rosiglitazone, Avandia (cont.)

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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.

SIDE EFFECTS AND PRECAUTIONS: The most common side effects seen with rosiglitazone alone or in combination with metformin are upper respiratory tract infection, headache, back pain, hyperglycemia (elevated blood sugar), fatigue, sinusitis, diarrhea, and hypoglycemia (low blood sugar).



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