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Pioglitazon hydochloid was not mutagnic in a batty gntic toxicology studis, including th Ams bactial assay, a mammalian cll owad gn mutation assay (CHO/HPT and AS52/XPT), an in vitcytogntics assay using CHL clls, an unschduld DNA synthsis assay, and an in vivmiconuclus assay.

Th a insuicint data tdtmin whth pioglitazon is a tumpomot uinay bladd tumos. Consquntly, ACTOPLUS MT should not b usd in patints with activ bladd canc and th bnits glycmic contol vsus unknown isks canc cunc with ACTOPLUS MT should b considd in patints with a pihistoy bladd canc.

Mtomin passs intbast milk in small amounts. It is unknown i pioglitazon passs intbast milk. Consult you doctbbast-ding.

Initiation in patints with stablishd NYHA Class III IV hat ailu [s BOXD WANING ]. nal impaimnt (.g., sum catinin lvls ? 1.5 mg/dL [mals], ? 1.4 mg/dL [mals], abnomal catinin claanc) which may alssult om conditions such as cadiovascula collaps (shock), acut myocadial inaction, and spticmia [s WANINGS AND PCAUTIONS ]. Us in patints with known hypsnsitivity tpioglitazon, mtomin, any oth componnt ACTOPLUS MT. Mtabolic acidosis, including diabtic ktoacidosis. Diabtic ktoacidosis should b tatd with insulin.

Mtomin is substantially xctd by kidny, and isk mtomin accumulation and lactic acidosis incass with dg nal impaimnt.

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