Q: My 49 years old mother has been taking Gluconorm PG 2 (two tablets twice a day) for the last three years. Now she is reporting heavy breathing and anxiety. Does Gluconorm PG 2 lead to heart problems? Is Gluconorm PG2 and Glycomet GP2 the same?

A:Gluconorm PG contains metformin and pioglitazone. Glycomet GP contains metformin and glimepiride. Their actions are similar but not exactly identical. Pioglitazone (one ingredient of Gluconorm) has adverse effects on heart. The innovator of pioglitazone, Takeda Pharmaceuticals, has issued additional guidelines and warnings on the use of the drug in Type II diabetes. Briefly it states that: • Pioglitazone is not for all type 2 diabetics. • It can cause fluid retention that can precipitate or worsen congestive heart failure (CHF). There is 39 per cent increase in the risk of CHF in patients taking pioglitazone compared to those who are not on this medicine. It is not to be used in moderate to severe heart failure. • Liver Function Tests must be done before starting pioglitazone and periodically thereafter. Patients must consult their doctors if there is rapid weight gain, shortness of breath, nausea, vomiting, abdominal pain, tiredness, loss of appetite, dark urine or yellowing of skin.