.

If you have questions about drinking alcohol while taking Actos, talk with your doctor.

Here’s a closer look at certain drug interactions of Actos.

Sulfonylureas

Sulfonylureas are a class of medications prescribed to help manage blood sugar levels in people with type 2 diabetes. Actos is also prescribed for this use.

Interaction result: Taking Actos with a sulfonylurea can raise your risk of hypoglycemia.

Interaction explained: Sulfonylureas lower your blood sugar level and commonly cause hypoglycemia as a side effect. Actos also lowers your blood sugar level and can cause hypoglycemia in some people. Taking Actos with a sulfonylurea is more likely to cause this side effect. For details about side effects of Actos, see this article.

Examples of sulfonylureas drugs: Here are some sulfonylureas that may interact with Actos:

• glimepiride (Amaryl)
• glipizide (Glucotrol XL)
• glyburide (DiaBeta)

Steps you or your doctor may take: If your doctor prescribes Actos with a sulfonylurea, they may lower the dose of either drug. Doing so may help reduce the risk of hypoglycemia. Do not take a higher dose of either medication than your doctor prescribes.

Before taking this combination of drugs, talk with your doctor about how to recognize symptoms of hypoglycemia. These may include:

• weakness
• dizziness
• tremor
• sweating
• irritability
• blurry vision

Your doctor can explain what to do if you have the symptoms listed above. Tell your doctor if you have episodes of hypoglycemia while taking Actos with a sulfonylurea. Your doctor may adjust your dosage of these medications.

If you have questions about taking Actos with a sulfonylurea or other diabetes medication, talk with your doctor or pharmacist.

Gemfibrozil (Lopid)

Gemfibrozil may be prescribed to lower high cholesterol or high triglyceride levels.

Interaction result: Taking Actos with gemfibrozil can raise your risk of Actos side effects, such as fluid buildup.

Interaction explained: Gemfibrozil slows the action of an enzyme (a type of protein) in your body called cytochrome P450 2C8 (CYP2C8). This enzyme helps clear Actos from your body. By slowing down CYP2C8, gemfibrozil can make Actos build up in your body. Having a higher level of Actos in your body is more likely to cause side effects.

Steps you or your doctor may take: If your doctor prescribes Actos with gemfibrozil, they’ll likely prescribe a dosage of Actos that’s lower than typical. Do not take a higher dose of either medication than your doctor prescribes.

Talk with your doctor if you have bothersome side effects, especially fluid buildup, while taking this combination of medications. Symptoms of fluid buildup may include:

• swollen, stretched, and shiny skin
• puffiness of the ankles, face, or around the eyes
• shortness of breath

If you have questions about taking Actos with gemfibrozil, talk with your doctor.

Topiramate (Topamax, others)

Topiramate is a medication doctors may prescribe to help manage seizures in people with epilepsy. It’s also prescribed to help prevent migraine episodes.

Interaction result: Taking Actos with topiramate can make Actos less effective.

Interaction explained: Topiramate can lower the level of Actos in your body. This can make Actos less effective at managing your blood sugar. (Actos is prescribed to help manage blood sugar levels in people with type 2 diabetes.)

Steps you or your doctor may take: If your doctor prescribes Actos with topiramate, they may prescribe a dosage of Actos that’s higher than typical. They may also monitor your blood sugar levels more often to make sure Actos is working for you. Do not take a higher dose of Actos than your doctor prescribes.

If you have questions about taking Actos with topiramate, talk with your doctor.

Actos may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Actos.

Actos interactions with supplements

Before you start treatment with Actos, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

Actos may interact with garlic supplements. Some people take these supplements to help lower high cholesterol levels or high blood pressure. They may also be taken to help prevent infections, such as the common cold.

However, if you take garlic supplements with Actos, both products can decrease your blood sugar level. This can raise your risk of hypoglycemia. Because of this, you should talk with your doctor before taking garlic supplements with Actos.

If you have questions about other interactions that may affect you, ask your doctor or pharmacist.

Actos and herbs

There are no specific reports of herbs interacting with Actos. However, that doesn’t mean herbal interactions won’t occur or be recognized in the future. Because of this, it’s important to check with your doctor or pharmacist before taking any of these products during Actos treatment.

Actos and vitamins

There are no specific reports of vitamins interacting with Actos. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Actos.

Actos interactions with minerals

Actos may interact with a mineral called chromium. Some people take this supplement to help manage their blood sugar levels.

However, if you take chromium with Actos, both products can decrease your blood sugar levels even further. This can increase your risk of hypoglycemia. Due to this risk, your doctor may recommend avoiding chromium supplements while taking Actos.

It’s also important to note that some multivitamins may also contain minerals such as chromium. Talk with your doctor to determine which multivitamin is safe for you.

Actos interactions with food

There were no reports of food interactions with the drug. However, garlic supplements may interact with Actos (see “Actos interactions with supplements” just above for details).

The amount of garlic consumed in food is usually small and divided into multiple servings. The quantity of garlic would be much less than what’s in a garlic supplement.

If you have additional questions or want more information about eating certain foods during Actos treatment, talk with your doctor.

Actos and vaccines

There aren’t any known interactions between Actos and vaccines. You can talk with your doctor or pharmacist to see whether you’re due for any vaccines.

Actos and lab tests

Actos isn’t known to interact with any lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.

ACTOS INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have been specifically reported to interact with Actos.

Cannabis and cannabis products can increase the level of Actos in your body. This can raise your risk of side effects from Actos.

Before you start treatment with Actos, tell your doctor and pharmacist if you use cannabis. By sharing this information with them, you may help prevent possible interactions.

Note: Cannabis is illegal at a federal level but is legal in many U.S. states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Actos. Before you take this drug, be sure to talk with your doctor about your health history. Actos may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Actos include:

• Heart failure: Actos can worsen heart failure. In fact, Actos has a boxed warning about the risk of heart failure. For more information, see “Boxed warning” at the beginning of this article. If you have heart failure, talk with your doctor about whether Actos is right for you. Your doctor may prescribe a dosage of Actos that’s lower than typical. But if you have severe heart failure, your doctor will likely not prescribe Actos. For more information, see the “When to avoid Actos” section above.
• Edema: Actos can worsen edema (fluid buildup). This can raise your risk of heart failure (see just above). If you have edema, talk with your doctor about whether Actos is the right medication option for you.
• Liver problems: Taking Actos may worsen liver problems. If you have a liver problem and take Actos, your doctor will likely order blood tests to monitor your liver function.
• Osteoporosis: Actos may increase the risk of bone fractures as a side effect. People with low bone density or osteoporosis who take Actos have an even higher risk of breaking a bone. If you have osteoporosis or have risk factors for it, talk with your doctor before starting Actos. They’ll determine whether Actos is the right treatment option for you.
• Irregular periods: If you have irregular periods, taking Actos can make you ovulate (the release of an egg from your ovaries). This can raise your risk of becoming pregnant. If you have irregular periods and you’re sexually active, talk with your doctor about your birth control needs while taking Actos.
• Allergic reaction: If you’ve had an allergic reaction to Actos or any of its ingredients, your doctor will likely not prescribe Actos. To learn more, see “When to avoid Actos” above.
• Pregnancy: There haven’t been enough clinical trials to determine whether Actos is safe to use while pregnant. If you’re pregnant or planning to become pregnant, tell your doctor before starting Actos. They can advise you on a treatment plan that meets your needs.
• Breastfeeding: It’s not known whether it’s safe to use Actos while breastfeeding. There isn’t enough information to determine whether the drug passes into breast milk or what effects Actos may have on a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor before using Actos. They can talk with you about treatment options and ways to feed your child.

You can take certain steps to help prevent interactions with Actos. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Actos label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If Actos doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Actos by taking it exactly as your doctor prescribes.

Besides learning about interactions, you may want to find out more about Actos. These resources might help:

• Overview of Actos: For a general overview of Actos, you can see this article.
• Side effects: If you’re interested in the side effects of Actos, see this article. Another option is to refer to the Actos prescribing information.
• Dosage specifics: To learn about the dosage of Actos, see this article.
• Facts about type 2 diabetes: To learn more about managing type 2 diabetes, see our diabetes hub.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.