Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Dr. Saltiel received his Pharm.D. from the University of California, San Francisco, in 1980, following undergraduate work at UCLA. At UCSF, he was the recipient of the Outstanding Service Award and the Bowl of Hygeia Award. He completed a residency in clinical pharmacy practice at the University of Illinois, in Chicago.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Rosiglitazone is an oral drug that reduces the
amount of sugar (glucose) in the blood. It is used for treating patients with
type 2 diabetes and is in a class of anti-diabetic drugs called
thiazolidinediones. The other member of this class is pioglitazone (Actos).
Insulin is a hormone produced by the pancreas that is important for controlling
the levels of glucose in the blood. Insulin stimulates the cells of the body to
remove glucose from the blood and thereby lowers the level of glucose in the
blood. Patients with type 2 diabetes cannot make enough insulin or are resistant
to the effects of insulin (insulin resistance). As a result, the cells in their
bodies do not remove enough glucose from the blood, and the level of glucose
rises. Rosiglitazone often is referred to as an "insulin sensitizer" because it
attaches to the insulin receptors on cells throughout the body and causes the
cells to become more sensitive (more responsive) to insulin and remove more
glucose from the blood. At least some insulin must be produced by the pancreas
in order for rosiglitazone to work. Rosiglitazone was approved by the FDA in May
1999.
GENERIC AVAILABLE: No
PRESCRIPTION: Yes
PREPARATIONS: Tablets: 2, 4, and 8 mg.
STORAGE: Tablets should be kept at room temperature, 15-30 C (59-86 F).
PRESCRIBED FOR: Rosiglitazone, combined with
diet and exercise is used for
treating type 2 diabetes in patients who have not responded to other diabetic
medications and cannot take pioglitazone (Actos). Rosiglitazone may be used
alone or in combination with other types of antidiabetic drugs such as
metformin (Glucophage) or sulfonylureas. Since it requires that individuals
produce some insulin to be effective, rosiglitazone is not recommended for use
in type I diabetes where the amount of insulin is very low or absent.
DOSING: Rosiglitazone may be taken once or twice daily, with or without
meals. Daily doses range from 4 to 8 mg either with or without other
antidiabetic medications. There is no additional benefit for doses greater than
8 mg per day.
DRUG INTERACTIONS: Rifampin decreases concentrations in the blood of
rosiglitazone by increasing its breakdown in the liver. Therefore, use of
rifampin may decrease the effectiveness of rosiglitazone.
Gemfibrozil (Lopid) increases the concentration of rosiglitazone in the blood
by reducing its breakdown in the liver. Therefore, rosiglitazone may increase
the side effects of rosiglitazone.
Rosiglitazone should not be combined with nitrates (for example,
isosorbide
dinitrate [Isordil Titradose, Dilatrate-SR, Isochron]). In clinical trials, the risk of chest pain and
heart attacks was
greater in individuals on nitrate therapy.
PREGNANCY: There are no adequate studies of rosiglitazone in
pregnant women.
Rosiglitazone crosses the placenta and is detectable in fetal tissue.
NURSING MOTHERS: It is unknown if rosiglitazone is secreted in
breast milk.
Therefore, the safety of rosiglitazone to nursing infants also is unknown.
Diabetes mellitus is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
The major goal in treating diabetes is controlling elevated blood sugar without causing abnormally low levels of blood sugar. Treatment for type 1 diabetes is with insulin, exercise, and a diabetic diet. Treatment for type 2 diabetes is first treated with weight reduction, a diabetic diet, and exercise. When these measures fail to control the elevated blood sugar, oral medications are used. If oral medications are still insufficient, insulin medications are considered.
The main features of metabolic syndrome include insulin resistance, hypertension (high blood pressure), cholesterol abnormalities, and an increased risk for clotting. Patients are most often overweight or obese. Lifestyle modification such as the Mediterranean diet, exercise, and quitting smoking are the preferred treatment of metabolic syndrome.
Managing your diabetes is important. The goal of diabetic therapy is to control blood glucose levels and prevent the complications of diabetes. Information about exercise, diet diet, and medication will help you manage your diabetes better. Blood glucose reagent strips, blood glucose meters, urine glucose tests, tests for urinary ketones, continuous glucose sensors, and Hemoglobin A1C testing information is also provided in this article.
Diabetes mellitus is a condition in
which the body does not produce enough insulin or the
insulin that is produced is ineffective. Insulin is produced and secreted by the
pancreas and is needed for the proper storage and
utilization of nutrients (glucose, proteins, and fat) by the cells of the body.
Insulin allows nutrients to enter the cells of the body. For example, insulin
allows cells to remove glucose from the blood, and the glucose is used to
generate the energy that is necessary to fuel the activities of the cells. When
insulin is absent or ineffective and the cells receive inadequate amounts of
glucose, the body releases more glucose into the blood in an attempt to overcome
the block to glucose entering the cells. The additional glucose cannot penetrate
the cells, of course, and the glucose levels in the blood rise. High levels of
blood and urine glucose is what causes the symptoms and signs of diabetes. For more, please re...
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