Actos® Adverse Effects

Actos® Adverse Effects

Many of us would be very surprised to find that a drug can be approved by the FDA yet still have serious—and undisclosed—side effects. The drug Actos, used in the treatment of Type 2 diabetes, is one such drug. Actos works by decreasing the body’s resistance to insulin as a way of controlling blood sugar levels. Actos is currently being used by millions of people across the globe, with sales jumping from around $2.9 billion in 2006 to over $4.3 billion in 2010. Actos has often been prescribed in place of the drug Avandia, which was found to carry significant risks of heart disease and possibly even death in 2007. Actos, which is manufactured by the Japanese pharmaceutical giant Takeda Pharmaceuticals, has recently fallen under scrutiny as well as studies have linked it to an increased risk of bladder cancer as well as correlating it to other serious diseases such as heart attack, stroke and liver failure.

“Minor” Side Effects of Actos
The truth is, all prescription medicines as well as most over-the-counter medications, carry some risk of adverse effects. Fortunately the incidence of serious side effects is rare and for the most part the majority of people have either no side effects or relatively minor ones. Minor side effects associated with Actos include flu-like symptoms, headaches, toothache, sore throat or sinus pain and weight gain. More serious side effects which should prompt the user to seek medical attention include an allergic reaction which includes difficulty breathing or chest tightness, blurry vision, symptoms of heart or liver failure including breathing difficulties, a sudden gain in weight, stomach pains, dark urine, jaundice or vomiting, low blood sugar symptoms such as tremors, anxiety or chills, severe and unusual bone pain and total exhaustion along with feeling weak and shaky.

Actos® and Bladder Cancer

Actos® and Bladder Cancer

Recent studies have shown that patients taking the drug Actos for longer than one year may suffer significantly increased risks of developing bladder cancer. The FDA warnings are being issued on the heels of France and Germany banning the use of Actos, and New Zealand also beginning the process of removing Actos from patient use. Takeda Pharmaceuticals, the Japanese corporation who began manufacturing Actos in 1999, is at the midway point in a ten-year study of the drug’s potentially serious side effects. While the five-year data shows no clear evidence of an overall increased risk of bladder cancer, patients who have taken the drug in the highest dosages or for the longest period of time appeared to be at a much greater risk of developing bladder cancer.

Actos is in a class of drugs known as thiazolidinediones, and is the second medication of its class to be associated with serious side effects. Avandia, the sister-drug of Actos, recently had its use severely restricted due to evidence of increased heart attack risk and even death. When metformin alone no longer works well for patients suffering from type 2 diabetes, doctors typically prescribe a drug such as Actos which increases the body’s insulin sensitivity, controlling blood sugar levels in the process. Type 2 diabetes, when left untreated, can potentially lead to serious health effects such as damage to the retina which can lead to blindness, injury to the kidneys, impairment of the nerves which could lead to amputations of limbs and an acceleration of the development of fat plaques on the interior of the arteries which can potentially lead to blood clots, blockages, cardiovascular disease, stroke and a lessening of critical circulation.

Actos® and Cardiovascular Dangers

Actos® and Cardiovascular Dangers

The drug Actos, marketed by Takeda Pharmaceutical Corporation, is used in the treatment of Type 2 diabetes. Actos largely replaced its predecessor, Avandia, after Avandia was found to have serious risks of heart attack and heart failure. At the time, it was believed that Actos offered much less risk of cardiovascular damage than Avandia. Actos is used to lessen blood glucose labels and improves how the body handles insulin. Type 2 diabetes, which affects between eighteen and twenty million Americans, can cause loss of sight, kidney trouble and cardiovascular illness if left untreated, however it appears that the treatment may also come with its fair share of serious dangers. Just like Avandia, Actos may carry significant levels of cardiovascular risks, however it has not been associated with heart attack deaths in the same way Avandia has.

Although Takeda is in the middle of a ten-year study regarding the safety of Actos, other studies have been conducted as well. One well-known cardiologist, Dr. Steven Nissen of the Clevenland clinic focused his review of Actos dangers, finding that it significantly increases the likelihood of a heart attack by as much as forty-two percent. The FDA issued a black box warning label for Actos in June of 2007 during a House of Representatives hearing. During this hearing the fact that the FDA was aware of the potential cardiovascular risks associated with Actos yet failed to adequately respond was discussed, and since that time both lawmakers and health experts have criticized the FDA for failing to properly safeguard public health.

Actos® and Congestive Heart Failure

Actos® and Congestive Heart Failure

The drug Actos, also known as pioglitazone is marketed by Takeda Pharmaceuticals and Eli Lilly for the treatment of Type 2 diabetes. The drug was approved in 1999, and although the manufacturer touts it as a miracle drug which has reduced the number of diabetes cases by as much as 70%, the side effects may far outweigh the benefits. A study done in 2003 by the Mayo Clinic definitively linked Actos to swelling in the feet, lung fluid retention, shortness of breath and congestive heart failure. The most recent studies have strongly indicated that Actos may also be responsible for a number of incidences of bladder cancer in those who have taken the drug in higher dosages or for longer than twelve months.

The American Diabetes Association presented a research report at a meeting in San Diego this past June which reported that Actos enhanced the risk of macular edema by as much as six times, causing thickening and swelling of the retina and leading to blindness. Another study which was reported in the American Heart Association Journal in August, 2010, associated Actos with an increased risk of death due to congestive heart failure. Although the FDA had mandated a black box warning for Actos regarding possible heart failure risks in 2007, the warnings became even more stringent this past June.

Actos® and Myocardial Infarction

Actos® and Myocardial Infarction

After a Journal of American Medical Association publication of a meta-analysis suggested that long-term use of the diabetes drug Avandia was associated with an increased risk of myocardial infarction, the maker of Avandia, GlaxoSmithKline, declared there was little difference in the safety profile of their drug, Avandia and the “other” drug for Type 2 diabetes, Takeda Pharmaceutical’s Actos. Further studies however have not completely backed up that declaration. In nineteen separate controlled trials, involving over 16,000 patients, the end results demonstrated that while 4.4 percent of the patients who received Actos underwent myocardial infarction or stroke 5.7 percent of patients receiving control therapy suffered a myocardial infarction.

In the same studies, serious heart failure was reported in 2.3 percent of those taking Actos, while only occurring in 1.8 percent of those in the control group. The author of the results of the studies, Michael Lincoff, stated that not only does Actos—also known as pioglitazone—not appear to have the same level of detrimental effects as Avandia, but it could potentially have a protective effect on the heart. Takeda Pharmaceuticals, currently struggling under the rash of lawsuits filed against them due to evidence that Actos may significantly increase the risk of bladder cancer, does not believe their drug is responsible for episodes of myocardial infarction, or heart attack.

Actos® Damages and Typical Settlements

Actos® Damages and Typical Settlements

The Type 2 diabetes drug Actos is one of a class of drugs known as thiazolidinediones and has recently been linked to an increased risk of bladder cancer, liver disease and cardiovascular issues. The FDA felt that the link between heart failure and Actos was serious enough to require increased warnings on the drug packaging concerning congestive heart failure. According to the Washington Post on 8/05/11, the first of what is expected to be literally thousands of lawsuits was filed alleging the use of Actos resulted in bladder cancer. Takeda Pharmaceuticals, a Japanese corporation is the manufacturer of Actos although it was jointly launched with the American company, Eli Lilly. Actos quickly became a top-seller of the giant pharmaceutical corporations, becoming the tenth best-selling drug in the United States in 2008 with sales over 2.5 billion dollars increasing to a staggering 4.3 billion in 2010.

In June of 2011, Takeda halted its sales of Actos in both France and Germany after receiving considerable pressure from health regulators in both those countries. New Zealand is currently in the process of pulling the drug as well. Since June, both the FDA and the European Medicines Agency have prudently issued warnings regarding the potential risk of bladder cancer for those taking the drug, but are allowing the continuation of sales pending further studies. The FDA has, however, warned doctors not to prescribe the drug for those who have a history of bladder cancer or who currently have bladder cancer.

Actos® European Recall and FDA Stance

Actos® European Recall and FDA Stance

A wave of recent studies which definitively link the prescription drug Actos—prescribed for Type 2 diabetes—to bladder cancer gives a fairly clear indication that Takeda Pharmaceuticals may soon be flooded with Actos lawsuits. August, 2011, saw the first Actos lawsuit filed by a 54-year old woman from Pennsylvania who had taken Actos for over a decade, then was diagnosed with bladder cancer. It is likely this particular victim may end up having her bladder removed and be subject to chemotherapy treatments due to the unexpected and severe side effects of Actos. Although the FDA has made substantial changes in labeling for Actos, they have refused to go as far out on the limb as other countries who have issued recalls of the drug.

France’s Medical Regulatory Agency made the decision to recall Actos once the serious side effects became known. Some 230,000 people regularly take Actos in France, and the possibility of an increase in bladder cancer was felt to be too great to allow patients to continue to take the drug. Soon after, Germany’s health regulators advised physicians to stop prescribing Actos for their patients with Type 2 diabetes due to the potentially dangerous side effects of the drug. These recalls and prohibitions were made after the European Medicines Agency conducted its own study of drugs which contained pioglitazone.

Actos® FDA Safety Review/Warning

Actos® FDA Safety Review/Warning

On June 15, 2011, the United States Food and Drug Administration informed the public that using the drug Actos, commonly prescribed in the treatment of Type 2 diabetes, has been positively associated with an increased risk of bladder cancer. Actos is manufactured by a Japanese pharmaceutical company, Takeda Pharmaceuticals, and is typically sold either as a single-ingredient product or in combination with the drug metformin. Actos is prescribed, along with diet and exercise, to help control blood sugar in adults. Initially the FDA’s safety warnings were based on a five-year interim analysis of an ongoing ten year study regarding the risks for those taking Actos.

While the study at the five-year mark noted an increased risk of bladder cancer among those who had taken Actos in the highest dosages and for the longest periods of time, it was unclear about the overall increased bladder cancer risk. Two other countries, France and Germany, have taken more definitive actions regarding Actos, believing it poses serious health risks. While France has suspended the use of Actos altogether, Germany has recommended to physicians that they not start new patients on the drug. New Zealand is currently in the midst of recalling the drug, yet the FDA continues to maintain that further study is warranted before issuing more stringent warnings.

Actos® Side Effects other than Heart Disease and Bladder Cancer

Actos® Side Effects other than Heart Disease and Bladder Cancer

Osteoporosis and Bone Fractures
While many people are now aware of the association between the Type 2 diabetes drug, Actos, and both bladder cancer and heart disease, there are several other quite serious side effects also associated with the drug. For instance, there is strong evidence to suggest that Actos, like its sister-drug, Avandai, may cause osteoporosis and bone fractures among those taking it, most especially in female patients. In one particular randomized trial which studied patients with Type 2 diabetes who were currently taking Actos, an increased occurrence of bone fractures was observed in the female patients and in a follow-up study at nearly three years, almost 5.1% of the females taking Actos had suffered a bone fracture.

Most of the bone fractures were seen in arms and legs, and there was no apparent escalation of fracture occurences among male patients. Because this drug study lasted less than five years, it is strongly believed that a much greater frequency of fractures and osteoporosis would be seen in women taking Actos for longer periods of time. Since men typically have much stronger bones than women, fractures and osteoporosis would probably not have been seen in men who were studied for only a few years. Since broken hipbones happen to be a primary killer of the elderly, seniors should not take Avandia or Actos as their benefits do not appear to outweigh the serious side effects.

Macular Edema
A study presented at the yearly meeting of the American Diabetes Association this past June found that those taking Actos have a three to six times increased risk of developing macular edema. Macular edema causes an eye disease in which the retina swells and thickens and can lead to permanent blindness. Diabetic eye disease is now the most common cause of blindness in those younger than age 65, and although the best way to avoid this particular side-effect of diabetes is by keeping your blood sugar under control, Actos appears to increase the risk of macular edema even though it does control the blood sugar.

Weight Gain
Weight gain also appears to be a side effect of Actos, however it must be noted that there is significant difference between a slow weight gain as the result of the drug and a rapid weight gain which could signal congestive heart failure. Rapid weight gain is any more than five pounds in a week, and should be a reason to consult your physicians immediately. On average, those taking Actos gained from two to six pounds over a period of four months to six months, while those patients not taking Actos lost about three pounds during the same time period.

In patients who were taking both Actos and insulin or other oral diabetes medications, the weight gain increased to between nine and ten pounds on average. Patients taking higher dosages of Actos gained larger amounts of weight than those taking lower doses, however those whose weight gain was related to fluid retention likely suffered more serious cardiovascular problems. Actos has been shown to worsen congestive heart failure or in some cases cause it. A primary initial symptom of congestive heart failure is an unexplained, quick weight gain, so it is important for those taking Actos to monitor their weight regularly.

Liver Disease
Patients who have shown signs of prior liver disease should not take Actos or any other drug in the thiazolidinedione class. These drugs have been definitively associated with significant elevations in liver enzymes, jaundice, liver failure and death due to liver failure. These liver problems have been seen both in long-term and short-term patient use of Actos. Any patients taking Actos should be aware of the potential liver problems, and should report any unexplained nausea, vomiting, fatigue, dark urine or abdominal pain to their physician immediately. If jaundice develops the medication should be immediately discontinued. Those taking Actos who show even a moderate increase in liver enzymes should continue the drug only with their physician’s approval, and with great caution. If Actos use has led to a seriously impaired liver, a liver transplant may be necessary. Conversely, while Actos has been shown to potentially cause liver enzymes to increase to serious levels, there is medical evidence which shows Actos may actually provide beneficial effects in treating fatty liver disease. Several studies have shown that Actos can reduce the liver fats by half in less than half a year.

Other Serious Side Effects
Actos has also been known to cause allergic reactions, blurry vision, easy bruising or bleeding, flu-like symptoms, muscle pain and serious tooth pain and problems. Actos is contraindicated in those who are scheduled for an upcoming surgery or have any type of known allergy to foods, dyes or preservatives. Women who are pregnant or thinking of becoming pregnant, or those who are breastfeeding should not take Actos as it is considered a Pregnancy Category C drug meaning it is not considered safe to take when pregnancy is a possibility. Actos can also pass into breast milk, so should definitely not be taken by women who are currently breastfeeding. Actos can also potentially interact with other prescription drugs as well as non-prescription medications, vitamins and herbal supplements, so it is important that your doctor be aware of everything you take regularly. While bladder cancer and cardiovascular problems are the most serious of the known side effects of Actos, the side effects listed above can also have potentially serious consequences.

FDA Issues Sterner Warnings to Manufacturers of Diabetic Drug Actos

FDA Issues Sterner Warnings to Manufacturers of Diabetic Drug Actos

Although the FDA issued recommendations regarding labeling cautions for the drug Actos to manufacturer Takeda Pharmaceuticals in 2006, following further safety reviews of the drug they have recently issued more stringent instructions to the Japanese company. Actos, also known as pioglitazone is used in the treatment of Type 2 diabetes to help control the levels of sugar in the blood.

Drugs Included, Safety Updates Required
In a letter to Takeda Pharmaceuticals the FDA states that supplemental new drug applications for Actos, Actoplus Met, Actoplus Met XR and Duetact were duly received and processed, and noted receipt of certain amendments and risk evaluation assessments relating to Actos. Takeda was notified of new safety information which the FDA deemed to be a necessary inclusion of any future labeling of Actos. Further, the FDA stated the safety updates must specifically address the potential risk in increase of bladder cancer in those taking higher dosages or taking the drug for extended periods of time.

Specific Changes to Labeling of Actos
The FDA asked that Takeda include under the warnings and precautions area of the Actos label a statement that preclinical and clinical trials had shown pioglitazone users experienced an increase in incidence of bladder cancer. The Actos labels must state that those who have bladder cancer or a prior history of bladder cancer should be extremely cautious when using the drug. The label must additionally state that statistical significance in bladder cancer risk is reached in those patients taking Actos for longer than two years. More specifically, the wording that taking Actos longer than twelve months increases the risk of developing bladder cancer to a 40% statistical probability is to be included.

Takeda Pharmaceuticals Received FDA Instructions for Diabetic Drug Actos

Takeda Pharmaceuticals Received FDA Instructions for Diabetic Drug Actos

The drug Actos, also known as pioglitazone, has recently come under fire due to studies showing a slight increased risk of bladder cancer in those taking high doses of the drug or those who have taken Actos for longer than two years. Manufactured by Takeda Pharmaceuticals of Japan, the drug has shown huge gains in popularity in the past few years as it quickly replaced the drug Avandia which suffered under claims of increased risk of heart attack and death. Actos is Takeda’s tenth best-selling drug, making over $3.4 billion dollars in the past year alone. While the recent safety reviews have alarmed many who are currently taking the drug, in fact there have been safety concerns regarding Actos for several years.

Warnings are Not New
As far back as 2006, the FDA issued instructions to Takeda regarding Actos and ActoPlus Met, advising the company to make specific label changes to the drug’s precautionary statements. These label changes were to specifically include information regarding reports of bladder cancer in those taking Actos. Takeda’s supplemental drug applications regarding Actos were approved conditionally, so long as the agreed-upon text was included in the drug’s labeling.

The FDA stipulated that the final printed label be identical to the proposed labeling changes, and required Takeda to submit an electronic version of the proposed label as well as 20 paper copies and fifteen copies mounted on heavy-weight paper, however final approval was not mandated prior to using the labels. Although these FDA instructions took place nearly five years ago, it was only recently that more stringent warnings regarding Actos were issued.

FDA Approves Cancer Warning for Diabetic Drug Actos

FDA Approves Cancer Warning for Diabetic Drug Actos

The blockbuster drug, Actos, which is prescribed to control Type 2 diabetes, has received new warning language on the label regarding a potential risk of bladder cancer for those taking the drug. Actos, also known as pioglitazone, is manufactured by Takeda Pharmaceuticals, a Japanese-based company, and is currently their best-selling drug, with sales of $3.4 billion last year alone. Sales of Actos had shown a significant upswing due to the fact that its primary competitor—Avandia—has been linked to a higher risk of heart attack and even death. The updated label warnings came on the heels of an EMA safety review of the drug as well as a ten-year study conducted by Takeda. The Takeda study indicated a statistically significant increase in the risk of bladder cancer for those taking the drug for longer than two years.

Other Drugs Containing Pioglitazone
Other than Actos, the drugs ActoPlus Met, ActoPlus Met XR and Duetact will all carry the same warnings due to containing pioglitazone as an active ingredient.  All of these drugs are used to treat Type 2 diabetes, to increase sensitivity to insulin and effectively control blood sugar levels. A combination drug containing metformin and pioglitazone is used for the same purpose, although all these drugs are expected to be used in conjunction with a healthy diet and sensible exercise program.

France and Germany Weigh In
Just this past June, both France and Germany issued recalls of Actos following a public insurance data review which showed a fairly strong correlation between pioglitazone and bladder cancer risk. Suggestions from the EMA study related primarily to including more cautionary warnings on the labels of the drug as well as a six-month review of each patient taking Actos.

European Medicines Agency Scientific Studies on Pioglitazone

European Medicines Agency Scientific Studies on Pioglitazone
The European Medicines Agency released a scientific study on the benefits and risks of the drug pioglitazone, also known as Actos, in January of 2007. This drug is currently used as a single treatment for Type 2 diabetes or in a dual combination form with metformin or sulphonylurea. When used alone, pioglitazone is typically used as therapy for the overweight patient whose Type 2 diabetes is not being controlled through diet and exercise and for whom the drug metformin is inappropriate. The combination drug is most often used in those patients who have insufficient glycemic control despite taking metformin alone or for those patients who have shown a level of intolerance to metformin. The results of the study showed that when pioglitazone was prescribed in conjunction with other anti-diabetic therapies such as insulin, the risk of macrovascular disease was greatly reduced. Macrovascular disease is common in those with long-term diabetes and refers to a disease of the large blood vessels in the body.

Clinical Support for Pioglitazone Application
Evidence was submitted which supported the application of pioglitazone, including four clinical trial reports which studied the safety of the drug when used in conjunction with insulin therapy. The studies were conducted according to prevailing ethical standards, and were random, double-blind, placebo controlled.

First Pioglitazone Study—PNFP-014
Pioglitazone was administered both in 15 mg dosages as well as 30 mg dosages in combination with insulin then compared with using insulin therapy alone. Participants in the studies were between the ages of 30 and 75, and had been on a fixed dose of insulin for at least a month prior to beginning the study. The mean baseline age was 57 years, with an average BMI of 33.6. Nearly 3/4ths of the participants in the study were Caucasian, with slightly more than half being female. Although the baseline systolic blood pressure was minimally higher in the group receiving pioglitazone plus insulin as opposed to the group receiving insulin alone, there were no other baseline variables involved. The patients who received both pioglitazone and insulin showed statistical decreases in the HbA1c levels which measure the average amount of sugar in the blood over a period of three months, and is different from glucose measurements. The HbA1c levels essentially give the physician an indication of how well the diabetes is being controlled.

Pioglitazone Receives New Warnings Due to Slight Increase in Bladder Cancer Risk

Pioglitazone Receives New Warnings Due to Slight Increase in Bladder Cancer Risk

The health review of the Type 2 diabetic drug, pioglitazone, performed by the European Medicines Agency, confirmed the drug remains a valid treatment option for certain patients while acknowledging a minimal increase in bladder cancer risk. The caveat in the conclusions of the health review centered upon advising physicians to use care and caution when prescribing the drug. The results further stated that those who are prescribed pioglitazone—especially those who take relatively high doses or have taken the drug for longer than a year—must have their overall health monitored closely.  Exclusion of certain higher risk groups, such as the elderly is also recommended.

Assessing Risk Factors in Potential Patients
Physicians are warned to screen patients carefully, and avoid prescribing pioglitazone to those who have a history of bladder cancer or who currently have bladder cancer. Patients with uninvestigated macroscopic haematuria are also advised against taking pioglitazone.  As stated, age carries a specific risk, as the elderly are already more likely to develop bladder cancer based solely on age. Because of this an alternative diabetes medication with less risk in this area should be prescribed. Patients taking Actos should undergo regular 3-6 month reviews to assess and monitor benefit vs. risk.

Sources of Information
In making its safety recommendations, the Committee for Medicinal Products for Human Use considered results of pre-clinical and clinical studies as well as spontaneous reports and epidemiological studies. The Scientific Advisory Group on Diabetes also weighed in with advice regarding pioglitazone. The CHMP concluded from this array of evidence that while there is a slight increase in bladder cancer among those taking pioglitazone, this risk exists primarily in those who take the drug for long periods of time or in relatively high doses. That being said, those who take the drug for a short amount of time cannot be excluded from the risks.

No Recall Yet for Type 2 Diabetes Drug, Actos

The FDA has joined forces with France and Germany regarding a warning about the Type 2 diabetes drug, pioglitazone, however no recall is expected at this time. Pioglitazone, also known as Actos, is manufactured by Takeda Pharmaceuticals, a Japanese drug company. The drug currently accounts for some 27% of Takeda’s annual revenues. 2008 saw this powerhouse diabetes medication become the tenth best-selling prescription medication in the United States. Over the past year, Takeda has accrued nearly $4.8 billion dollars in revenues through worldwide sales of Actos.

Clinical Studies of Pioglitazone
Pre-clinical studies—in which male rats were given body-weight equivalent doses of Actos—showed an increase in the incidence of bladder cancer while two subsequent clinical studies using human subjects also revealed an elevated risk of bladder cancer. Due to these findings, the FDA mandated that the potential risks be revealed on the label of the drug, ordering a safety review in September, 2010.  Takeda additionally agreed to carry out a ten-year observational study in those diabetic patients currently taking Actos, to be conducted on patients from Kaiser Permanente Northern California Health Plan.

Benefit-Risk Balance Deemed Positive for Type 2 Diabetics Taking Pioglitazone

Benefit-Risk Balance Deemed Positive for Type 2 Diabetics Taking Pioglitazone

Following safety reviews of the drug pioglitazone—a medicine used in the treatment of Type 2 diabetes—the European Medicines Agency delivered their decision that while there is a marginally increased risk of bladder cancer in those taking the drug, it remains a viable treatment option for some patients. Pioglitazone, also sold under the brand name Actos, is used along with a sensible diet and exercise program to increase the body’s sensitivity to insulin, thereby controlling blood sugar levels.

Reducing Potential Risks
The EMA’s conclusions following extensive study of the drug was that the slight increased risk of bladder cancer could be alleviated through implementation of a more stringent screening of potential patients. Medical professionals are warned against prescribing pioglitazone in any patients with a history of bladder cancer, and to exercise caution when prescribing the drug to the elderly as well. Those patients deemed good candidates for pioglitazone should nonetheless be monitored closely every three to six months to ensure the benefits continue to outweigh the risks.

High Doses, Significant Duration Linked
The results of the controlled epidemiological studies determined that the small risk associated with pioglitazone was seen primarily in those patients who took the drug for significant lengths of time and in the highest doses. Even though the studies showed only a 0.15% increase in risk of bladder cancer this does not mean that those who are prescribed the drug for short term use have no risk at all of contracting bladder cancer.