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Rosiglitazone

Read and learn more about Rosiglitazone Drug.

Q: is rosiglitazone a safe drug for diabetes patients who have heart disease?
this drug was prescribed by a doctor for diabetes. recently told by another to STOP taking it now, its bad for your heart. prior to being told to stop taking this drug an angiogram had been ordered by cardiology because of symptoms relating to the heart.

A: Don’t play around with meds…..see a doctor.

Q: Has anyone else with diabetes type 2 experienced problems with metformin?
When first diagnosed 7 years ago I was prescribed metformin, then a couple of years ago for no apparent reason it stopped working and I was prescribed Avandamet, a combined metformin and rosiglitazone. A month ago a blood test showed my overall sugar level to have risen from the usual 5 to 6 and my doctor put me back on metformin only. (I know there was some concern about rosiglitazone at the time so that could have been the reason for the change) Now it is, again, as if I was not taking any medication at all.

I am due for another check up this week, and wondering what the doctor will suggest next. Is it that the metformin is not suitable for me and what alternatives can I expect. My doctor is not a great one for discussing anything with patients, so it’s a case of being forwarned is forarmed.

A: The obvious answer would be to wait until your HbA1C result confirms any abnormality. I presume you have been continuously taking metformin for at least one clear month so it may be advisable to have another HbA1C three months after discontinuing the rosiglitazone. Your blood glucose levels do not indicate any cause for concern and could easily be attributed to changes to your normal routine of diet/exercise/health/social factors. Examine these possibilities and ask to speak to the Diabetes Nurse at your G.P. practice if you need another sounding board other than your Doctor.

Q: Which of the following drug is most likely to cause hypoglycaemia if taken orally without food?
A. Mixtard 30
B. Metformin
C. Gliclazide
D. Rosiglitazone
E. Soluble insulin

A: The risk of hypoglycemia depends on the type and nature of the diabetes a patient has. Understanding this is important, for there can be no universally exact answers to this question. Diabetic drugs and their levels should be selected in cooperation with a physician or physician’s associate; not by answers to questions here..

That said, any insulin will cause hypoglycemia if it is not covered by adequate glucose intake from food. Especially in diabetics whose hypoglycemic defense responses have broken down. Usually, glucagon is secreted in response to low blood glucose levels; in many long term diabetics, this response has been more or less lost and doesn’t always work effectively. Differences between insulins depend on the action timing of the insulin used (eg, onset, peak action, duration of action). Quick acting insulin will need food sooner and in higher quantities than longer acting insulin, and the constant level analog insulins (glargine and equivalent) will require food distributed over a longer time than the others..

Drugs which increase internal insulin production, such as gliciazide will have the effect iof insulin injections with the proviso that most such drugs also depend on glucose levels in the blood. Without blood glucose, even gliclazide will not force insulin release. With sufficiently high levels of gliclazide, even a small amount of blood glucose will evoke insulin release and a possible episode of hypoglycemia.

Drugs which reduce insulin insensitivity, such as rosiglitazone (Actos), should not cause hypoglycemia if other medications (eg, injected insulin) are adjusted properly.

Drugs which regulate liver release of glucose from glycogen stores, such as metformin, are unlikly to cause hypoglycemia in the absence of additional drugs such as injected insulin. These drugs largely affect timing of glucose release in the absence of insulin.

Q: Medical treatment using a combination of drugs?
My elderly Mother has recently been admitted to hospital with suspected renal failure. She had been prescribed the following medicines by her GP,Furosemide, Digoxin, Ramipril, Rosiglitazone, Gliclazide, Atenolol, Allopurinol, Aspirin & Cyclizine. She had been admitted two weeks previously complaining of stomach and chest pains. I have written to the GP concerned who refuses to reply. I would like to know what effect the drugs listed would have as each was to be taken 4 times a day i.e. a total of 36 tablets daily. Please help.

A: Furosemide is a diuretic, it gets rid of “fluid” in the body, often from the lugs or lungs from heart failure. It is usually taken once or twice a day.

Digoxin in a drug to try and slow down an irregular heartbeat, taken once a day.

Ramipril is a bood pressure lwering tablet, taken once a day

Rosiglitazone is a diabetes drug ususally taken once a day.

Gliclazide is a very popular diabetic drug taken up to twice a day.

Atenolol is called a beta blocker and reduces blood pressure and can slow the heart a little. Usually taken once a day.

Allopurinol is used to prevent gout.

Aspirin in used to prevent platlet aggregation in the blood (in effect thining the blood, but not that simple) and is very effective in reducing heart disease. It is take once a day.

Cyclazine is a anti-sickness tablet taken 3 times a day. It has some sedative properties.

This is quite a typical drug list for an eldery person, seen with many, many people.

You have not mentioned ANY doses.

A person taken all these drugs 4 time a day is NOT reading the instructions on the packet or those given to them by their GP. They could suffer many effects from extreem low blood pressure to low blood sugar reading.

Souind like this person needs a medication review to me, with an understanding relative to help her understand what she should b taking. Prehaps a daily pill box would help.

Q: I am a diabetic and suddenly I have pain on my penis (Soft Tissue Part).?
I am on Rosiglitazone and Metformin and now I am taking Mixtard Novolet 30/70 40 units every day.

A: It is probably nerve damage. Do you feel pinpricks and tingling in your legs?

Q: Diabetes question … Avandia substitute?
I am aware of the new health advisory bulletin regarding rosiglitazone http://www.diabetes.org/uedocuments/pr-ada-rosiglitazone-statement-060607.pdf and advised our neurointensivist of same. He d/c’d the scheduled Avandia (even though the patient had been taking it for several years). The pt. is on a Nov. T.O. insulin gtt right now and will likely be in the ICU for a couple of weeks; does anyone know a safe substitute for rosiglitazone (I checked PubMed and couldn’t find info. on this) that I could suggest to the intensivist prior to the patient leaving the ICU?

A: a similar sub for Avandia is Actos but both pose a significant risk of heart failure, or reduced cardiac function. Although all medications pose risks, it is up to the doctor to determine if the medication outweighs those risks.

try this website for more info on diabetic medications:
www.rxlist.com

Q: Oral Antidiabetic Agents – Help!?
Is there any easy way to remember the differences in function between the following:

Sulfonylureas (focus on Glyburide)
Meglitinides (focus on Repaglinide)
Biguanides (focus on Metformin)
Alpha-Glucosidase Inhibitors (focus on Acarbose)
Thiazolidinedoiones (focus on Rosiglitazone)

A mouthful, yes. When reading them I understand them clearly, but as soon as I don’t have the book in front of me I struggle to remember which drugs do what.
Any helpful hints (even one or two words in laymans terms) that will be a memory aide?

Thanks, here goes a shot in the dark!
I’m actually just trying to remember them for a pharmacology exam. When your exam is at 0800 and the words are longer than your paper you need all the help you can get :-P

A: sulfonilurea & meglitine have the same function to repair secretion insulin, work in different place. biguanides & tzd have the same fuction to repair recistency insulin, work in different place. alpa glucosidase have function to block your nutrition in digestive system….

Q: Fresh fruit and raised sugar levels?
I am a type 2 Diabetic and take Metformin and Rosiglitazone. Toward the end of last year my levels went very high after being controlled very successfully by diet and tablets. I was eating 2 portions of fruit a day and after having my 6 monthly bloods I was asked to take an extra metformin tablet per day to see if this would reduce my level. Just had bloods done again and my level is back to normal. I also stopped eating fresh fruit. I am convinced that fruit – any fruit – puts my level up. Have any other Type 2s experienced this?
Thanks to all for your comments. I think I’ll follow submissive male’s example and not cut out fruit completely! Good health to all who are diabetic.
Jan

A: Couple of issues here, the first is that there are significant general concerns about the use of glitazones, including rosiglitazone. I made an initial decision not to initiate them when they first came out some years ago. A number of recent journal articles have been published, they seem to produce an increased fracture risk, In addition to years-old information about increased heart failure in patients using AVANDIA, new evidence has emerged about increased heart attacks as well. In addition, there was an almost significant 37 percent excess in the rosiglitazone group of what the authors called cardiovascular events composite, comprised of heart attacks, strokes, cardiovascular deaths, heart failure, the appearance of new angina attacks, and the need for heart surgery such as bypass or angioplasty. They can also cause macular oedema, so any eye problems should also be reported to your GP.

With regard to fruit intake, this can be a problem, just when you think you are taking the healthy option and eating more fruit rather than junk food! Another even worse offender is smoothies, innocent or otherwise, that are absolutely loaded with sugar. I usually recommended 2 fruit and 3 vegetables for your 5 a day, and to advise against things like melon whose sugars are to rapidly released, better to take apples, and no more than 5 large grapes.

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