Actos Lactic Acidosis

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Actos lactic acidosis is a reported side effect from Actos treatment.  Actos lactic acidosis is a medical condition where a patient’s blood pH becomes dangerously low. A low blood pH indicates an acidified concentration in the blood. While Actos lactic acidosis is a serious health condition, it is generally rare. When Actos lactic acidosis occurs, nearly 50 percent of the cases are fatal. Actos lactic acidosis may also occur with other physiological problems such as diabetes. Since Actos is a type 2 diabetes treatment, Actos patients are at particular risk of experiencing Actos lactic acidosis from their treatment.

Types of Actos Lactic Acidosis

The condition can be classified into Type A or Type B lactic acidosis. The main differentiation between the two is the level of tissue oxygen delivery. Both types present the same problem which is that the mitochondria, or energy producing area of cellular biology, cannot handle the amount of pyruvate in the system. The main difference between the two is that Type A lactic acidosis cannot compensate for oxygen deficiency. Type B, on the other hand, can compensate for oxygen deficiency by increasing tissue blood flow.

Symptoms and Risks of Actos Lactic Acidosis

The onset of Actos lactic acidosis is often times subtle. Actos lactic acidosis is accompanied by nonspecific symptoms like malaise (tiredness), increased somnolence (sleeping), abdominal pain and other myalgia (muscle pain). Signs and symptoms are variable according to case reports.

Other symptoms from Actos lactic acidosis:

  • Vomiting
  • Nausea
  • Fatigue
  • Altered consciousness
  • Abdominal pain
  • Increased thirst

Physicians prescribing Actos should be familiar with the risk factors for Actos lactic acidosis. Elderly patients are particularly at risk for Actos lactic acidosis, especially with other predisposing factors. Actos lactic acidosis is an increased risk if the patient also suffers from any renal impairment. The patient’s risk increases along with the degree of renal impairment.

Actos Lactic Acidosis Causes

There is only a small amount of information regarding the causes of Actos lactic acidosis. Some speculations suggest that biguanides, the chemical class which they are a part of, have an effect on various aspects of the energy producing processes of cellular activity. The most crucial point of this issue is increased conversion of pyruvate into lactate which causes excessive lactic acid production. This lactic acid then builds up into the blood which decreases, or acidifies, blood pH.

There are two other reasons for the development of Actos lactic acidosis. These are excess tissue production of lactate, and hepatic impairment of lactate metabolism. These two reasons can influence other risk factors such as strenuous exercise since exercise is a source of lactic acid build up in muscle tissue.

A continuing case of Actos lactic acidosis is symptomatic of hepatic impairment to metabolize lactate. This could be the result of other health conditions affecting the liver. These adverse conditions are rare, however, they can be very complicating and dangerous to the patient.

Conditions which exacerbate Actos lactic acidosis:

  • Cirrhosis
  • Sepsis
  • Hypoperfusion due to hypovolemia (circulatory shock from decreased blood volume)
  • Hypotension
  • Hyperthermia

Actos Lactic Acidosis Lawsuits

Actos lactic acidosis is only one of the complaints heard in lawsuits against the manufacturers. By 2012, the drug’s manufacturers, Takeda, had over 10,000 lawsuits regarding patient claims of cancer from the drug. Cases of bladder cancer from Actos were particularly reported. The evidence of Actos bladder cancer is quoted as being “unusually strong and clear.”

In 2011, legal actions were taken against Takeda in the form of a multidistrict litigation (MDL). An MDL affords the benefits of consolidating several similar lawsuits into a smaller series of lawsuits. This is slightly different from a class-action lawsuit where several court cases are filed as a single lawsuit on behalf of a class of individuals.

View Sources

  1. Feeley, Jef. “Takeda Put Actos Sales Ahead of User Safety, Witness Says.” Bloomberg. Bloomberg, 6 Mar 2013. Web. 23 Mar 2013. http://www.bloomberg.com/news/2013-03-05/takeda-put-actos-sales-ahead-of-user-safety-witness-says.html
  2. Lincoff, Michael, Kathy Wolski, et al. “Pioglitazone and Risk of Cardiovascular Events in Patients With Type 2 Diabetes Mellitus.” Journal of the American Medical Association. N.p., 12 Sep 2007. Web. 23 Mar 2013. http://jama.jamanetwork.com/article.aspx?articleid=208777
  3. “Update on ongoing European review of pioglitazone–containing medicines.” European Medicines Agency. European Medicines Agency, 9 Jun 2011. Web. 23 Apr 2013. http://www.ema.europa.eu/ema/index.jsp?curl=pages/news_and_events/news/2011/06/news_detail_001275.jsp&murl=menus/news_and_events/news_and_events.jsp&mid=WC0b01ac058004d5c1
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