Actos contains pioglitazone, a medicine that improves the body’s response to insulin. It is used for type 2 diabetes and has an important warning about fluid retention and heart failure.
The approved uses and formulations described here follow US prescribing information. They may differ in other countries.
| Medicine detail | Details |
|---|---|
| Active ingredient(s) | pioglitazone |
| Medicine class | Thiazolidinedione |
| Forms and strengths | Oral tablets: 15, 30 and 45 mg |
What pioglitazone does
Pioglitazone acts on PPAR-gamma receptors involved in insulin sensitivity. The US Actos label covers adults with type 2 diabetes, alongside diet and exercise. It does not replace insulin for type 1 diabetes or treat diabetic ketoacidosis.
Source: [1]
Tablets and the treatment plan
Actos tablets contain 15, 30 or 45 mg and are taken once daily. The appropriate dose depends on glucose response, other diabetes medicines and side effects. The prescriber chooses the dose; the strengths listed here are not a recommendation for an individual.
Source: [1]
Why the heart-failure warning matters
Actos carries a boxed warning that thiazolidinediones can cause or worsen congestive heart failure. Starting treatment in NYHA class III or IV heart failure is contraindicated. New breathlessness, rapid weight gain or swelling warrants prompt medical attention; fluid retention can be more likely with insulin.
Source: [1]
Other important precautions
The prescribing information also warns about bladder cancer, fractures, liver injury and macular edema, a cause of blurred vision. Actos should not be used in people with active bladder cancer. A history of bladder cancer, liver problems or changes in vision should be discussed with the prescribing clinician.
Source: [1]
Keeping the medicine list accurate
Actos and pioglitazone refer to a brand and its ingredient, not two separate therapies to take together. Bring the actual pack and a complete medicine list to a review. Local product names and approved uses may differ outside the United States.
Source: [1]
Questions and answers
Is Actos insulin?
No. Pioglitazone changes insulin sensitivity; it is not an insulin product.
Why does swelling matter with Actos?
Fluid retention is a labeled concern and can signal worsening heart failure. New or worsening symptoms need prompt assessment.
Does the Actos name identify the dose?
No. The prescription must also specify a tablet strength and directions.
Related reading
Sources
Sources checked 1 October 2026. This information does not replace advice from your healthcare professional. For complete warnings and instructions, read the product information and consult the prescribing team.
Reviewed by: Mattias Hagman, PhD
About the reviewer:
Dr Mattias Hagman (PhD, University of Sydney) has an academic background and experience working with healthcare-related content and regulated industries. He has lecturing experience at international universities, including Stockholm University and the University of Malta.
Last reviewed: October 2026