Actos, ingredient pioglitazone, is a drug that reduces the amount of glucose (sugar) in the blood. It is in a class of anti-diabetic drugs called ,thiazolidinediones, that are used in the treatment of type II diabetes. Children < 18yrs: not recommended. Precautions Not for treating type 1 diabetes or diabetic ketoacidosis. Hepatic disease. Do not start therapy in active liver disease or if ALT >2.5xULN. Monitor ALT at baseline, then periodically. If ALT 1?2.5xULN, follow-up and monitor closely; discontinue if ALT >3xULN persists or if jaundice occurs. Not for use in patients with history of troglitazone-associated jaundice. Heart failure: if NYHA Class II: start at lowest approved dose and titrate carefully; if NYHA Class III or IV: not recommended. Edema. May increase plasma volume (monitor for heart failure); discontinue if cardiac status deteriorates. Resumption of premenopausal ovulation in anovulatory patients may occur (may result in unintended pregnancy). Pregnancy (Cat.C): consider using insulin instead. Nursing mothers: not recommended. Interactions Monitor glycemic control more frequently with ketoconazole. Monitor for heart failure with insulin. May antagonize oral contraceptives. Adverse Reactions Upper respiratory tract infection, headache, sinusitis, pharyngitis, myalgia, anemia, edema, weight gain, hypoglycemia, dyspnea; changes in serum lipids (may be beneficial).