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Before having surgery or any X-ray/scanning procedure using iodinated contrast.tell your doctor or dentist about all the products you use (including prescription drugs.nonprescription drugs.and herbal products). You may need to stop this medication for a short time for the surgery/procedure. Ask your doctor or dentist for instructions before your surgery/procedure.

Although there was no statistically significant difference between pioglitazone and placebo for the three-year incidence of a first event within this composite.there was no increase in mortality or in total macrovascular events with pioglitazone. The number of first occurrences and total individual events contributing to the primary composite endpoint is shown in Table 9.

Cheap actoplus met of fasting venous plasma lactate above the upper limit of normal but less than 5 mmol/L in patients taking metformin do not necessarily indicate impending lactic acidosis and may be explainable by other mechanisms.such as poorly controlled diabetes or obesity.vigorous physical activity.or technical problems in cheap actoplus met handling [see Monitoring of Renal Function ].

Controlled clinical studies of metformin did not include sufficient numbers of elderly patients to determine whether they respond differently from younger patients.although other reported clinical experience has not identified differences in responses between the elderly and young patients. Metformin is known to be substantially excreted by the kidney and because the risk of serious adverse reactions to the drug is greater in patients with impaired renal function.ACTOPLUS MET should only be used in patients with normal renal function [see CONTRAINDICATIONS .WARNINGS AND PRECAUTIONS .and CLINICAL PHARMACOLOGY ]. Because aging is associated with reduced renal function.ACTOPLUS MET should be used with caution as age increases. Care should be taken in dose selection and should be based on careful and regular monitoring of renal function. Generally.elderly patients should not be titrated to the maximum dose of ACTOPLUS MET [see WARNINGS AND PRECAUTIONS and DOSAGE AND ADMINISTRATION ].

Along with its needed effects.metformin/pioglitazone may cause some unwanted effects. Although not all of these side effects may occur.if they do occur they may need medical attention.

A very serious allergic reaction to this drug is rare. However.get medical help right away if you notice any of the following symptoms of a serious allergic reaction. rash.itching/swelling (especially of the face/tongue/throat).dizziness.trouble breathing.

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Immdiat-las (I): Initial dos: 15 mg/500 mg I oally twic a day 15 mg/850 mg I oally onc a day -patints inadquatly contol on mtomin monothapy: May initiat with 15 mg/850 mg I oally twic a day (dpnding on pvious mtomin dos) -patints with NYHA Class I Class II CH: Initial dos: 15 mg/500 mg I 15 mg/850 mg I oally onc a day Maintnanc dos: Gadually titat dos basd on saty and icacy Maximum dos: Pioglitazon 45 mg/Mtomin 2550 mg p day.

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