A type of thiazolidinediones, used to treat polycystic ovarian disease and diabetes, rosiglitazone is an insulin sensitizer.
In type 2 diabetics insulin insufficiency is often caused by insulin-resistance in cells. Considered an insulin-sensitizer, rosiglitazone works by reducing the resistance allowing the body to use the insulin it produces rather than promote the creation of insulin by the pancreas like other drugs. While rosiglitazone can be used with other drugs it should not be used while taking insulin. Doses of four or eight mg may be taken once or twice a day with or without food.
Diabetes – Rosiglitazone Use
In the U.S. rosiglitazone is marketed as Avandia and manufactured by GlaxoSmithKline. Before beginning Avandia tell your doctor if you have heart or liver problems, edema, developed liver problems with taking Rezulin, are premenopausal, pregnant, or breast feeding. While Avandia may be used with drugs such as metaformin, certain prescription drugs can interact negatively with rosiglitazones and should be used with precaution or not at all while using rosiglitazone.
Diabetes – Rosiglitazone Side Effects
Minor side effects of rosiglitazone include headache, back pain, hyperglycemia, diarrhea, hypoglycemia, and upper respiratory tract infection. However, there are far greater risk factors associated with rosiglitazone. A paper published in 2006 in the Canadian Medical Journal linked rosiglitazone and peripheral edema as well as macular edema. Macular edema occurs when blood vessels leak plasma in to the retina. The first cases of rosiglitazone-related edema are from 2005 and occurred along with the symptoms of fluid retention, weight gain, and peripheral edema. The patients thought to be at the greatest risk of peripheral edema, weight gain, fluid retention, pulmonary edema, and congestive heart failure are users of insulin, have a cardiac condition, or renal insufficiency. The effects are dose related and usually clear after the medication has stopped being used. It is hypothesized that peripheral edema is caused by “interfering with renal and intestinal ion transport, increasing plasma volume and sympathetic activation, causing growth factor-related vascular permeability” (http://www.canadianmedicaljournal.ca/content/174/5/623.full.pdf). In another Canadian report 38 cases of suspected serious drug reactions between March 200 and February 2001. Of the 38, eight were reports of heart failure of which five occurred within three days to six weeks of starting on rosiglitazones. Another study found that long-term use of rosiglitazone doubled the risk of bone fracture in women with type 2 diabetes but not in men.
The most alarming side effect of rosiglitazones is the increased risk of heart failure. Multiple studies leading to the same conclusion led the European Union to ban their use and the FDA to significantly limit their availability in the United States.
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