Rosiglitazone

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Rosiglitazone is an anti-diabetic drug in the thiazolidinedione class of drugs and is used to treat type 2 diabetes known as non-insulin dependant diabetes mellitus. It can be used alone or combined with metformin or with a sulphonylurea or with both. It’s function is to reduce insulin resistance in fatty tissue, the skeletal muscles and in the liver. The knock on effect is the reduction of blood glucose levels. The drug does not act instantly as its effects appear gradually reaching their full potential in about 8 weeks.The drug can be used as a stand alone but is more likely used in combination with other drugs being prescribed alongside, such as metformin or a sulphonylurea (derivatives are a class of antidiabetic drugs that are used in the management of diabetes mellitus type 2 (“adult-onset”), if metformin is contraindicated (A condition which makes a particular treatment or procedure inadvisable). They act by increasing insulin release from the beta cells in the pancreas

Although rosiglitazone can cause weight gain as well as adverse effects on LDL cholesterol levels it works much better in obese diabetic individuals and treatment with this drug can produce significant improvements in diabetic control. There are reports that say rosiglitazone contributes signiicanty to the risk of heart attacks however, there are other reports that disagree with these finding.

Detailed Information

Avandia (discontinued in the UK – November 2010).

Quick Guide

• Antidiabetic drug with overdose danger – HIGH.
• Dependency is said to be – LOW.
• Prescription only drug – YES.
• Available as generic – NO. (generic drugs, short: generics) is a drug which is produced and distributed without patent protection.
• Alcohol Avoidance – NO.
• Alcohol no special problems.

Side Effects

You may if prescribed rosiglitazone suffer one or more of these side effects, in the initial stages. However, you may find you do not suffer any at all. It does not follow that being on this medication will cause unwanted side effects.

Common: Nausea, indigestion, Wind (flatulence), Abdominal Pain, Fatigue, Weakness, Headache, Weight Gain.
Rare: Night Cough, Painful Breathing, Dark Urine, Sleepiness, Pins and Needles, Swollen Ankles, dizziness.

Note: If you start to feel sick for no apparent reason, or suffer loss of appetite, dark urine, or stomach pains contact your doctor immediately. You also need to be aware there could be changes in your vision, if there are any see your doctor or optician as soon as possible.

The side effects listed here are the most common and rare problems reported by patients using rosiglitazone It may not include all of the side effects reported by the drug’s manufacturer. If common side effects persist you need to inform your doctor. Notify your doctor if you suffer any of the rare or some other side effects not listed here. For total peace of mind, seek information from your doctor or chemist.

Prolonged Use

Rosiglitazone is used as an indefinite treatment, you will also need to have regular blood tests to check your blood sugar, cholesterol levels and liver function. Heart performance will be monitored on a regular basis, and your weight should be measured at regular intervals.

Driving, Hazardous Work & Alcohol

Apart from being aware of how your diabetes affects you keeping safety in mind at all times there should be no special problems, as far as the drug goes, with these areas. This also applies to alcohol.

Pregnancy and Breast-Feeding

Safety in pregnancy or breast feeding has not been established. You should discuss both issues with your doctor before you start taking rosiglitazone .

Rosiglitazone is classified as a Pregnancy Category C Medicine, by the U.S. Food and Drug Administration (FDA). Category C… Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

Tell Your Doctor or Pharmacist

You should tell your doctor if you have a current health problem. For example: heart disease, kidney problems, if you are pregnant or you intend to become pregnant, or if you think you may be at risk from drug treatment for any other reason. Some types of medication can cause serious adverse effects when taken side by side so it is important to tell your doctor of any other medication you are already taking. This should also include any over-the-counter medication. For example: Painkillers, cold remedies, herbal and complimentary / alternative medication.

Over 60’s & Children

Rosiglitazone should not cause any problems for the older generation. This drug is not recommended for children.

Overdose

Never take more than the prescribed dose, if you have or you know someone who has seek immediate medical advice in all cases. If there is a loss of consciousness you need to take emergency action take the individual to your nearest accident and emergency department in your local hospital taking with you the container (even if it is empty) and any tablets that may be left, with you.

Surgery and Dental Treatment

Discuss with your dentist, surgeon or doctor before you under-go any surgery. Rosiglitazone may need to be stopped before having a general anaesthetic. If you find you need to take painkillers following a tooth extraction do not use Aspirin choose another type (eg. paracetamol). This is because Aspirin is used to thin the blood and this would interfere with the body’s natural clotting ability.

Other Medication Reactions

MHRA (Medicines and Healthcare products Regulatory Agency)/CHM (Commission on Human Medicines) advise Rosiglitazone should not be used in patients with heart failure or history of heart failure; incidence of heart failure is increased when rosiglitazone is combined with insulin. Rosiglitazone should not be used in patients with acute coronary syndrome. Patients should be closely monitored for signs of heart failure. Rosiglitazone may be associated with a small increased risk of cardiac ischaemia (reduced blood supply) particularly in combination with insulin.

Paclitaxel may reduce the metabolism and increase the effects of rosiglitazone, ace inhibitors may also increase the effects of rosiglitazone, and diazoxide reduces the effects of rosiglitazone. The combination of rosiglitazone and insulin should be used only in exceptional cases, and under close supervision.

Missed A Dose

Take the missed dose as soon as you remember. However, if it is almost time for the next dose, continue the regular dosing schedule. Do not take a double dose to make up for a missed one. Ideally you would have already checked with your doctor. Failing this ring the surgery, check with your pharmacist or speak with your doctor at your next appointment.

Reducing or Stopping Medication

Do not stop taking this rosiglitazone without consulting with your doctor first. It is possible if the drug is stopped abruptly it may lead to a worsening of your condition.

Effect Of Medication (from one dose)

The effects of rosiglitazone can be felt within 1 hour, as already mentioned above it could take up to 8 weeks before the full benefits of this drug is felt. The duration of this drugs actions can be felt for 12 to 24 hours.

Storage and Safety

• Keep your regular appointment with your doctor or diabetic nurse.
• Never take more than the original dosage prescribed by your doctor.
• If your due to have treatment like an operation or dental work tell the person carrying out the treatment which medicines you are taking.
• It is important that you follow any dietary instructions that you have been given by your doctor or diabetic nurse.
• Test for sugar in the blood or urine regularly to check your diabetes is being well controlled.
• When you buy any medicines over-the-counter check with the pharmacist that they are safe to take with your other medicines.
• Never take rosiglitazone if it has past the expiry date shown on the box or container.
• Keep rosiglitazone in its original container, in a cool dry place, away from the reach and eye sight of children.
• Do not discard old or unwanted drugs into your trash, sink or toilet.
• Return all unused or old medicines/drugs to your pharmacist. who will dispose of them, for you, safely.

If rosiglitazone has been prescribed for you never allow anyone else to use it, even if you know or others feel their symptom are similar to your own.

Do not leave your doctors surgery until you have a clear understanding of what the drug your doctor has prescribed for you does, and why you have been prescribed it. It is common for people who do not understand the reason behind there treatment to take their medication correctly.

Reference

British National Formulary – 61st Edition (March 2011) British Medical Association and Royal Pharmaceutical Society of Great Britain, London.