Actos can also cause or aggravate congestive heart failure. Patients with a history of heart failure should be monitored when taking the drug, or should not take it at all. Symptoms of congestive heart failure include rapid weight gain, difficulty breathing, and fluid retention or swelling.
Another dangerous side effect of Actos is chronic kidney disease: in one study, people who took the drug were four times more likely to develop kidney disease than non-users. Women who take Actos are susceptible to developing bone fractures, especially in the hands, fee, ankles, and lower legs. And Actos carries a warning for risk of developing lactic acidosis, whose symptoms include liver disease and fever.
A number of drugs may be substituted for Actos and may be safer than it, including Acarbose, Saxagliptin, and Anylin.