Manufacturer of Avandia
GlaxoSmithKline
Also know under brand names: Avandia
Active ingredient / generic name: rosiglitazone (oral)
Approximate US Retail Price for Avandia 2 mg (60 ea): $145.99
4 mg (30 ea): $114.99
8 mg (30 ea): $214.00
Short leafletAvandia is an anti-diabetic drug in the thiazolidinedione class of drugs. It is marketed by the pharmaceutical company GlaxoSmithKline as a stand-alone drug (Avandia) and in combination with metformin (Avandamet) or with glimepiride (Avandaryl). Recent findings suggest that Avandia is associated with a statistically significant risk of cardiovascular disease events.
Like other thiazolidinediones, the mechanism of action of Avandia is by activation of the intracellular receptor class of the peroxisome proliferator-activated receptors (PPARs), specifically PPARγ. Avandia is a selective ligand of PPARγ, and has no PPARα-binding action.
Apart from its effect on insulin resistance, it appears to have an anti-inflammatory effect: nuclear factor kappa-B (NFκB) levels fall and inhibitor (IκB) levels increase in patients on Avandia.
Recent research has suggested that Avandia may also be of benefit to a subset of patients with Alzheimer's disease not expressing the ApoE4 allele. This is the subject of a clinical trial currently underway.
The medication might also be effective in the treatment of mild to moderate Ulcerative Colitis, due to its antiinflammatory properties as a PPAR ligand.
A press release by GlaxoSmithKline in February 2007 noted that there is a greater incidence of fractures of the upper arms, hands and feet in female diabetics given Avandia compared with those given metformin or glyburide. The information was based on data from the ADOPT trial.
An article by Dr. Steven Nissen and his colleague Kathy Wolski in the June 14, 2007 issue of The New England Journal of Medicine reported that the use of Avandia was associated with a slightly increased risk of heart attack (20% more likely, odds ratio=1.43). The FDA issued an alert on May 21, 2007.
On July 30, 2007 an Advisory Committee of the Food and Drug Administration concluded that the use of Avandia for the treatment of type 2 diabetes was associated with a greater risk of myocardial ischemic events (including heart attacks) than a placebo, metformin, or sulfonylurea. The FDA Advisory Committee recommended that label warnings and educational efforts to this effect be instituted immediately. An article by the committee chairman, Dr. Clifford J. Rosen, called "The Avandia Story -- Lessons from an FDA Advisory Committee Meeting" appeared in the August 30, 2007 issue of The New England Journal of Medicine.
Pioglitazone, the other thiazolidinedione on the market, was found not to have the same risks as Avandia. Indeed, a study sponsored by its manufacturer Takeda Pharmaceutical Co. found that it reduces the risk of heart attack, stroke and death, but - like Avandia - increases the risk of heart failure.
Avandia: Patient Education
Do not use rosiglitazone if you have type 1 diabetes, or if you are in a state of
diabetic ketoacidosis (call your doctor for treatment with insulin).
Before taking rosiglitazone, tell your doctor if you have congestive heart failure or heart
disease, a history of heart attack or stroke, liver disease, or eye problems caused by diabetes.
Know the signs of low blood sugar (hypoglycemia) and how to recognize them,
including hunger, headache, confusion, irritability, drowsiness, weakness, dizziness, tremors,
sweating, fast heartbeat, seizure (convulsions), fainting, or coma (severe hypoglycemia can be
fatal). Always keep a source of sugar available in case you have symptoms of low blood sugar.
Some women using rosiglitazone have started having menstrual periods, even after
not having a period for a long time due to a medical condition. You may be able to get pregnant
if your periods restart. Talk with your doctor about the need for birth control.
Women may also be more likely than men to have bone fractures in the upper arm,
hand, or foot while taking rosiglitazone. Talk with your doctor if you are concerned about this
possibility.
Rosiglitazone is an oral diabetes medicine that help control blood sugar levels.
Rosiglitazone is for people with type 2 (non-insulin-dependent) diabetes. Rosiglitazone is
sometimes used in combination with insulin or other medications, but it is not for treating type 1
diabetes.
Rosiglitazone may also be used for purposes other than those listed in this medication
guide.
Do not use rosiglitazone if you have type 1 diabetes, or if you are in a state of
diabetic ketoacidosis (call your doctor for treatment with insulin).
Before taking this medication, tell your doctor if you have:
congestive heart failure or heart disease;
a history of heart attack or stroke;
liver disease; or
eye problems caused by diabetes.
If you have any of these conditions, you may not be able to use
rosiglitazone, or you may need a dosage adjustment or special tests during treatment.
Some women using rosiglitazone have started having menstrual periods, even after
not having a period for a long time due to a medical condition. You may be able to get pregnant
if your periods restart. Talk with your doctor about the need for birth control.
Women may also be more likely than men to have bone fractures in the upper arm,
hand, or foot while taking rosiglitazone. Talk with your doctor if you are concerned about this
possibility.
FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell
your doctor if you are pregnant or plan to become pregnant during treatment.
It is not known whether rosiglitazone passes into breast milk or if it could harm a
nursing baby. Do not take rosiglitazone without first talking to your doctor if you are
breast-feeding a baby.
Take this medication exactly as it was prescribed for you. Do not take the medication in
larger or smaller amounts, or take it for longer than recommended by your doctor. Your doctor
may occasionally change your dose to make sure you get the best results from this medication.
Rosiglitazone is usually taken in the morning and evening. You may take the medicine
with or without food.
Rosiglitazone is only part of a complete program of treatment that also includes diet,
exercise, and weight control. Your doctor may also recommend other medicines to treat your
diabetes.
It is important to use this medicine regularly to get the most benefit. Get your
prescription refilled before you run out of medicine completely.
To be sure this medication is helping your condition, your blood will need to be tested on
a regular basis. Your liver function may also need to be tested, and you may need regular eye
exams. It is important that you not miss any scheduled visits to your doctor.
Your medication needs may change if you become sick or injured, if you have a serious
infection, or if you have any type of surgery. Your doctor may want you to stop taking
rosiglitazone for a short time if any of these situations affect you.
Take care not to let your blood sugar get too low, causing hypoglycemia. You may have
hypoglycemia if you skip a meal, exercise too long, drink alcohol, or are under stress.
Know the signs of low blood sugar (hypoglycemia) and how to recognize them:
hunger, headache, confusion, irritability;
drowsiness, weakness, dizziness, tremors;
sweating, fast heartbeat;
seizure (convulsions); or
fainting, coma (severe hypoglycemia can be fatal).
Always keep a source of sugar available in case you have symptoms of
low blood sugar. Sugar sources include orange juice, glucose gel, candy, or milk. If you have
severe hypoglycemia and cannot eat or drink, use an injection of glucagon. Your doctor can give
you a prescription for a glucagon emergency injection kit and tell you how to give the injection.
Store rosiglitazone at room temperature away from moisture, heat, and light.
Take the missed dose as soon as you remember. If it is almost time for your next dose,
skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.
Seek emergency medical attention if you think you have used too much of this
medicine. You may have signs of low blood sugar, such as hunger, headache, confusion,
irritability, drowsiness, weakness, dizziness, tremors, sweating, fast heartbeat, seizure
(convulsions), fainting, or coma.
Avoid drinking alcohol while taking rosiglitazone. Alcohol lowers blood sugar and
may increase the risk of hypoglycemia while you are taking this medicine.
Get emergency medical help if you have any of these signs of an allergic
reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Stop using rosiglitazone and call your doctor at once if you have any of these serious
side effects:
feeling short of breath, even with mild exertion;
swelling or rapid weight gain;
chest pain or heavy feeling, pain spreading to the arm or
shoulder, sweating, general ill feeling;
nausea, stomach pain, low fever, loss of appetite, dark
urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
blurred vision;
increased thirst or hunger, urinating more than usual; or
pale skin, easy bruising or bleeding, weakness.
Continue taking this medication and talk to your doctor if you have
any of these less serious side effects:
sneezing, runny nose, cough or other signs of a cold;
headache;
gradual weight gain;
mild diarrhea; or
back pain.
Side effects other than those listed here may also occur. Talk to your
doctor about any side effect that seems unusual or that is especially bothersome.
You may be more likely to have hyperglycemia (high blood sugar) if you are taking
rosiglitazone with other drugs that raise blood sugar. Drugs that can raise blood sugar include:
isoniazid;
diuretics (water pills);
steroids (prednisone and others);
phenothiazines (Compazine and others);
thyroid medicine (Synthroid and others);
birth control pills and other hormones;
seizure medicines (Dilantin and others); and
diet pills or medicines to treat asthma, colds or allergies.
You may be more likely to have hypoglycemia (low blood sugar) if
you are taking rosiglitazone with other drugs that lower blood sugar. Drugs that can lower blood
sugar include:
nonsteroidal anti-inflammatory drugs (NSAIDs);
aspirin or other salicylates (including Pepto-Bismol);
sulfa drugs (Bactrim and others);
a monoamine oxidase inhibitor (MAOI);
beta-blockers (Tenormin and others); or
probenecid (Benemid).
Some medications may interact with rosiglitazone. Tell your doctor if
you are using any of the following drugs:
gemfibrozil (Gemcor); or
rifampin (Rifater, Rifadin, Rimactane).
If you are using any of these drugs, you may not be able to take
rosiglitazone, or you may require a dosage adjustment or special monitoring.
There may be other drugs not listed that can affect rosiglitazone. Tell your doctor about
all the prescription and over-the-counter medications you use. This includes vitamins, minerals,
herbal products, and drugs prescribed by other doctors. Do not start using a new medication
without telling your doctor.
Your pharmacist has additional information about rosiglitazone written for health
professionals that you may read.
Avandia: Dosingdiabetes mellitus, type 2: 4-8 mg/day PO div qd-bid: Start: 4 mg PO qd or 2 mg PO bid; Max: 8 mg/day if monotx or in combo w/ metformin and/or sulfonylurea; 4 mg/day in combo w/ insulin
renal dosing: no adjustment: HD: no supplement
hepatic dosing: see below: ALT<2.5x ULN: caution advised; active liver dz/ALT>2.5x ULN: avoid use
Avandia: Drug Interactions
Avandia vs A2R blocker/HCTZ combos: monitor glucose: combo may decr. hypoglycemic agent efficacy; thiazides may cause hyperglycemia and antagonistic effects. A2R blocker/HCTZ combos: also know as candesartan/hydrochlorothiazide, eprosartan/hydrochlorothiazide, hydrochlorothiazide/irbesartan, hydrochlorothiazide/losartan, hydrochlorothiazide/olmesartan, hydrochlorothiazide/valsartan, telmisartan/hydrochlorothiazide
Avandia vs acarbose: monitor glucose; use for therapeutic advantage: combo may incr. risk of hypoglycemia and synergistic effects
Avandia vs ACE inhibitor/HCTZ combos: monitor glucose: combo may decr. hypoglycemic agent efficacy; thiazides may cause hyperglycemia and antagonistic effects. ACE inhibitor/HCTZ combos: also know as benazepril/hydrochlorothiazide, captopril/hydrochlorothiazide, enalapril/hydrochlorothiazide, fosinopril/hydrochlorothiazide, hydrochlorothiazide/lisinopril, hydrochlorothiazide/moexipril, hydrochlorothiazide/quinapril
Avandia vs amprenavir: monitor glucose: combo may decr. hypoglycemic agent efficacy and antagonistic effects, protease inhibitors cause hyperglycemia and insulin resistance
Avandia vs androgens: monitor glucose: combo may incr. risk of hypoglycemia and androgens may cause hypoglycemia. Androgens: also know as danazol, methyltestosterone, testosterone buccal, testosterone cypionate, testosterone topical, testosterone transdermal
Avandia vs antihist/decongest/DM combos: monitor glucose: combo may decr. hypoglycemic agent efficacy; decongestants may cause hyperglycemia and antagonistic effects. Antihist/decongest/DM combos: also know as brompheniramine/dextromethorphan/pseudoephedrine, chlorpheniramine/phenylephrine/dextromethorphan
Avandia vs antihist/decongestant combos: monitor glucose: combo may decr. hypoglycemic agent efficacy; decongestants may cause hyperglycemia and antagonistic effects. Antihist/decongestant combos: also know as acrivastine/pseudoephedrine, brompheniramine/phenylephrine, chlorpheniramine/phenylephrine, chlorpheniramine/pseudoephedrine, pseudoephedrine/triprolidine
Avandia vs antipsychotics, atypical: monitor glucose: combo may decr. hypoglycemic agent efficacy; atypical antipsychotics may cause hyperglycemia and antagonistic effects. Antipsychotics, atypical: also know as aripiprazole, clozapine, olanzapine, paliperidone, quetiapine, risperidone, ziprasidone
Avandia vs aprepitant: monitor glucose: combo may decr. rosiglitazone levels, efficacy and hepatic metab. induced
Avandia vs atazanavir: monitor glucose: combo may incr. rosiglitazone levels, risk of hypoglycemia; combo may decr. hypoglycemic agent efficacy and hepatic metab. inhibited; antagonistic effects, protease inhibitors cause hyperglycemia and insulin resistance
Avandia vs baclofen: monitor glucose: combo may decr. hypoglycemic agent efficacy; baclofen may rarely cause hyperglycemia and mechanism unknown
Avandia vs barbiturates: monitor glucose: combo may decr. hypoglycemic agent efficacy and hepatic metab. induced. Barbiturates: also know as butabarbital, methohexital, pentobarbital, phenobarbital, primidone, secobarbital, thiopental
Avandia vs beta blocker/thiazide combos: monitor glucose: combo w/ beta blockers may alter glucose metab., prolong hypoglycemia, mask hypoglycemic sx; thiazides may cause hyperglycemia and adrenergic antagonism; antagonistic effects. Beta blocker/thiazide combos: also know as atenolol/chlorthalidone, bendroflumethiazide/nadolol, bisoprolol/hydrochlorothiazide, hydrochlorothiazide/metoprolol, hydrochlorothiazide/propranolol, hydrochlorothiazide/timolol
Avandia vs beta blockers, systemic: monitor glucose: combo may alter glucose metab., prolong hypoglycemia, mask hypoglycemic sx and adrenergic antagonism. Beta blockers, systemic: also know as acebutolol, atenolol, betaxolol, bisoprolol, carvedilol, esmolol, labetalol, metoprolol, nadolol, nebivolol, penbutolol, pindolol, propranolol, timolol
Avandia vs bortezomib: monitor glucose: combo may alter glycemic control, incr. risk of hypoglycemia, hyperglycemia and mechanism unknown
Avandia vs budesonide: monitor glucose: combo may decr. hypoglycemic agent efficacy; corticosteroids may cause hyperglycemia and antagonistic effects
Avandia vs contraceptives, oral combo: monitor glucose: combo may decr. hypoglycemic agent efficacy; estrogens may cause hyperglycemia and antagonistic effects. Contraceptives, oral combo: also know as desogestrel/ethinyl estradiol, drospirenone/ethinyl estradiol, ethinyl estradiol/ethynodiol, ethinyl estradiol/levonorgestrel, ethinyl estradiol/norethindrone, ethinyl estradiol/norgestimate, ethinyl estradiol/norgestrel, mestranol/norethindrone
Avandia vs contraceptives, other combo: monitor glucose: combo may decr. hypoglycemic agent efficacy; estrogens may cause hyperglycemia and antagonistic effects. Contraceptives, other combo: also know as ethinyl estradiol/norelgestromin transdermal, etonogestrel/ethinyl estradiol vaginal
Avandia vs corticosteroids, systemic: monitor glucose: combo may decr. hypoglycemic agent efficacy; corticosteroids may cause hyperglycemia and antagonistic effects. Corticosteroids, systemic: also know as cortisone, dexamethasone, dexamethasone sodium phosphate, hydrocortisone, hydrocortisone sodium succinate, methylprednisolone, methylprednisolone acetate, methylprednisolone sodium succinate, prednisolone, prednisone, triamcinolone
Avandia vs darunavir: monitor glucose: combo may decr. hypoglycemic agent efficacy and antagonistic effects, protease inhibitors cause hyperglycemia and insulin resistance
Avandia vs decongest/opiate combos: monitor glucose: combo may decr. hypoglycemic agent efficacy; decongestants may cause hyperglycemia and antagonistic effects. Decongest/opiate combos: also know as guaifenesin/hydrocodone/phenylephrine
Avandia vs decongestants: monitor glucose: combo may decr. hypoglycemic agent efficacy; decongestants may cause hyperglycemia and antagonistic effects. Decongestants: also know as desloratadine/pseudoephedrine, fexofenadine/pseudoephedrine, guaifenesin/phenylephrine, guaifenesin/pseudoephedrine, loratadine/pseudoephedrine, pseudoephedrine
Avandia vs diazoxide: monitor glucose: combo may decr. hypoglycemic agent efficacy; diazoxide causes hyperglycemia and antagonistic effects
Avandia vs disopyramide: monitor glucose; caution advised especially if elderly, or impaired hepatic, renal fxn: combo may incr. risk of hypoglycemia, disopyramide may cause hypoglycemia and mechanism unknown
Avandia vs diuretics, loop: monitor glucose: combo may decr. hypoglycemic agent efficacy; loop diuretics may cause hyperglycemia and antagonistic effects. Diuretics, loop: also know as bumetanide, ethacrynic acid, furosemide, torsemide
Avandia vs diuretics, potassium-sparing/HCTZ: monitor glucose: combo may decr. hypoglycemic agent efficacy; thiazides may cause hyperglycemia and antagonistic effects. Diuretics, potassium-sparing/HCTZ: also know as amiloride/hydrochlorothiazide, hydrochlorothiazide/spironolactone, hydrochlorothiazide/triamterene
Avandia vs diuretics, thiazide: monitor glucose: combo may decr. hypoglycemic agent efficacy; thiazides may cause hyperglycemia and antagonistic effects. Diuretics, thiazide: also know as chlorothiazide, chlorthalidone, chlorthalidone/clonidine, hydralazine/hydrochlorothiazide, hydrochlorothiazide, indapamide, methyclothiazide, metolazone
Avandia vs ethanol: caution advised, monitor glucose: combo may prolong hypoglycemia and hepatic gluconeogenesis altered
Avandia vs fosamprenavir: monitor glucose: combo may decr. hypoglycemic agent efficacy and antagonistic effects, protease inhibitors cause hyperglycemia and insulin resistance
Avandia vs gatifloxacin: caution advised, monitor glucose: combo may alter glycemic control, incr. risk of hypoglycemia, hyperglycemia and mechanism unknown
Avandia vs gemfibrozil: monitor glucose: combo may incr. pioglitazone or rosiglitazone levels, risk of hypoglycemia or other adverse effects and hepatic metab. inhibited
Avandia vs growth hormone: monitor glucose: combo may decr. hypoglycemic agent efficacy and antagonistic effects, growth hormone causes hyperglycemia, insulin resistance. Growth hormone: also know as somatropin recombinant
Avandia vs HRT, estrogen: monitor glucose: combo may decr. hypoglycemic agent efficacy; estrogens may cause hyperglycemia and antagonistic effects. HRT, estrogen: also know as estradiol, estradiol acetate, estradiol cypionate, estradiol topical, estradiol transdermal, estradiol vaginal, estradiol valerate, estrogens, conjugated, estrogens, conjugated synthetic, estrogens, conjugated B synthetic, estrogens, conjugated vaginal, estrogens, esterified, estrogens, esterified/methyltestosterone, estropipate
Avandia vs HRT, estrogen/progestin combo: monitor glucose: combo may decr. hypoglycemic agent efficacy; estrogens may cause hyperglycemia and antagonistic effects. HRT, estrogen/progestin combo: also know as drospirenone/estradiol, estradiol/levonorgestrel transdermal, estradiol/norethindrone acetate, estradiol/norethindrone acetate transdermal, estradiol/norgestimate, estrogens, conjugated/medroxyprogesterone, ethinyl estradiol/norethindrone acetate
Avandia vs indinavir: monitor glucose: combo may decr. hypoglycemic agent efficacy and antagonistic effects, protease inhibitors cause hyperglycemia and insulin resistance
Avandia vs insulins: monitor glucose, adverse effects; use for therapeutic advantage: combo may incr. risk of hypoglycemia, fluid retention, edema, weight gain, CHF and additive effects. Insulins: also know as insulin aspart, insulin aspart protamine/insulin aspart, insulin detemir, insulin glargine, insulin glulisine, insulin inhaled, insulin lispro, insulin lispro protamine/insulin lispro, insulin NPH, insulin NPH/regular, insulin regular
Avandia vs isoniazid: monitor glucose: combo may decr. hypoglycemic agent efficacy; isoniazid may cause hyperglycemia and antagonistic effects
Avandia vs isoniazid/pyrazinamide/rifampin: monitor glucose: combo may decr. rosiglitazone levels, hypoglycemic agent efficacy; isoniazid may cause hyperglycemia and hepatic metab. induced; antagonistic effects
Avandia vs isoniazid/rifampin: monitor glucose: combo may decr. rosiglitazone levels, hypoglycemic agent efficacy; isoniazid may cayse hyperglycemia and hepatic metab. induced
Avandia vs lanreotide: monitor glucose: combo may alter glycemic control, lanreotide may cause hyperglycemia or hypoglycemia and pancreatic hormone effects
Avandia vs levofloxacin: caution advised, monitor glucose: combo may alter glycemic control, incr. risk of hypoglycemia, hyperglycemia and mechanism unknown
Avandia vs lopinavir/ritonavir: monitor glucose: combo may incr. or decr. rosiglitazone levels; combo may decr. hypoglycemic agent efficacy and hepatic metab. altered; antagonistic effects, protease inhibitors cause hyperglycemia and insulin resistance
Avandia vs mecasermin recombinant: monitor glucose: combo may incr. risk of hypoglycemia and additive effects. Mecasermin recombinant: also know as mecasermin recombinant, mecasermin rinfabate recombinant
Avandia vs metformin: monitor glucose, adverse effects; use for therapeutic advantage: combo may incr. risk of hypoglycemia, fluid retention, edema, weight gain and additive effects
Avandia vs metformin/sulfonylurea combos: monitor glucose, adverse effects; use for therapeutic advantage: combo may incr. risk of hypoglycemia, fluid retention, edema, weight gain and additive effects. Metformin/sulfonylurea combos: also know as glipizide/metformin, glyburide/metformin
Avandia vs miglitol: monitor glucose; use for therapeutic advantage: combo may incr. risk of hypoglycemia and synergistic effects
Avandia vs nateglinide: monitor glucose; use for therapeutic advantage: combo may incr. risk of hypoglycemia and synergistic effects
Avandia vs nelfinavir: monitor glucose: combo may decr. hypoglycemic agent efficacy and antagonistic effects, protease inhibitors cause hyperglycemia and insulin resistance
Avandia vs niacin: monitor glucose: combo may decr. hypoglycemic agent efficacy; niacin may cause hyperglycemia and antagonistic effects
Avandia vs niacin/lovastatin: monitor glucose: combo may decr. hypoglycemic agent efficacy; niacin may cause hyperglycemia and antagonistic effects
Avandia vs nicotine: monitor glucose: combo may decr. hypoglycemic agent efficacy; nicotine may cause hyperglycemia and antagonistic effects. Nicotine: also know as nicotine gum, nicotine inhaled, nicotine lozenge, nicotine nasal, nicotine transdermal
Avandia vs octreotide: monitor glucose: combo may alter glycemic control, octreotide may cause hyperglycemia or hypoglycemia and pancreatic hormone effects
Avandia vs pegvisomant: monitor glucose: pegvisomant may incr. glucose tolerance, reduce need for antidiabetic tx and antagonism of growth hormone-mediated effects on insulin sensitivity
Avandia vs pentamidine: caution advised, monitor glucose: combo may alter glycemic control; pentamidine may cause hypoglycemia followed by hyperglycemia and pancreatic beta cell toxicity
Avandia vs phenothiazines: monitor glucose: combo may decr. hypoglycemic agent efficacy; phenothiazines may cause hyperglycemia and antagonistic effects. Phenothiazines: also know as chlorpromazine, fluphenazine, fluphenazine decanoate, perphenazine, prochlorperazine edisylate, prochlorperazine maleate, prochlorperazine rectal, promethazine, promethazine rectal, thioridazine, trifluoperazine
Avandia vs phenytoins: monitor glucose: combo may decr. rosiglitazone levels, hypoglycemic agent efficacy; phenytoins may cause hyperglycemia and hepatic metab. induced; antagonistic effects. Phenytoins: also know as fosphenytoin, phenytoin
Avandia vs pramlintide: monitor glucose; may need to further adjust coadministered insulin doses: combo may incr. risk of hypoglycemia and additive synergistic effects
Avandia vs repaglinide: monitor glucose; use for therapeutic advantage: combo may incr. risk of hypoglycemia and synergistic effects
Avandia vs rifabutin: monitor glucose: combo may decr. hypoglycemic agent efficacy and hepatic metab. induced
Avandia vs rifampin: monitor glucose: combo may decr. rosiglitazone levels, efficacy and hepatic metab. induced
Avandia vs rifapentine: monitor glucose: combo may decr. pioglitazone, rosiglitazone levels, efficacy and hepatic metab. induced
Avandia vs ritonavir: monitor glucose: combo may incr. or decr. rosiglitazone levels; combo may decr. hypoglycemic agent efficacy and hepatic metab. altered; antagonistic effects, protease inhibitors cause hyperglycemia and insulin resistance
Avandia vs saquinavir: monitor glucose: combo may decr. hypoglycemic agent efficacy and antagonistic effects, protease inhibitors cause hyperglycemia and insulin resistance
Avandia vs sitagliptin/metformin: monitor glucose, adverse effects; use for therapeutic advantage: combo may incr. risk of hypoglycemia, fluid retention, edema, weight gain and additive/synergistic effects
Avandia vs sotalol: monitor glucose: combo may alter glucose metab., prolong hypoglycemia, mask hypoglycemic sx and adrenergic antagonism. Sotalol: also know as sotalol, sotalol AF
Avandia vs sulfonylureas: monitor glucose, adverse effects; use for therapeutic advantage: combo may incr. risk of hypoglycemia, fluid retention, edema, weight gain and additive effects. Sulfonylureas: also know as chlorpropamide, glimepiride, glipizide, glyburide, glyburide micronized, tolazamide, tolbutamide
Avandia vs sympathomimetics, all: monitor glucose: combo may decr. hypoglycemic agent efficacy; sympathomimetics may cause hyperglycemia and antagonistic effects. Sympathomimetics, all: also know as dobutamine, dopamine, ephedrine, epinephrine, isoproterenol, norepinephrine, phenylephrine, terbutaline
Avandia vs thyroid hormones: monitor glucose: combo may decr. hypoglycemic agent efficacy; high dose thyroid hormone may cause hyperglycemia and antagonistic effects. Thyroid hormones: also know as levothyroxine, liothyronine, liotrix, thyroid desiccated
Avandia vs tipranavir: monitor glucose: combo may incr. or decr. rosiglitazone levels; combo may decr. hypoglycemic agent efficacy and hepatic metab. altered; antagonistic effects, protease inhibitors cause hyperglycemia and insulin resistance
Avandia vs vorinostat: monitor glucose: combo may decr. hypoglycemic agent efficacy; vorinostat may cause hyperglycemia and antagonistic effects
Avandia vs exenatide: use for therapeutic advantage: combo may incr. risk of hypoglycemia and additive effects
Avandia vs montelukast: caution advised: combo may incr. thiazolidinedione levels, risk of hypoglycemia or other adverse effects and hepatic metab. inhibited
Avandia vs pregabalin: caution advised: combo may incr. risk of edema, weight gain and additive effects
Avandia vs sorafenib: caution advised: combo may incr. thiazolidinedione levels, risk of hypoglycemia or other adverse effects and hepatic metab. inhibited
Avandia: Adverse Reactions
hypoglycemia (combo tx)
CHF, new or worsening
MI
angina
pleural effusion
pulmonary edema
hepatotoxicity
diabetic macular edema (rare)
anaphylactic rxn (rare)
angioedema (rare)
Stevens-Johnson syndrome (rare)
fractures (female pts)
URI
headache
fluid retention
edema
weight gain
anemia, dilutional
dypsnea
hypoglycemia (combo tx)
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