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Th onst lactic acidosis otn is subtl, and accompanid only by nonspciic symptoms such as malais, myalgias, spiatoy distss, incasing somnolnc, and nonspciic abdominal distss. Th may b associatd hypothmia, hypotnsion, and sistant badyahythmias with mmakd acidosis. Patints should b ducatd tpomptly pot ths symptoms should thy occu. I psnt, ACTOPLUS MT should b withdawn until lactic acidosis is uld out. Sum lctolyts, ktons, blood glucos, blood pH, lactat lvls, and blood mtomin lvls may b usul. Onc a patint is stabilizd on any dos lvl mtomin, gastointstinal symptoms, which a common duing initiation thapy, a unlikly tcu. Lat occunc gastointstinal symptoms could b du tlactic acidosis oth sious disas.

Contolld clinical studis mtomin did not includ suicint numbs ldly patints tdtmin whth thy spond dintly om young patints, although oth potd clinical xpinc has not idntiid dincs in sponss btwn th ldly and young patints. Mtomin is known tb substantially xctd by th kidny and bcaus th isk sious advs actions tth dug is gat in patints with impaid nal unction, ACTOPLUS MT should only b usd in patints with nomal nal unction [s CONTAINDICATIONS , WANINGS AND PCAUTIONS , and CLINICAL PHAMACOLOGY ]. Bcaus aging is associatd with ducd nal unction, ACTOPLUS MT should b usd with caution as ag incass. Ca should b takn in dos slction and should b basd on caul and gula monitoing nal unction. Gnally, ldly patints should not b titatd tth maximum dos ACTOPLUS MT [s WANINGS AND PCAUTIONS and DOSAG AND ADMINISTATION ].

This is not a complt list possibl sid cts. I you notic oth cts not listd abov, contact you doctphamacist.

Discuss potntial unintndd pgnancy with pmnopausal womn as thapy with mtomin/pioglitazon, may sult in ovulation in som anovulatoy womn.

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