Rosiglitazone is an oral drug that reduces the amount of sugar glucose in the blood. It is used for treating patients with type 2 diabetes and is in a class of anti-diabetic drugs called thiazolidinediones. The other member of this class is pioglitazone Actos. Insulin is a hormone produced by the pancreas that is important for controlling the levels of glucose in the blood. Insulin stimulates the cells of the body to remove glucose from the blood and thereby lowers the level of glucose in the blood. Patients with type II diabetes cannot make enough insulin. As a result the cells in their bodies do not remove enough glucose from the blood and the level of glucose rises. Rosiglitazone often is referred to as an insulin sensitizer because it attaches to the insulin receptors on cells throughout the body and causes the cells to become more sensitive more responsive to insulin and remove more glucose from the blood. At least some insulin must be produced by the pancreas in order for rosiglitazone to work. Rosiglitazone was approved by the FDA on May 28 1999.

Rosiglitazone may be taken once or twice daily with or without meals. Daily doses range from 4 to 8 mg either with or without other antidiabetic medications. Studies do not demonstrate additional effects when more than 8mg per day are taken

The most common side effects seen with rosiglitazone alone or in combination with metformin are upper respiratory tract infection headache back pain hyperglycemia fatigue sinusitis diarrhea and hypoglycemia. Rosiglitazone has been shown to cause mild to moderate accumulation of fluid edema and can lead to heart failure. In addition anemia may occur with rosiglitazone alone or combined with metformin. Rosiglitazone also causes increasing amounts of weight gain with increasing doses.

Since troglitazone a related drug was associated with liver injury it is recommended that liver tests be obtained before starting therapy and periodically thereafter. Side effects which may suggest liver injury include unexplained nausea vomiting abdominal pain fatigue anorexia loss of appetite or dark urine.

Rosiglitazone may cause ovulation in premenopausal women who have stopped ovulating because they are resistant to insulin. Rosiglitazone may improve insulin sensitivity sufficiently to cause ovulation. Therefore there is the potential for rosiglitazone to lead to pregnancy.

Studies testing rosiglitazone excluded New York Heart Association Class III and IV patients who have more serious heart disease. Therefore it is not known how these classes of patients will respond to treatment. The concern is that fluid accumulation may lead to heart failure in these patients.

Rosiglitazone alone or combined with metformin has demonstrated various effects on blood lipids. Studies have shown elevated total and low-density cholesterol LDL levels within the first two months of rosiglitazone therapy with or without metformin while high-density cholesterol HDL levels increase and free fatty acids decrease with continued therapy.

Rifampin decreases the blood concentration of rosiglitazone by increasing its breakdown in the liver. Therefore use of rifampin may decrease the effect of rosiglitazone.

Gemfibrozil increases the concentration of rosiglitazone in the blood by reducing its breakdown. Therefore rosiglitazone may increase the side effects of rosiglitazone.

If you miss a dose of this medicine take it as soon as you remember. However if you do not remember it until it is time for your next dose skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Rosiglitazone combined with diet exercise weight control and cessation of smoking is used for treating type II diabetes. Rosiglitazone may be used alone or in combination with other types of anti-diabetic drugs such as metformin or sulfonylureas as well as insulin. Since it requires naturally-secreted insulin to be effective rosiglitazone is not recommended for use in type I diabetes where the amount of insulin is very low or absent.

Tablets should be kept at room temperature 15-30°C 59-86°F.