Avandamet
Generic Name: metformin and rosiglitazone (met FOR min and roh si GLI ta zone)
Brand Names: Avandamet
What is metformin and rosiglitazone?
Metformin and rosiglitazone is a combination of two oral diabetes medicines that help
control blood sugar levels.
Metformin and rosiglitazone is for people with type 2 diabetes who do not use daily
insulin injections. This medication is not for treating type 1 diabetes.
Metformin and rosiglitazone may also be used for purposes other than those listed in this
medication guide.
What is the most important information I should know about metformin and
rosiglitazone?
Do not use metformin and rosiglitazone if you have kidney disease, or if you are in a
state of diabetic ketoacidosis (call your doctor for treatment with insulin).
Before taking metformin and 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.
Some people have developed a life-threatening condition called lactic acidosis while
taking metformin and rosiglitazone. Get emergency medical help if you have any of
these symptoms of lactic acidosis: weakness, increasing sleepiness, slow heart rate,
cold feeling, muscle pain, shortness of breath, stomach pain, feeling light-headed, and fainting.
Some women using metformin and 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 metformin and rosiglitazone. Talk with your doctor if you are
concerned about this possibility.
What should I discuss with my healthcare provider before taking metformin
and rosiglitazone?
Some people have developed a life-threatening condition called lactic acidosis while
taking metformin and rosiglitazone. Get emergency medical help if you have any of
these symptoms of lactic acidosis: weakness, increasing sleepiness, slow heart rate,
cold feeling, muscle pain, shortness of breath, stomach pain, feeling light-headed, and fainting.
You may be more likely to develop lactic acidosis if you have congestive heart failure.
Older adults may have a higher risk of developing lactic acidosis. Talk with your doctor about
your individual risk.
Do not use metformin and rosiglitazone if you have kidney disease, 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.
You may need a dosage adjustment or special tests during treatment.
Some women using metformin and 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 metformin and 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 metformin and rosiglitazone passes into breast milk or if it
could harm a nursing baby. Do not take metformin and rosiglitazone without first talking to your
doctor if you are breast-feeding a baby.
How should I take metformin and rosiglitazone?
Take this medication exactly as it was prescribed for you. Do not take the medication in
larger amounts, or take it for longer than recommended by your doctor.
Take metformin and rosiglitazone with meals to reduce nausea, diarrhea, and upset
stomach that may occur, especially during the first few weeks of therapy.
Metformin and rosiglitazone is only part of a complete program of treatment that also
includes diet, exercise, and weight control. 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 kidney or liver function may also need to be tested, and you may need
regular eye exams. Do 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
metformin and 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.
Your doctor may have you take extra vitamin B12 while you are taking metformin and
rosiglitazone. Take only the amount of vitamin B12 that your doctor has prescribed.
If you need to have any type of x-ray or CT scan using a dye that is injected into your
veins, you may need to temporarily stop taking metformin and rosiglitazone. Be sure the surgeon
knows ahead of time that you are using this medication.
Store this medicine at room temperature away from moisture and heat.
What happens if I miss a dose?
Take the missed dose as soon as you remember (be sure to take the medicine with food).
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.
What happens if I overdose?
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.
An overdose of metformin and rosiglitazone may cause a life-threatening condition
called lactic acidosis. Get emergency medical help if you have any of these symptoms
of lactic acidosis: weakness, increasing sleepiness, slow heart rate, cold feeling,
muscle pain, shortness of breath, stomach pain, feeling light-headed, and fainting.
What should I avoid while taking metformin and rosiglitazone?
Avoid drinking alcohol while taking metformin and rosiglitazone. Alcohol lowers
blood sugar and may increase the risk of lactic acidosis while you are taking this medicine.
Metformin and rosiglitazone side effects
Stop using metformin and rosiglitazone and 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.
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;
-
fever, chills, body aches, flu symptoms;
-
severe blistering, peeling, and red skin rash; or
-
nausea, stomach pain, low fever, loss of appetite, dark
urine, clay-colored stools, jaundice (yellowing of the skin or eyes).
Other less serious side effects may be more likely to occur, such as:
-
sneezing, runny nose, cough or other signs of a cold;
-
back pain, joint or muscle pain;
-
headache; or
-
mild diarrhea.
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.
What other drugs will affect metformin and rosiglitazone?
You may be more likely to have hyperglycemia (high blood sugar) if you are taking
metformin and 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 metformin and rosiglitazone with other drugs that lower blood sugar. Drugs that
can lower blood sugar include:
-
some 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 metformin and rosiglitazone.
Tell your doctor if you are using any of the following drugs:
-
gemfibrozil (Gemcor);
-
rifampin (Rifater, Rifadin, Rimactane);
-
nifedipine (Adalat, Procardia);
-
cimetidine (Tagamet) or ranitidine (Zantac);
-
amiloride (Midamor) or triamterene (Dyrenium);
-
digoxin (Lanoxin);
-
morphine (MS Contin, Kadian, Oramorph);
-
procainamide (Procan, Pronestyl, Procanbid);
-
quinidine (Cardioquin, Quinidex, Quinaglute);
-
trimethoprim (Proloprim, Primsol, Bactrim, Cotrim,
Septra); or
-
vancomycin (Vancocin, Lyphocin).
If you are using any of these drugs, you may not be able to take
metformin and rosiglitazone, or you may require a dosage adjustment or special monitoring.
There may be other drugs not listed that can affect metformin and 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.
Where can I get more information?
-
Your pharmacist has information about metformin and rosiglitazone written for health
professionals that you may read.
-
Remember, keep this and all other medicines out of the reach of children, never share
your medicines with others, and use this medication only for the indication prescribed.
- Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate,
up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum
information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not
warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does
not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist
licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not
a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or
drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any
given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information
Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug
interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse
or pharmacist.
Copyright 1996-2006 Cerner Multum, Inc. Version: 4.07. Revision Date: 07/23/2007 3:35:52 PM.
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