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There are many medications that interact with actos or that may increase the problems. Some of the medications that interact with Actos are Gemfibrozil, Ketoconazole and Rifampin. There are some conditions that must be noted before using Actos. The patients should inform doctors if they have any of the following symptoms: macular edema or history of diabetic ketoacidosis, problems in heart or any heart failure, diabetes of type 1, liver disease, fever, tauma, fragile bones, bladder cancer, pregnant or having idea to become pregnant. The dosage of actos differs for patients based on the conditions. The patients should follow the dose recommended. Actos comes in tablets also. The patients who took Actos in over dose should the doctor immediately. The signs for usage of over dosage of Actos are: low blood sugar, seizures, fainting and coma. The actos recall gave a warning which shows that Actos has the potential of developing lactic acidosis. This lactic acidosis may occur from an excess accretion of metformin. The symptoms for this are discomfort stomach, diarrhea, decreased appetite, pain in muscles, cramping, sleepiness and shallow breathing. Actos recall was issued in July 2009 for tablets. The cancer from actos can severe health problems which even reduces the lifetime of the patients.