"The Food and Drug Administration approved generic versions of the type 2 diabetes medication Actos (pioglitazone) last week. But we say skip Actos as both a generic and brand-name medication, unless other options have not worked. Pioglitazone can cause serious side effects, such as an increased risk of heart failure, bone fractures, and bladder cancer. Other medications to treat diabetes, such as metformin, are a better first choice.
For those who must take it, only three manufacturers are currently allowed to make the generic formulations of Actos for the next six months, so the price will likely stick close to the brand-name version, which can run an average of $377 for a prescription, if you pay the retail price. Once more manufacturers are approved to produce it, the price of generic Actos will begin to drop.
Bottom Line: Our medical advisers say that people with diabetes should use pioglitazone, generic or brand-name Actos, only as a last resort. If you're on the drug, ask your doctor if it's absolutely necessary and if you should switch to another drug. Our Consumer Reports Best Buy Drug recommendation is the drug metformin, either alone or with glipizide or glimepiride, for most people with type 2 diabetes, combined with a healthy diet, regular exercise, and losing excess weight. Those three generic medications can be usually found on the discount $4 generic drug lists at the pharmacy of most chain stores such as Kroger, Target and Walmart, and may be purchased for as little as $10 for a three-month supply."
Consumer Reports, Avoid generic Actos, August 2012