Glados Medicine

[Marie Ota]

Pioglitazoneincreases insulin sensitivity (how your body responds to your own insulin). This helps your body use sugar as an energy source. It also lowers the amount of glucose (sugar) your liver makes.

There may be other side effects of pioglitazone that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

Severe Allergic Reactions. Pioglitazone may cause allergic reactions, which can be serious. Stop taking pioglitazone and get help right away if you have any of the following symptoms of a serious allergic reaction.

Edema (fluid retention). Pioglitazone may increase your risk of fluid retention, especially if you take a higher dose. Tell your healthcare provider right away if you notice swelling in your feet, ankles, or legs, or unexplained weight gain.

Fractures (broken bones). Pioglitazone may increase your risk of breaking a bone (usually in the hand, arm, or feet), especially in females. Talk with your healthcare provider about how to keep your bones healthy.

Liver Damage. Liver damage, also called hepatotoxicity, can happen when taking pioglitazone. Call your healthcare provider right away if you have any of the following symptoms of liver damage.

Bladder Cancer. You may be more likely to get bladder cancer if you take pioglitazone. Tell your healthcare provider right away if you have any of the following symptoms of bladder cancer.

Macular Edema. Pioglitazone may increase your risk of macular edema (increased fluid in parts of your eye). You may not have any symptoms, so keep your scheduled eye appointments. Tell your healthcare provider right away if you notice changes in your vision.

Low Blood Sugar (Hypoglycemia). Pioglitazone can cause low blood sugar, especially if you skip meals, use insulin or other medicines that increase your insulin levels. Hypoglycemia can be serious and may lead to death. Your healthcare provider may lower your dose of your other diabetes medicines to reduce your risk of low blood sugar. Do not use pioglitazone and call your healthcare provider right away if you have any of the following symptoms of hypoglycemia.

Pioglitazone can cause ovulation (release of an egg from your ovary), if you have not gone through menopause, even if you do not have regular periods. This can increase your chance of getting pregnant.

Certain conditions that cause increased stress on your body, like fever, trauma (such as a car accident), infection, or surgery can change the amount of diabetes medicines you need to take to control your diabetes. Talk to your healthcare provider if you have any of these conditions to decide if your medicine needs to be changed.

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if pioglitazone is right for you.

Other Medicines and Supplements. Pioglitazone may interact with other medicines and supplements. Before using pioglitazone, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how pioglitazone could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should take pioglitazone while you are pregnant or trying to get pregnant.

It is unknown if drinking alcohol will affect pioglitazone, but alcohol may affect blood sugar levels in people with diabetes. This may interfere with the effect of pioglitazone. It is best to limit the amount of alcohol you drink.

1. Making a Deal2. Limits3. Give and Take4. Tension5. Relief6. Failure7. Gathering Storm8. When the Chips Are Down9. A New Start10. The Final Straw11. All I Ask of You12. Friends with Benefits13. A Happy Accident?14. Hold Me15. Let Me Please You16. Unwelcome Guests17. This is War18. Revenge19. Aftermath20. The Deep Past21. The Breach22. Give Them Hell for Me23. I'm Still Here24. The Last Blizzard of Winter25. The Final Proposal26. Spring

It was a short walk with a few turns before the robots lead her to a hallway with a regular door on the end. GLaDOS watched the human approach from a camera right in front of the door. The robots moved aside to let the woman pass. She warily opened the door. Inside was a bedroom created from an extended relaxation vault.

The next morning, GLaDOS asked her to come to her chamber for a health check. Chell slowly made her way there, and found that all traces of her stay in the chamber had been eliminated. She stood awkwardly by the door for a moment.

GLaDOS injected her with pain medicine and waited for it to take effect. Chell went limp, surprised at how strong the medicine was. Just how fast was GLaDOS going to go? Then, about a dozen mechanical arms came up from the floor and surrounded her. Several tendrils came down from the ceiling and lightly pinned her.

The clock struck 9 a.m., and Chell slowly got up, took a deep breath, and left the kitchen, heading to the elevator that would take her to the testing course. As she walked, took a hair tie off her wrist and put her hair in a ponytail, just like it was when she previously tested in Aperture.

Having Chell as a test subject again brought GLaDOS huge relief. No whining, no back-talking, no refusal to test, not even any destruction of testing elements. She just tested, quickly and efficiently.

GLaDOS felt a bit concerned with the unresponsiveness of the human. She was acting much like she did when she and GLaDOS were enemies. After giving it some thought, she felt it was best to leave the human alone for a bit and try to reach out later in the day.

pioglitazone will increase the level or effect of baricitinib by decreasing elimination. Avoid or Use Alternate Drug. Coadministration of baricitinib with strong organic anion transporter 3 (OAT3) inhibitors is not recommended.

pioglitazone will increase the level or effect of etrasimod by Other (see comment). Avoid or Use Alternate Drug. Increased exposure of etrasimod expected in patients who are CYP2C9 poor metabolizers if coadministered with moderate to strong CYP2C8 inhibitors.

pioglitazone will increase the level or effect of tovorafenib by decreasing metabolism. Avoid or Use Alternate Drug. Avoid coadministration of tovorafenib (a CYP2C8 substrate) with strong or moderate CYP2C8 inhibitors.

pioglitazone will increase the level or effect of tucatinib by Other (see comment). Avoid or Use Alternate Drug. Coadministration of tucatinib (a CYP2C8 substrate) with a strong or moderate CYP2C8 inhibitors increases tucatinib plasma concentrations and risk of toxicities.

pioglitazone will increase the level or effect of zavegepant intranasal by Other (see comment). Avoid or Use Alternate Drug. NTCP inhibitors may result in a significant increase in systemic exposure of zavegepant (a NTCP substrate).

aripiprazole, pioglitazone. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

asenapine, pioglitazone. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

bexarotene increases effects of pioglitazone by pharmacodynamic synergism. Use Caution/Monitor. Based on the mechanism of action, bexarotene capsules may increase the action of insulin enhancing agents, resulting in hypoglycemia. Hypoglycemia has not been associated with bexarotene monotherapy.

cannabidiol will increase the level or effect of pioglitazone by decreasing metabolism. Modify Therapy/Monitor Closely. Cannabidiol may potentially inhibit CYP2C8 activity. Consider reducing the dose when concomitantly using CYP2C8 substrates.

pioglitazone increases toxicity of cholic acid by decreasing elimination. Modify Therapy/Monitor Closely. Avoid concomitant use of inhibitors of the bile salt efflux pump (BSEP). May exacerbate accumulation of conjugated bile salts in the liver and result in clinical symptoms. If concomitant use is necessary, monitor serum transaminases and bilirubin.

ciprofloxacin increases effects of pioglitazone by pharmacodynamic synergism. Use Caution/Monitor. Hyper and hypoglycemia have been reported in patients treated concomitantly with quinolones and antidiabetic agents. Careful monitoring of blood glucose is recommended.

clozapine, pioglitazone. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

pioglitazone will increase the level or effect of daprodustat by Other (see comment). Modify Therapy/Monitor Closely. Moderate CYP2C8 inhibitors increase daprodustat exposure. If coadministered with moderate CYP2C8 inhibitors, reduce daprodustat starting dose by half (except if starting dose is already 1 mg). Monitor hemoglobin and adjust daprodustat dose when initiating or stopping therapy with moderate CYP2C8 inhibitors during treatment

pioglitazone will decrease the level or effect of dienogest/estradiol valerate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Advise women to use alternative method of contraception or back-up method when moderate or weak enzyme inducer is used with combination contraceptives. Back-up contraception should be continued for 28 days after discontinuing medication to ensure contraceptive reliability.

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