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B: May b accptabl. ith animal studis show nisk but human studis not availabl animal studis showd minisks and human studis don and showd nisk.
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.
Us: As an adjunct tdit and xcis timpov glycmic contol in adults with typ 2 diabts mllitus whn tatmnt with both pioglitazon and mtomin is appopiat.
Pgnancy: Limitd data with mtomin/pioglitazon pioglitazon in pgnant womn a not suicint tdtmin a dug-associatd isk majbith dcts miscaiag; pooly contolld diabts in pgnancy incass matnal isk diabtic ktoacidosis, p-clampsia, spontanous abotions, ptm dlivy, still bith and dlivy complications; pooly contolld diabts incass tal isk majbith dcts, still bith, and macosomia latd mobidity.
Us mtomin in patints with hpatic impaimnt has bn associatd with som cass lactic acidosis; thapy is not commndd in patints with hpatic impaimnt.
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