Rosiglitazone and Metformin (Oral)

Rosiglitazone and Metformin is a combination treatment used in conjunction with diet and exercise for managing Type 2 Diabetes.

Overview

Rosiglitazone and Metformin is a combination treatment for Type 2 Diabetes, otherwise known as diabetes mellitus. This prescription is not a cure for the condition, but rather an auxiliary treatment that supports an appropriate diet and exercise plan

How it Works

In essence, both drugs help to regulate high blood sugar levels. Each medicine has a specific role to play in the management of this chronic health condition. For example:

  • Rosiglitazone is prescribed by medical professionals to help Type 2 Diabetics better optimize the use of insulin.
  • Metformin could be thought of a sugar monitor. It's a triple threat to the substance, in that it lowers the stomach's absorption of sugar. In addition, it funnels the liver's dispersal of sugar while generally aiding the body in better redistributing glucose.

In the United States, Rosiglitazone and Metformin is generally dispensed under the trade name "Avandamet", which is taken orally and is only available with a written order from a certified medical provider.

The Main Benefits of Regulating Blood Sugar Levels

Type 2 Diabetes is considered to be a chronic medical condition. The main concerns of not properly managing Type 2 Diabetes are the risk of:

  • Loss of Sexual Function
  • Kidney Failure
  • Losing Eyesight
  • Losing Limbs
  • Nerve-Related Issues

It is therefore important for patients to make every effort to follow their doctor's orders by using Rosiglitazone and Metformin as prescribed and sticking to a meal and exercise regimen.

Conditions Treated

Type Of Medicine

  • Anti-Diabetic Medicine

Side Effects

Most medicines could potentially cause side effects, including Rosiglitazone and Metformin.

Some are more severe than others and most subside with time, with the exception of rare and life-threatening symptoms.

Read the warning signs below for more information or speak to a medical provider if you have questions or concerns about using Rosiglitazone and Metformin.

The Most Common Side Effects of Rosiglitazone and Metformin Include:

  • Congestion in the Ears and/or Nose
  • Coughing
  • Difficulty Breathing - Fast and Shallow
  • Extreme Lethargy
  • Incessant Sneezing
  • Pain in the Muscles or Joins
  • Runny Nose
  • Skin that Looks Pale
  • Sore Throat
  • Spikes in Temperature
  • Voice Changes

The Rare Side Effects of Rosiglitazone and Metformin Include:

  • A Jittery or Shaky Sensation
  • Abnormal Heartbeat
  • Blurred Vision
  • Challenges Getting Up or Moving Around
  • Changes in Urine Color or Volume
  • Cool to the Touch or Pale Looking Skin
  • Edema or Swelling
  • Falling into a Coma
  • Feeling Anxious or Depressed
  • Feeling Confused
  • Feeling Dizzy
  • Feeling Extremely Tired or Sleepy
  • Feeling Nauseous
  • Hallucinations
  • Incessant Headaches
  • Joint Pain
  • Pain in the Back
  • Pain or Cramps in the Muscles
  • Profuse Sweating
  • Rapid Weight Gain
  • Skin Irritation
  • Sudden Hunger or Cravings
  • Veins that Protrude from the Neck

Dosage

As no two patients are the same, Rosiglitazone and Metformin dosage is customized based on a range of factors, including:

  • How Long the Treatment Will Be
  • The Extent of the Type 2 Diabetes
  • The Intervals Between Daily Doses
  • The Medication Strength
  • The Patient's Age
  • The Patient's History of Use of this Combination Treatment
  • The Patient's Pre-Existing Conditions
  • The Patient's Weight

Based on these factors, medical providers will generally write the following orders:

Average Doses of Rosiglitazone and Metformin for Type 2 Diabetes

  • Children: Varies Based on the Discretion of a Medical Provider
  • Adults: 2 mg Rosiglitazone + 500 mg Metformin | 1-2X per Day

Max Daily Dose: 8 mg Rosiglitazone + 2000 mg Metformin

Note: Dose May be Adjusted Based on Patient Tolerance and Effects

Average Doses of Rosiglitazone for Patients Who Currently Take Metformin:

  • Children: Varies Based on the Discretion of a Medical Provider
  • Adults: 4 mg Rosiglitazone + Prescribed Amounts of Metformin | 2X per Day

Note: Dose May be Adjusted Based on Patient Tolerance and Effects

Average Doses of Metformin for Patients Who Currently Take Rosiglitazone

  • Children: Varies Based on the Discretion of a Medical Provider
  • Adults: 1000 mg Metformin + Prescribed Amounts of Rosiglitazone | 2X per Day

Note: Dose May be Adjusted Based on Patient Tolerance and Effects

Missed Doses

If you happen to forget a prescheduled dose of Rosiglitazone and Metformin, take the medicines as soon as you remember to do so. However, it is very important that you do not double the doses. In other words, if just an hour or two has passed since the prescheduled dose time, it is generally safe to take the missed dose. If the time for the next dose is drawing near, skipped the missed dose, and continue the normal schedule.

If you are unsure of what to do, consult your pharmacist or medical provider for advice.

How to Take Rosiglitazone and Metformin

Your pharmacist will recommend taking Rosiglitazone and Metformin with a full meal. This lowers the side effects of having an upset stomach, which is commonly reported by first-time users. As the body becomes acclimatized to the medicine, this side effect typically subsides.

All medications should be used as prescribed. There are some rules of thumb to pay attention to anytime you're taking prescription medicines, which could cause serious adverse effects when taken incorrectly. These include:

  • Do Not Take More of the Dosage
  • Do Not Take it More Often than Prescribed
  • Do Not Take it for Longer Than Prescribed

Most medications, including Rosiglitazone and Metformin, come with insert labels listing the proper instructions for use. Take a minute or two to read this label before commencing treatment to ensure best practices are being followed.

How It's Supplied

Rosiglitazone and Metformin, the combo treatment which is known by medical specialists as Avandamet, is supplied as an oval-shaped tablet in the following strengths of rosiglitazone/metformin hydrochloride:

  • 2 mg/500 mg (Pink Pill)
  • 4 mg/500 mg (Yellow Pill)
  • 2 mg/1,000 mg (Orange Pill)
  • 4 mg/1,000 mg (Pink Pill)

Interactions

Certain medicines are known to cause adverse reactions when used in conjunction with Rosiglitazone and Metformin. These include, but aren't limited to:

  • Iotroxic Acid
  • Iocarmic Acid
  • Sotalol
  • Lomefloxacin
  • Thioctic Acid
  • Selegiline
  • Gemfibrozil
  • Iopromide
  • Linezolid
  • Levobunolol
  • Iodipamide
  • Ioglicic Acid
  • Guar Gum
  • Phenelzine
  • Bisoprolol
  • Iotrolan
  • Nadifloxacin
  • Ofloxacin
  • Acebutolol
  • Metoprolol
  • Iodohippuric Acid
  • Furazolidone
  • Ioversol
  • Gatifloxacin
  • Esmolol
  • Iophendylate
  • Moclobemide
  • Pefloxacin
  • Bupropion
  • Moxifloxacin
  • Iproniazid
  • Iodopyracet
  • Procarbazine
  • Iopamidol
  • Octreotide
  • Ceritinib
  • Rufloxacin
  • Carvedilol
  • Labetalol
  • Gemifloxacin
  • Betaxolol
  • Ioxaglate
  • Iotasul
  • Rasagiline
  • Timolol
  • Penbutolol
  • Iothalamate
  • Ioglycamic Acid
  • Oxprenolol
  • Patiromer
  • Nadolol
  • Practolol
  • Iopentol
  • Propranolol
  • Iodixanol
  • Insulin
  • Flumequine
  • Pazufloxacin
  • Aspirin
  • Iosimide
  • Carteolol
  • Lanreotide
  • Abiraterone
  • Ciprofloxacin
  • Celiprolol
  • Nialamide
  • Atenolol
  • Iocetamic Acid
  • Tosufloxacin
  • Prulifloxacin
  • Methylene Blue
  • Rifampin
  • Psyllium
  • Fleroxacin
  • Isocarboxazid
  • Fenofibrate
  • Iodamide
  • Tranylcypromine
  • Ranolazine
  • Metipranolol
  • Safinamide
  • Iodoxamic Acid
  • Acetrizoic Acid
  • Nebivolol
  • Glucomannan
  • Opicapone
  • Iohexol
  • Fenofibric Acid
  • Iopronic Acid
  • Paritaprevir
  • Dasabuvir
  • Enoxacin
  • Sparfloxacin
  • Diatrizoate
  • Iopanoic Acid
  • Trimethoprim
  • Dofetilide
  • Fenugreek
  • Iomeprol
  • Metrizamide
  • Dolutegravir
  • Pindolol
  • Ethiodized Oil
  • Ritonavir
  • Levofloxacin
  • Iobenzamic Acid
  • Vandetanib
  • Besifloxacin
  • Bitter Melon
  • Tyropanoate Sodium
  • Ioxitalamic Acid
  • Metrizoic Acid
  • Pixantrone
  • Norfloxacin
  • Ipodate
  • Entacapone
  • Iobitridol
  • Pasireotide
  • Ombitasvir
  • Ioseric Acid
  • Balofloxacin

Most Noteworthy Drug Classes

The above lists of drugs are extensive and some users may ask:

What classes of drugs should I worry about the most in terms of causing negative drug interactions with Rosiglitazone and Metformin?

The best way to get a definitive answer to this question is to consult with your medical provider. It is also crucial that you disclose your full medication list. For the most part, medical specialists do not usually prescribe Rosiglitazone and Metformin when users take:

  • Gemfibrozil - otherwise known as a CYP2C8 Inhibitor, concurrent use escalates rosiglitazone in the body.
  • Rifambin - otherwise known as a CYP2C8 Inducer, simultaneous use lowers rosiglitazone in the body.

Over-the-Counter Drug Interactions

Some OTC drugs can cause contraindications to occur. Inform your medical provider if you take or plan on using:

  • Aspirins
  • Asthma Relief Drugs
  • Cold Or Cough Drugs
  • Hay Fever Medicines
  • Non-Prescription Sinus Medications
  • Weight Or Appetite Control Medicines

Alcohol Interactions

Taking Rosiglitazone and Metformin concurrently with alcohol can cause serious drops in blood sugar levels. Patients are therefore advised to stop drinking alcohol when undergoing treatment with Rosiglitazone and Metformin.

Warnings

Rosiglitazone and Metformin come with a number of warnings. Find some of the most common below:

Follow a Holistic Treatment Plan

One of the primary treatments for diabetes is a strict diet and exercise regime. Rosiglitazone and Metformin merely supplement this dietary and exercise plan.

It is in the patient's best interest to follow the plan outlined by a medical provider, as this is proven as one of the best ways to manage Type 2 Diabetes.

Check Blood Sugar Levels Often

Medical practitioners generally advise patients to test blood sugar levels often to determine if it's under control.

As an extra precaution, follow-up visits are usually scheduled in-office for medical providers to assess sugar levels via blood or urine tests. These checkups moreover provide key insight for medical practitioners to determine if an adjusted dosage of Rosiglitazone and Metformin is required. Patients should, therefore, make every effort to attend these appointments.

Pre-Existing Medical Conditions

When patients have certain pre-existing medications, care should be taken to inform medical providers.

The below list of conditions can become worse with the use of oral Rosiglitazone and Metformin:

  • Angina
  • Bone Health Issues
  • Diabetic Ketoacidosis
  • Edema
  • Heart Health Issues
  • Liver or Kidney Disease
  • Metabolic Acidosis
  • Other Types of Diabetes
  • Sepsis
  • The Deficiency of Vitamin B12
  • Underactive Adrenal or Pituitary Glands
  • Weak Immune System

Note: In the event that Rosiglitazone and Metformin treatment is deemed necessary, then a modified dose may be prescribed.

In the event of a serious medical emergency, such as when a patient has sepsis, serious infections, or surgery scheduled, the medical provider will weigh the benefits and risks before determining if treatment with Rosiglitazone and Metformin is suitable.

Life-Threatening Conditions

This medicine could potentially cause serious and life-threatening side effects to occur. Pay attention to some of the warning signs below and in the event that any of these occur, discontinue use and contact 911 immediately:

Signs of Low Blood Sugar

As Rosiglitazone and Metformin help to regulate high blood sugar levels, one of the most commonly reported side effects is low blood sugar, which is otherwise known as hypoglycemia. The risk increases when patients skip meals or drink alcohol. Some of the telltale signs of hypoglycemia include:

  • Confusion
  • Cool to the Touch Skin That's Pale
  • Extreme Drowsiness
  • Extreme Hunger
  • Feel Restless
  • Feeling Anxious or Jittery
  • Hallucinations
  • Incessant Headaches
  • Insomnia
  • Irregular Heartbeat
  • Seizures
  • Sudden Weakness
  • Trouble Speaking

In extreme cases of hypoglycemia, patients can lose consciousness or fall into a diabetic coma. This is a severe side effect. To prevent loss of consciousness, the following tips should be followed when taking Rosiglitazone and Metformin:

  • Read and Study The Warning Signs Of Hypoglycemia
  • Always Walk With A Snack Or Drink (Preferably Sugary)
  • Test Your Blood Sugar Levels Often
  • Walk With A Glucagon Kit With Needle or Syringe Accessories
  • Inform Your Family Of The Warning Signs Of Hypoglycemia
  • Teach Your Loved Ones How to Use the Glucagon Kit in the Event of An Emergency
  • Call 911 If You Have Extreme Hypoglycemia

Signs of Hyperglycemia

On the other end of the scale, this combo treatment could also cause hyperglycemia or high blood pressure to occur. In the majority of patient cases, this occurs as a result of not sticking to a meal plan.

In other words, patients may overeat and consume too many sugars. Another reason for hyperglycemia when taking Rosiglitazone and Metformin is a missed dose. It is therefore important to create a meal plan, a medication schedule, and exercise regime. All three working in sync will generally normalize blood sugar levels without triggering extremes.

In some events, however, high blood sugar is beyond a patient's control due to an underlying infection of sudden spikes in fever. Regardless, it important to pay attention to some of the warning signs of hyperglycemia, which include:

  • Dry Mouth
  • Extreme Dry Skin
  • Extreme Sleepiness
  • Feeling Nauseous
  • Fruity Smelling Breath
  • Pain in the Stomach
  • Redness in the Skin
  • Vision Changes

If you have persistent high blood sugar based on daily test readings while using Rosiglitazone and Metformin, call your medical provider for help. In these circumstances, an adjusted dose may be necessary.

Signs of a Heart Attack

Pay attention to the symptoms of a heart attack while using Rosiglitazone and Metformin. These include:

  • Chest Tightness or Pain
  • Difficulty Breathing
  • Edema in the Hands or Feet
  • Increased Sweating
  • Muscle Pain, Particularly in the Next, Arms, Jaw, or Back
  • Nausea
  • Severe Lethargy
  • Sudden Weight Gain
  • Throwing Up

Note: There are explicit label warnings noting the risk of congestive heart failure in select patients who use Rosiglitazone and Metformin. This medicine, therefore, is not suggested for patients who have had a history of heart failure. In addition, all patients who are prescribed this combo treatment should be carefully monitored for signs of heart failure with follow up treatments. In this event, the dosage should be stopped altogether or decreased.

Signs of Lactic Acidosis

Some of the main signs of this condition include:

  • Extreme Drowsiness
  • Lack of Appetite
  • Pain and Cramps in the Muscles
  • Pain and/or Discomfort in the Stomach Area
  • Quick Breathing
  • Severe Diarrhea

The risk of Lactic Acidosis increases when patients are experiencing kidney failure or a heart attack in most cases.

Signs of Hepatic Issues

Some of the main signs of this condition include:

  • Appetite Loss
  • Changes in the Color of the Urine
  • Extreme Drowsiness
  • Eye or Skin Color Changes (Yellow Color)
  • Feeling Nauseous
  • Sudden Weakness

Note: These conditions require immediate medical intervention.

Bone Fractures in Women

In medical studies, it has been confirmed that the use of Rosiglitazone and Metformin increases the risk of bone fractures, particularly in female users.

Effects on Ovulation

The use of Rosiglitazone and Metformin has been proven to cause an increased risk of pregnancy in women of childbearing age, even when women have had past challenges getting pregnant.

In medical studies, the combo treatment demonstrates an effect on ovulation - it is increased significantly. As a result, female patients should ask medical providers for birth control options if pregnancy is not in the cards at this time.

Effects on Pregnancy and Breastmilk

Use caution when taking Rosiglitazone and Metformin if you are pregnant, nursing, or plan to be. The safety of Rosiglitazone and Metformin has not been studied in this demographic. The drug/s is therefore not recommended for pregnant or nursing mothers.

Effects on Medical Tests

Using Rosiglitazone and/or Metformin could distort lab test results. As a precaution, inform medical providers if you use this medicine before completing any medical tests, especially kidney tests that use contrast dyes.

Effects on Children

Rosiglitazone and Metformin are not generally prescribed for children under the age of 18.

Effects on Seniors

Senior patients over the age of 65 may be more susceptible to the risks of using Rosiglitazone and Metformin due to the presence of underlying medical conditions. As a result, an individualized dose should be provided and close monitoring exercised following use. This is particularly true for older patients who have been diagnosed with a renal impairment.

Disclose Full Medical History

To protect patient's health and safety, doctors should query into the patient's full medical history.

Patients, too, are advised to fully disclose any medications being taken, including prescription medicines and over the counter drugs such as vitamins or herbal supplements. This is an important step as using certain drugs together with Rosiglitazone and Metformin could increase the risk of negative side effects.

Sign Up for Nutrition Consults

One of the best ways to manage Type 2 Diabetes is sticking to a dedicated meal and exercise plan. As such, most medical providers treating patients with this condition generally refer them to a nutritionist.

To help you adhere to the plan, people who live in the same household are usually asked to provide support to Type 2 Diabetics, in terms of following a strict diet plan and watching for signs of a medical crisis.

Important Tips for Traveling

Patients who are diagnosed with Type 2 Diabetes are sometimes apprehensive about traveling. When prescription medicines are being taken, this fear sometimes escalates.

There is a safe workaround, however.

For the most part, doctors advise patients to keep an extra prescription or refill handy in the event of a flight or travel delay. This is most important for patients who are traveling overseas. Also, keep in mind the time zone differences in other cities or countries to prevent the risk of overdose. This will also help you adhere to the schedule.

To prevent sudden fluctuations in blood sugar levels, mealtimes should be followed, if possible. Keep a few handy snacks close by in the event of drops in blood sugar levels.

As an extra precaution, it is suggested that medical bracelet is worn to inform EMTs of pre-existing conditions and medications currently being taken in the event of a medical crisis.

Other Tips:

  • Drink More - In order to prevent dehydration or fluid loss, up the intake of fluids throughout the day. Moreover, be careful about exposure to heat or direct sunlight, as this may increase the risk of dehydration.
  • Visit an Ophthalmologist - If you take Rosiglitazone and Metformin, regular visits should be scheduled with an Ophthalmologist.
  • Safety While Driving - If a home test reveals too high or too low blood sugar, do not drive or operate heavy machinery. Wait until blood sugar levels have stabilized before getting behind the wheel.
  • Allergies - Tell your doctor if you have had any history of allergies before starting treatment.

Storage

Rosiglitazone and Metformin should be stored at a room temperature of 25°C (77°F). Pay attention to the resealing instructions to ensure that the airtight cap is in place after each use. Doing so prolongs the quality of the medicine.

This medicine should be kept out of the reach of children and pets, preferably in a high place and away from areas that experience heat, humidity, or direct sunlight.

Any unused portion of Rosiglitazone and Metformin should be discarded appropriately. The best practices include returning bottles to a local pharmacy.

Summary

Rosiglitazone and Metformin is an adjunct treatment for Type 2 Diabetes. It is used in conjunction with a specific diet and exercise program in order to regulate glycemic or sugar levels throughout the body.

From filtering how much sugar the liver produces to reducing absorption levels in the stomach, this medication works in a number of ways to control patient's blood sugar levels.

One of the risks of using this drug is too high or too low blood sugar levels. As such, care should be taken to watch for hypoglycemia or hypoglycemia by completing home tests often.

In most cases, these conditions are brought on by incorrect diet, dosing, or underlying medical conditions.

As a precaution, an emergency plan should be put in place. For example, patients should keep sugary foods or drinks on hand in the event of low blood sugar levels. Most notably, a Glucagon Kit should be available at all times to counter the risk of a diabetic coma.

The dose of Rosiglitazone and Metformin is generally individualized for each patient. Rosiglitazone and Metformin is usually well-tolerated in adult patients and it is intended for minors under 18 years of age.

In most cases, patients who take this medicine as prescribed, generally benefit from maintaining normal blood sugar levels. Consequently, this prevents the perils associated with Type 2 Diabetes, including loss of limb, vision loss, kidney failure, and a host of other issues.

 

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Last Reviewed:
January 31, 2018
Last Updated:
April 27, 2018
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