When the FDA issued its second warning regarding Actos bladder cancer this past summer, many diabetics taking the drug wondered why they were being told to continue using Actos and why it wasn’t being recalled. With well over one million Americans with Type 2 diabetes using Actos to control their blood sugar, this seems to be playing out like Avandia. Avandia is the diabetes drug that was found to cause heart attacks, strokes and other forms of cardiovascular disease. The first FDA Actos warning was for heart attacks, but an FDA Actos cancer warning was issued in September of 2010 and then an update to that warning was issued in June of 2011. Because Actos is similar in composition to Avandia, much of the initial focus on the drug’s safety was regarding cardiovascular disease, despite some of the earliest Actos safety studies showing increased occurrence of bladder cancer. Actos was approved by the FDA in 1999 and a ten-year safety study evaluating the increased risk of bladder cancer after taking Actos was ordered. Recent Actos bladder cancer medical studies in Europe have drawn a more substantial link between the drug’s usage and greater risk of developing bladder cancer. The pharmaceutical regulatory bodies in France and Germany saw fit to remove Actos from the market, in France to all users and just to new users in Germany. Because it was estimated that an additional 50,000 heart attacks were caused because Avandia was allowed to remain on the market after initial serious safety issues were voiced, and that Avandia and Actos have had similar numbers of people using them, concerns over Actos bladder cancer are that it could be as bad, if not worse than Avandia.