- What is rosiglitazone, and how does it work (mechanism of action)?
- What are the side effects of rosiglitazone?
- What is the dosage for rosiglitazone?
- Which drugs or supplements interact with rosiglitazone?
- Is rosiglitazone safe to take if you are pregnant or breastfeeding?
- What else should you know about rosiglitazone?
What is rosiglitazone, and how does it work (mechanism of action)?
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.
What are the side effects of rosiglitazone?
AND PRECAUTIONS The most common side effects seen with rosiglitazone alone or in combination with metformin are:
- upper respiratory tract infection,
- back pain,
- hyperglycemia (elevated blood sugar),
- diarrhea, and
- hypoglycemia (low blood sugar).
Rosiglitazone has been shown to cause mild to moderate accumulation of fluid (edema) and can lead to heart failure. Patients who already have heart failure may develop worsening symptoms with rosiglitazone. Therefore, rosiglitazone should not be used by patients with heart failure. Rosiglitazone also has been associated with an increased risk of chest pain and heart attacks. The risk of heart attacks may be greater in those with established heart disease and taking nitrates or individuals receiving insulin.
Other important side effects include:
- anemia with rosiglitazone alone or combined with metformin.
- weight gain, and
- Increased risk of bone fractures in women who received rosiglitazone for 4 to 6 years.
What is the dosage for rosiglitazone?
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.
Which drugs or supplements interact with rosiglitazone?
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.
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Is rosiglitazone safe to take if you are pregnant or breastfeeding?
- There are no adequate studies of rosiglitazone in pregnant women. Rosiglitazone crosses the placenta and is detectable in fetal tissue.
- It is unknown if rosiglitazone is secreted in breast milk. Therefore, the safety of rosiglitazone to nursing infants also is unknown.
Rosiglitazone (Avandia) is a drug prescribed for the treatment of type 2 diabetes combined with diet and exercise. Avandia is only prescribed under strict FDA regulations to patients who have not responded to treatment with other diabetic medications such as pioglitazone (Actos). Rosiglitazone (Avandia) is to be used in combination with exercise, smoking cessation, diet, and weight control for effective diabetes treatment. Side effects, drug interactions, warnings and precautions, and pregnancy safety information should be reviewed prior to taking any medication.
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Managing your diabetes is a full time commitment. The goal of diabetic therapy is to control blood glucose levels and prevent the complications of diabetes. Information about exercise, 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 will enable you to mange your diabetes at home successfully.
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You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
FDA Prescribing Information for Avandia.