Pioglitazone (Actos) can cause side effects when used. Side effects that can result from pioglitazone use include headache, upper respiratory infection, muscle aches, sinus pain and worsening of one’s underlying diabetes. Hypoglycemia is a risk from taking pioglitazone. Pioglitazone can also increase the risk of getting bladder cancer, heart failure and eye problems and should be used under the close supervision of a medical provider given these risks. People who have a known hypersensitivity or allergy to pioglitazone, Actos or ingredients in the formulation should not use the medication. Pioglitazone and alcohol should not be used together. Before using pioglitazone HCl, it is important to discuss concerns and potential side effects that may occur while using Actos medication with a licensed pharmacist and medical provider.