- What brand names are available for rosiglitazone/metformin?
- What are the uses for rosiglitazone/metformin?
- What are the side effects of rosiglitazone/metformin?
- What is the dosage for rosiglitazone/metformin?
- Which drugs or supplements interact with rosiglitazone/metformin?
- Is rosiglitazone/metformin safe to take if I'm pregnant or breastfeeding?
- What else should I know about rosiglitazone/metformin?
What brand names are available for rosiglitazone/metformin?
Avandamet
Is rosiglitazone/metformin available as a generic drug?
Yes
Do I need a prescription for rosiglitazone/metformin?
Yes
What are the uses for rosiglitazone/metformin?
Avandamet is used with diet and exercise to improve blood glucose control in adult patients with type 2 diabetes.
What are the side effects of rosiglitazone/metformin?
The most common side effects include
- nausea,
- vomiting,
- diarrhea, and
- upset stomach.
Taking Avandamet with food may help lessen some of these side effects. Other commonly reported side effects include
- headache,
- cold-like symptoms,
- joint aches, and
- dizziness.
Rare but serious side effects include new or
- worsening heart failure,
- heart attack,
- edema or swelling (water retention),
- weight gain,
- liver problems,
- macula edema (a diabetic eye disease with swelling in the back of the eye),
- bone fractures,
- low red blood cell count,
- low blood glucose (hypoglycemia), and
- ovulation (increasing the chance of pregnancy).
Metformin can cause a rare but serious condition known as lactic acidosis, a build-up of acid in the blood. Lactic acidosis can cause death and requires immediate treatment. Symptoms of lactic acidosis include
- tiredness,
- weakness,
- unusual muscle pain,
- pain in the stomach,
- difficulty breathing,
- dizziness, and
- slow or irregular heartbeat.
Patients suspected of have signs or symptoms of lactic acidosis must seek emergency medical help.
What is the dosage for rosiglitazone/metformin?
The dosage of Avandamet should be individualized based on patient response and tolerability. It is generally given in divided doses with meals.
For patients inadequately controlled on diet and exercise
- Generally, the recommended starting dose of Avandamet is 2/500 mg administered once or twice daily.
- A starting dose of 2/500 mg twice daily may be considered for patients with HbA1c >11% or fasting plasma glucose (FPG) >270 mg//dL.
- If patients are not adequately controlled after 4 weeks of treatment the dosage may be increased in increments of 2/500 mg as necessary.
- The maximum daily dose of Avandamet is 8/2,000 mg.
For patients inadequately controlled on rosiglitazone or metformin monotherapy
- The selection of the dose of Avandamet must be based on the patient's current doses of rosiglitazone and/or metformin.
- To switch to Avandamet for patients currently treated with metformin
- The usual starting dose of Avandamet is 4 mg rosiglitazone and base the metformin dose on the current dose of metformin.
- To switch to Avandamet for patients currently treated with rosiglitazone
- The usual starting dose of Avandamet is 1,000 mg metformin and the corresponding dose of rosiglitazone that the patient is taking.
The safety and efficacy of Avandamet has not been established in pediatric patients. Therefore, use of Avandamet in this patient population is not recommended.
Metformin-containing drugs may be safely used in patients with mild to moderate renal impairment. Renal function should be assessed before starting treatment and at least yearly.
Metformin should not be used by patients with an estimated glomerular filtration rate (eGFR) below 30 mL/minute/1.73 m2 and starting metformin in patients with an eGFR between 30-45 mL/minute/1.73 m2 is not recommended.
Metformin should be stopped at the time of or before administering iodinated contrast in patients with an eGFR between 30 and 60 mL/minute/1.73 m2; in patients with a history of liver disease, alcoholism, or heart failure; or in patients who will be administered intra-arterial iodinated contrast. Kidney function should be evaluated 48 hours after receiving contrast and metformin may be restarted if kidney function is stable.

QUESTION
______________ is another term for type 2 diabetes. See AnswerWhich drugs or supplements interact with rosiglitazone/metformin?
Rosiglitazone is extensively metabolized or broken down by a group of liver enzymes known as CYP2C8. Gemfibrozil (Lopid), a known inhibitor of CYP2C8 may increase blood levels of rosiglitazone and consequently increase the risk of side effects. Concomitant use of agents that also inhibit CYP2C8 requires a reduction in the dose of rosiglitazone.
Rifampin (Rimactane or Rifadin), a known inducer of CYP2C8, increases the breakdown of rosiglitazone. Therefore, concomitant use of agents that induce CYP2C8 may decrease the effectiveness of rosiglitazone.
Drugs which cause blood glucose levels to increase may diminish the effectiveness of Avandamet therapy. These drugs include
- thiazides,
- other diuretics,
- corticosteroids,
- phenothiazines,
- thyroid medications,
- estrogens,
- birth control pills,
- phenytoin (Dilantin),
- nicotinic acid,
- sympathomimetics,
- calcium channel blockers (CCBs), and
- isoniazid (Nydrazid).
Is rosiglitazone/metformin safe to take if I'm pregnant or breastfeeding?
- Avandamet has not been adequately evaluated in pregnant women. Due to the lack of conclusive safety data, Avandamet should be used in pregnancy only if the potential benefit justifies the potential risk to the fetus. Avandamet is classified as FDA pregnancy risk category C.
- It is not known if Avandamet is excreted in breast milk. Due to the lack of safety data, Avandamet is not recommended for use in nursing mothers.
What else should I know about rosiglitazone/metformin?
What preparations of rosiglitazone/metformin are available?
Oral tablets containing Avandamet: 2/500, 4/500, 2/1,000, and 4/1,000 mg.
How should I keep rosiglitazone/metformin stored?
- Tablets should be stored at room temperature, between 15 C and 30 C (59 F and 86 F).
- Tablets should be dispensed and stored in an air-tight, light-resistant container.
Summary
Avandamet (rosiglitazone and metformin) is a combination drug prescribed to treat type 2 diabetes in conjunction with exercise and diet. Side effects include upset stomach, vomiting, nausea, diarrhea, headache, dizziness. Drug interactions, dosage, storage, and pregnancy and breastfeeding information should be reviewed prior to taking this medication.
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Related Disease Conditions
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Diabetes (Type 1 and Type 2)
Diabetes 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.
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Type 2 Diabetes Diet Plan
A type 2 diabetes diet or a type 2 diabetic diet is important for blood sugar (glucose) control in people with diabetes to prevent complications of diabetes. There are a variety of type 2 diabetes diet eating plans such as the Mediterranean diet, Paleo diet, ADA Diabetes Diet, and vegetarian diets.Learn about low and high glycemic index foods, what foods to eat, and what foods to avoid if you have type 2 diabetes.
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High Blood Sugar (Hyperglycemia)
Hyperglycemia or high blood sugar is a serious health problem for diabetics. There are two types of hyperglycemia, 1) fasting, and 2)postprandial or after meal hyperglycemia. Hyperglycemia can also lead to ketoacidosis or hyperglycemic hyperosmolar nonketotic syndrome (HHNS). There are a variety of causes of hyperglycemia in people with diabetes. Symptoms of high blood sugar may include increased thirst, headaches, blurred vision, and frequent urination.Treatment can be achieved through lifestyle changes or medications changes. Carefully monitoring blood glucose levels is key to prevention.
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Low Blood Sugar (Hypoglycemia)
Low blood sugar or hypoglycemia occurs when blood sugar is dangerously low and is often complication of type 1 and type 2 diabetes. Learn about symptoms, dangers, and treatment.
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Stroke
A stroke is an interruption of the blood supply to part of the brain caused by either a blood clot (ischemic) or bleeding (hemorrhagic). Symptoms of a stroke may include weakness, numbness, double vision or vision loss, confusion, vertigo, difficulty speaking, or understanding speech. A physical exam, imaging tests, neurological exam, and blood tests may be used to diagnose a stroke. Treatment may include administration of clot-busting drugs, supportive care, and in some instances, neurosurgery. The risk of stroke can be reduced by controlling high blood pressure, high cholesterol, diabetes, and stopping smoking.
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Type 2 Diabetes: Diagnosing Diabetes
Second Source WebMD Medical Reference
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Type 2 Diabetes
Type 2 diabetes is a chronic condition that may be reversible with diet and lifestyle changes. Symptoms include excessive thirst, frequent urination, weight loss, fatigue, and an unusual odor to your urine. Most people don't know they have type 2 diabetes until they have a routine blood test. Treatment options include medications, a type 2 diabetes diet, and other lifestyle changes.
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Diabetes Treatment: Medication, Diet, and Insulin
The major goal in treating diabetes is controlling elevated blood sugar without causing abnormally low levels of blood sugar. Type 1 diabetes is treated with: insulin, exercise, and a diabetic diet. 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.
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How to Prevent Diabetes Naturally
Prediabetes is a condition in which a person has early symptoms of diabetes, but has not yet fully developed the condition. If prediabetes is not treated with lifestyle changes, the person could develop type 2 diabetes. Type 2 diabetes and prediabetes can be prevented with lifestyle changes, for example, eating a healthy diet, getting more exercise, reducing stress, quitting smoking, reducing or managing blood pressure and cholesterol, and managing any other health conditions or risk factors that you may have for developing type 2 diabetes.
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Diabetes Foot Problems
Diabetes related foot problems can affect your health with two problems: diabetic neuropathy, where diabetes affects the nerves, and peripheral vascular disease, where diabetes affects the flow of blood. Common foot problems for people with diabetes include athlete's foot, fungal infection of nails, calluses, corns, blisters, bunions, dry skin, foot ulcers, hammertoes, ingrown toenails, and plantar warts.
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Eye Problems and Diabetes
Diabetes and eye problems are generally caused by high blood sugar levels over an extended period of time. Types of eye problems in a person with diabetes include glaucoma, cataracts, and retinopathy. Examples of symptoms include blurred vision, headaches, eye aches, pain, halos around lights, loss of vision, watering eyes. Treatment for eye problems in people with diabetes depend on the type of eye problem. Prevention of eye problems include reducing blood pressure, cholesterol levels, quitting smoking, and maintaining proper blood glucose levels.
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Types of Diabetes Type 2 Medications
Type 2 diabetes oral medications are prescribed to treat type 2 diabetes in conjuction with lifestyle changes like diet and exercise. There are nine classes of drugs approved for the treatment of type 2 diabetes. Examples of type 2 oral diabetes medications include acarbose (Precose), chlorpropamide (Diabinese), glipizide (Glucotrol, Glucotrol XL), and metformin (Glucophage). Side effects, drug interactions, warnings and precautions, dosage, and breastfeeding and pregnancy safety information should be reviewed prior to taking any medication.
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Tips for Managing Type 1 and 2 Diabetes at Home
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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