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Important information about Avandia (Rosiglitazone):Avandia.com:"Avandia is contraindicated in patients with known hypersensitivity to Avandia or any one of its components. Avandia should not be used in type 1 diabetes or for the treatment of diabetic ketoacidosis. Avandia in combination with insulin may increase the risk of serious heart problems. Because of this, talk to your doctor before using Avandia and insulin together. Avandia may cause fluid retention or swelling, which could lead to or worsen heart failure, so tell your doctor if you have a history of these conditions. Avandia is not for everyone. If you have severe heart failure or active liver disease, Avandia is not recommended. If you experience an unusually rapid increase in weight, swelling or shortness of breath while taking Avandia, talk to your doctor immediately. Avandia should be used with caution in patients with edema. Also, blood tests to check for serious liver problems should be conducted before and during Avandia therapy. Tell your doctor if you have liver disease, or if you experience unexplained tiredness, stomach problems, dark urine or yellowing of skin while taking Avandia" http://www.avandia.com/global/important_info.jsp General Precautions with Avandia (Rosiglitazone):fda.gov:"In drug testing, Avandia did not cause liver toxicity or an increase in liver enzymes. However, Avandia is in the same class of drugs as Rezulin, which has been associated with rare but serious liver injury, including liver failure leading to transplant or death. Because Avandia’s liver safety profile is not fully determined yet, your doctor will do blood tests that evaluate your liver before starting you on Avandia. These blood tests should be repeated every two months for the first year, then regularly after that. Call your health care provider right away if you develop nausea, vomiting, stomach pain, a feeling of tiredness, or having no energy, loss of appetite, dark urine, or jaundice (yellow coloring of eyes and skin). These may be symptoms of liver problems. When taking Avandia with other oral diabetes medicines, there is a risk of your blood sugar becoming dangerously low. Ask your health care provider abut symptoms of low blood sugar, conditions that make low blood sugar more likely, and what to do if you get it. Make sure to explain to family members. If you are a woman who has not reached menopause but have not had menstrual periods; you may become pregnant unless you use an effective method of birth control. Avandia, like other drugs in this class, may cause insulin resistant women to start ovulating again. Women should tell their doctor if they notice any changes in their monthly menstrual cycle. During periods of stress on the body, such as fever, trauma, infection, or surgery, your medication requirements may change; contact your health care provider promptly." http://www.fda.gov/cder/consumerinfo/druginfo/avandia.htm Who should avoid taking Avandia (Rosiglitazone)?:Joslin diabetes Center:"Avandia should not be taken by people with a history of liver problems or severe heart problems. If you have a history of these disorders, discuss it with your health care team. People with type 1 diabetes will not need Avandia. The safety of using Avandia in pregnant women has not been established. A woman should tell her healthcare provider immediately if she becomes pregnant or is planning to become pregnant so the right medication can be prescribed." http://www.joslin.harvard.edu/education/library/avandia.shtml Why is Avandia (Rosiglitazone) prescribed?:gettingwell.com:"Avandia is used to hold down blood sugar levels in people with type 2 diabetes (also known as "non-insulin dependent" or "adult onset" diabetes). Blood sugar levels are ordinarily controlled by the body's natural supply of insulin, which helps sugar move out of the bloodstream and into the cells. In type 2 diabetes, the buildup of sugar in the blood is often due not to a lack of insulin, but to the body's inability to make proper use of it. Avandia works first by decreasing sugar production, then by helping the body make more efficient use of whatever insulin is available. It does not increase the actual amount of insulin in circulation. Avandia is a new type of diabetes medication. It can be used alone or in conjunction with metformin (Glucophage) or a member of the sulfonylurea class of diabetes drugs (Diabinese, Micronase, Orinase). It takes effect slowly. You may not see a reduction in blood sugar levels for the first 2 weeks of therapy, and it may take 2 to 3 months for the medication to deliver maximum results" http://www.gettingwell.com/drug_info/rxdrugprofiles/drugs/AVA1532.shtml Avandia (Rosiglitazone) drug class and mechanism:diabetesnet.com:"Thiazolidinediones or glitazones are the first class of oral medication designed to reverse the basic problem in Type 2 diabetes, resistance to insulin. Insulin resistance also appears to cause most cases of high blood pressure, as well as the high triglyceride plus low HDL cholesterol problem that puts many people at risk for heart disease. The drugs in this group, Avandia and Actos, reverse insulin resistance by improving sensitivity of insulin receptors in muscle, liver and fat cells. They improve sensitivity partly by reducing levels of inflammatory particles like tumor necrosis factor alpha and PPAR gamma. They also help keep the liver from overproducing glucose. They have been shown to lower blood sugar levels about 15% while at the same time lowering insulin levels by 20%. These drugs have some effect on cholesterol levels, either varied or slightly beneficial. Blood pressure and triglyceride levels are also lowered, while HDL levels are raised" http://www.diabetesnet.com/diabetes_treatments/actos_avandia.php Avandia (Rosiglitazone) clinical results:centerwatch.com:"A total of 2315 patients with type II diabetes, previously treated with diet alone or antidiabetic medication(s), were treated with Avandia as monotherapy in six double-blind studies, which included two 26-week placebo-controlled studies, one 52-week glyburide-controlled study, and three placebo-controlled dose-ranging studies of 8 to 12 weeks duration. Previous antidiabetic medication(s) were withdrawn and patients entered a 2 to 4 week placebo run-in period prior to randomization. Two 26-week, double-blind, placebo-controlled trials, in patients with type 2 diabetes with inadequate glycemic control (mean baseline FPG approximately 228 mg/dL and mean baseline HbA1c 8.9%), were conducted. Treatment with Avandia produced statistically significant improvements in FPG and HbA1c compared to baseline and relative to placebo" http://www.centerwatch.com/patient/drugs/dru528.html What is Avandia (Rosiglitazone) used for? :rezulinnewsletter.com:"Avandia, in addition to diet and exercise, improves blood sugar control in adults with type 2 (non-insulin-dependent) diabetes. Avandia can be used alone or in combination with a sulfonylurea or metformin, when diet, exercise, and one of these agents or diet, exercise, plus Avandia alone are not enough to control blood sugar." http://www.rezulinnewsletter.com/Avandia_diabetes_drug_info_from_FDA.htm What are the precautions when taking Avandia (Rosiglitazone)?:healthtrust.com:"Wear disease medical alert identification for diabetes. Do not use if you have liver disease. Talk with healthcare provider. Use caution if you have high cholesterol (increases bad cholesterol). Talk with healthcare provider. Use caution if you have a weakened heart. May cause water weight gain. Talk with healthcare provider. Watch for weight gain. Tell healthcare provider if you are allergic to any medicine. Make sure to tell about the allergy and how it affected you. This includes telling about rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, throat; or any other symptoms involved. This medicine can cause ovulation in premenopausal women who have not been ovulating. Birth control may need to be considered. Tell healthcare provider if you are pregnant or plan on getting pregnant. Tell healthcare provider if you are breast-feeding" http://www.healthtrust.com/intmed/Access2Cons2/ConsDrugs/Rosiglitazonecd.shtml Avandia (Rosiglitazone) side effects and drug interactions:rxlist.com:"There were a small number of patients treated with Avandia who had adverse events of anemia and edema. Overall, these events were generally mild to moderate in severity and usually did not require discontinuation of treatment with Avandia. In double-blind studies, anemia was reported in 1.9% of patients receiving Avandia compared to 0.7% on placebo, 0.6% on sulfonylureas and 2.2% on metformin. Edema was reported in 4.8% of patients receiving Avandia compared to 1.3% on placebo, 1.0% on sulfonylureas, and 2.2 % on metformin. Overall, the types of adverse experiences reported when Avandia was used in combination with metformin were similar to those during monotherapy with Avandia. Reports of anemia (7.1%) were greater in patients treated with a combination of Avandia and metformin compared to monotherapy with Avandia. Lower pre-treatment hemoglobin/hematocrit levels in patients enrolled in the metformin combination clinical trials may have contributed to the higher reporting rate of anemia in these studies" http://www.rxlist.com/cgi/generic2/rosigl_ad.htm Avandia (Rosiglitazone) Treatment May Arrest Diabetes Progression:metabolism.com:"Over 80% of people with diabetes in the United States have the form known as Type 2 . This type of diabetes can generally be treated successfully, at least initially, with oral medication. A major study of Type 2 diabetes published in the early 1990’s from the United Kingdom (the UKPDS study) showed that patients taking oral medication or even insulin itself tended to have worsening of their diabetes control over the years they were studied. Since the time of that study a new class of oral medication known as the ‘glitazones’ has shown promise to prevent what otherwise seemed to be inevitable worsening of diabetes control. Glitazones work differently from other diabetes therapies by entering the cells to the body to make them more sensitive to insulin. Earlier medications appear to act by raising the level of insulin in the blood or effecting glucose (sugar) metabolism. A study of diabetics taking the glitazone, Avandia, (rosiglitazone), revealed that blood sugar control remained constant over 2.5 years of treatment and did not deteriorate as with the other medication types." http://www.metabolism.com/news/2001-10-21/ Search Nursing Diabetics http://www.nursingdiabetics.com/A-Z_list/ ******************************************************
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