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Overview: Pioglitazone/glimepiride helps lower blood sugar levels in people with type 2 diabetes. Pioglitazone/glimepiride increases your insulin level and helps insulin work better. Common side effects are fluid retention and infections of the nose and throat. Notify your healthcare provider if you have severe or frequent episodes of low blood sugar.

Uses

What is pioglitazone/glimepiride used for?

Pioglitazone/glimepiride is commonly used to help lower blood sugar levels in people with type 2 diabetes.

Pioglitazone/glimepiride may also be used for other conditions as determined by your healthcare provider.

How does pioglitazone/glimepiride work (mechanism of action)?

Pioglitazone/glimepiride works in a few ways to help keep your blood sugar from getting too high. It increases your insulin levels and insulin sensitivity (how your body responds to your own insulin). This helps your body use sugar as an energy source. It also decreases the amount of sugar your liver makes. 

How is pioglitazone/glimepiride supplied (dosage forms)?

Brand and other names

  • Duetact

Dosage forms and strengths

  • 30 mg/2 mg oral tablets
  • 30 mg/4 mg oral tablets

How should I store pioglitazone/glimepiride?

Pioglitazone/glimepiride should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.

Side Effects

What are the most common side effects of pioglitazone/glimepiride?

The most common side effects of pioglitazone/glimepiride are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

  • Infection in the nose or throat, sore throat
  • Accidental injury
  • Edema (fluid retention) (see below)

There may be other side effects of pioglitazone/glimepiride that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of pioglitazone/glimepiride?

While less common, the most serious side effects of pioglitazone/glimepiride are described below, along with what to do if they happen.

Severe Allergic Reactions. Pioglitazone/glimepiride may cause allergic reactions, which can be serious. Stop taking pioglitazone/glimepiride and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Heart Failure. Pioglitazone/glimepiride may increase your risk of heart failure, especially if you also use insulin. Tell your healthcare provider right away if you have any of the following symptoms of heart failure.

  • Shortness of breath or trouble breathing, especially while lying down
  • Swelling in your feet, ankles, or legs
  • Unusually fast weight gain
  • Unusual tiredness

Edema (Fluid Retention). Pioglitazone/glimepiride may increase your risk of fluid retention, especially if you take a higher dose. Tell your healthcare provider right away if you notice swelling in your feet, ankles, or legs, or unexplained weight gain. 

Fractures (Broken Bones). Pioglitazone/glimepiride may increase your risk of breaking a bone (usually in the hand, arm, or feet), especially in females. Talk with your healthcare provider about how to keep your bones healthy.

Liver Damage. Liver damage, also called hepatotoxicity, can happen when taking pioglitazone/glimepiride. Call your healthcare provider right away if you have any of the following symptoms of liver damage.

  • Nausea or vomiting
  • Stomach or belly pain
  • Fever
  • Weakness or unusual tiredness
  • Itching
  • Loss of appetite
  • Light-colored poop
  • Dark-colored urine
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Bladder Cancer. You may be more likely to get bladder cancer if you take pioglitazone/glimepiride. Tell your healthcare provider right away if you have any of the following symptoms of bladder cancer.

  • Red pee or blood in your pee
  • Pain when you pee
  • Need to pee more often than normal

Macular Edema. Pioglitazone/glimepiride may increase your risk of macular edema (increased fluid in parts of your eye). You may not have any symptoms, so keep your scheduled eye appointments. Tell your healthcare provider right away if you notice changes in your vision. 

Low Blood Sugar (Hypoglycemia). Pioglitazone/glimepiride can cause low blood sugar, especially if you skip meals, use insulin or other medicines that increase your insulin levels. Hypoglycemia can be serious and may lead to death. Your healthcare provider may lower your dose of your other diabetes medicines to reduce your risk of low blood sugar. Call your healthcare provider right away if you have any of the following symptoms of hypoglycemia.

  • Headache
  • Crankiness or anxiety Hunger
  • Hunger
  • Dizziness or confusion
  • Blurry vision
  • Slurred speech
  • Sweating
  • Feeling jittery or shakiness
  • Fast heartbeat
  • Seizures

Hemolytic Anemia. Pioglitazone/glimepiride may cause hemolytic anemia (when your body destroys your red blood cells faster than it can make new ones), if you have glucose-6-phosphate dehydrogenase (G6PD) deficiency. Tell your healthcare provider right away if you have any of the following symptoms of hemolytic anemia.

  • Chills
  • Fast heartbeat, known as tachycardia
  • Pale skin that may start to yellow
  • Shortness of breath
  • Weakness and fatigue
  • Chest pain
  • Yellow skin or whites of the eyes (jaundice)
  • Dark colored pee
  • A feeling of fullness in your stomach related to a big spleen

Warnings & Precautions

Who should not use pioglitazone/glimepiride?

Allergies to Ingredients. People who are allergic to any of the following should not take pioglitazone/glimepiride.

  • Duetact
  • Pioglitazone
  • Glimepiride
  • Any other medicine known as a sulfonamide
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific pioglitazone/glimepiride products they stock.

Heart Failure. People with New York Heart Association (NYHA) Class III or IV heart failure (moderate to severe heart failure) should not start taking pioglitazone/glimepiride. 

What should I know about pioglitazone/glimepiride before using it?

Do not take pioglitazone/glimepiride unless it has been prescribed to you by a healthcare provider. Take it as prescribed. 

Do not share pioglitazone/glimepiride with other people, even if they have the same condition as you. It may harm them.

Keep pioglitazone/glimepiride out of the reach of children.

Pioglitazone/glimepiride can cause ovulation (release of an egg from your ovary), if you have not gone through menopause, even if you do not have regular periods. This can increase your chance of getting pregnant.

Take pioglitazone/glimepiride with breakfast or your first meal each day.

Certain conditions that cause increased stress on your body, like fever, trauma (such as a car accident), infection, or surgery can change the amount of diabetes medicines you need to take to control your diabetes. Talk to your healthcare provider if you have any of these conditions to decide if your medicine needs to be changed.

Some medicines may make it difficult to notice signs of low blood sugar. Talk to your healthcare provider about how to prevent, recognize, and manage low blood sugar (hypoglycemia), high blood sugar (hyperglycemia), and diabetes-related problems.

People who are 65 years or older can be at greater risk for some side effects from pioglitazone/glimepiride. Talk to your healthcare provider about your risks if you are in this age group.

Pioglitazone/glimepiride can affect your alertness or coordination, especially if your blood sugar drops too low. Do not drive or do other activities that require alertness or coordination until you know how pioglitazone/glimepiride affects you.

What should I tell my healthcare provider before using pioglitazone/glimepiride?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if pioglitazone/glimepiride is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

Other Medicines and Supplements. Pioglitazone/glimepiride may interact with other medicines and supplements. Before taking pioglitazone/glimepiride, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how pioglitazone/glimepiride could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Talk to your healthcare provider about how to control your blood sugar while you are pregnant. 

Breastfeeding. It is not known if pioglitazone/glimepiride passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should take pioglitazone/glimepiride while breastfeeding.

Interactions

Does pioglitazone/glimepiride interact with foods or drinks?

There are no known interactions between pioglitazone/glimepiride and foods or drinks.

It is unknown if drinking alcohol will affect pioglitazone/glimepiride, but alcohol may affect blood sugar levels in people with diabetes. This may interfere with the effect of pioglitazone/glimepiride. It is best to limit the amount of alcohol you drink.

Does pioglitazone/glimepiride interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking pioglitazone/glimepiride.

  • Colesevelam (Welchol), which is a medicine for high cholesterol and high blood sugar from type 2 diabetes
  • Topiramate (Topamax, Trokendi XR, Qudexy XR), which is a medicine commonly used to treat seizures or prevent migraine

Many other medicines can increase your blood sugar and can interfere with the effect of pioglitazone/glimepiride. Talk to your pharmacist or healthcare provider before starting or stopping other medicines while taking pioglitazone/glimepiride. You may need to monitor your blood sugar levels more closely during these times.

Some medicines can decrease your blood sugar, adding to the effect of pioglitazone/glimepiride. Talk to your pharmacist or healthcare provider before starting or stopping other medicines while taking pioglitazone/glimepiride. You may need to monitor your blood sugar levels more closely or lower your dose of pioglitazone/glimepiride during these times.

Some other medicines may alter the blood levels of pioglitazone/glimepiride. Tell your healthcare provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with pioglitazone/glimepiride. Always check with your healthcare provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much pioglitazone/glimepiride?

If you or someone else has used too much pioglitazone/glimepiride, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of pioglitazone/glimepiride?

If you miss a dose, skip the missed dose. Take the next dose when you normally would. Do not double up or take two doses at the same time.