Rosiglitazone

Indications

Rosiglitazone is used for: Type 2 Diabetes Mellitus

Adult Dose

Type 2 Diabetes Mellitus Initial 4 mg PO qDay or divided q12hr If inadequate response afer 8-12 weeks, may increase dose to 8 mg PO qDay or divided q12hr Active liver disease (ALT >2.5 x ULN): Do not inititate rosiglitazone

Child Dose

Renal Dose

Renal impairment: No dosage adjustments required

Administration

Contra Indications

Hypersensitivity to rosiglitazone Diabetic ketoacidosis Heart failure NYHA class III-IV Active liver disease: do not start rosiglitazone if ALT >2.5 x ULN

Precautions

Fluid retention, which may exacerbate or lead to heart failure, may occur; combination use with insulin and use in congestive heart failure NYHA Class I and II may increase risk of other cardiovascular effects If ALT >3 x ULN stop treatment; if 1.5-3 x normal, retest qWeek until normal or 3 x normal and need to discontinue Not for use in diabetes mellitus type 1; mechanism requires presence of endogenous insulin; use with insulin may increase risk of heart failure; not recommended Thiazolidinediones, which are peroxisome proliferator-activated receptor (PPAR) gamma agonists, can cause dose-related fluid retention, particularly when used in combination with insulin; dose-related edema and weight gain may occur When used in combination with other hypoglycemic agents, a dose reduction of concomitant agent may be necessary to reduce risk of hypoglycemia Associated with rare cases of new onset or worsening of macular edema May result in ovulation in some premenopausal anovulatory women; ensure adequate contraception Increased risk of fractures of upper arm, hand, or foot in female patients Dose-related decreases in hemoglobin and hemocrit reported Monitor: ALT at start of treatment, qMonth for 12 months then q3Months thereafter Lactation: Unsafe

Pregnancy-Lactation

Interactions

Adverse Effects

Side effects of Rosiglitazone : >10% Increased LDL-cholesterol,Increased HDL-cholesterol,Increased total cholesterol 1-10% Edema,Hypertension,Heart failure/congestive heart failure,Myocardial ischemia,Diarrhea,Upper respiratory tract infection Frequency Not Defined Accidental injury Anemia Back pain Fatigue Headache Hypoglycemia Myalgia Sinusitis Weight gain

Mechanism of Action

Lowers glucose by improving target cell response to insulin without increasing pancreatic cell secretion; activates nuclear peroxisome proliferator-activated receptor gamma, which influences the production of gene products involved in glucose and lipid metabolism