Avandamet

Generic name: Rosiglitazone maleate and metformin hydrochloride

What is Avandamet?

Avandamet is an oral medication used to control blood sugar levels in people with type 2 (non-insulin-dependent) diabetes. It contains two drugs commonly used to lower blood sugar, rosiglitazone and metformin. Avandamet replaces the need to take these two drugs separately. It is also used when treatment with metformin hydrochloride alone doesn't work. Avandamet is not, however, meant to take the place of weight loss or diet and exercise. You should continue to follow the regimen your doctor recommends.

What is the most important information I should know about Avandamet?

Avandamet could cause a very rare—but potentially fatal—side effect known as lactic acidosis. It is caused by a buildup of lactic acid in the blood. The problem is most likely to occur in people whose liver or kidneys are not working well, and in those who have multiple medical problems, take several medications, or have congestive heart failure. The risk also is higher if you are an older adult or drink alcohol. Lactic acidosis is a medical emergency that must be treated in a hospital.

Who should not take Avandamet?

You should not use Avandamet if you need to take medicine for congestive heart failure.

Do not take Avandamet if you have ever had an allergic reaction to rosiglitazone or metformin. Also, do not begin treatment with Avandamet if you have metabolic or diabetic ketoacidosis (a life-threatening medical emergency caused by insufficient insulin and marked by excessive thirst, nausea, fatigue, pain below the breastbone, and fruity breath). You should not use Avandamet if you have type 1 (insulin-dependent) diabetes, or if you are already taking insulin.

What should I tell my doctor before I take the first dose of Avandamet?

Tell your doctor about all prescription, over-the-counter, and herbal medication you are taking before beginning treatment with Avandamet. Also, talk to your doctor about your complete medical history, especially if you have heart or kidney problems, or you are going to have a surgical procedure.

What is the usual dosage?

The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.

Inadequately controlled on metformin therapy alone

Adults: The recommended daily starting dose is 4 milligrams (mg) of rosiglitazone plus the dose of metformin you are already taking.

Inadequately controlled on rosiglitazone therapy alone

The recommended daily starting dose is 1000 mg of metformin plus the dose of rosiglitazone you are already taking.

Combination therapy taking separate doses of rosiglitazone and metformin

The usual starting dose of Avandamet is based on your current doses of rosiglitazone and metformin.

Increasing dose of Avandamet

The daily dose of Avandamet may be increased by increments of 4 mg of rosiglitazone and/or 500 mg of metformin, up to a maximum daily dose of 8 mg of rosiglitazone and 2000 mg of metformin.

How should I take Avandamet?

Do not take more or less of this medication than directed by your doctor. Avandamet should be taken in divided doses with meals to reduce the possibility of nausea or diarrhea, especially during the first few weeks of therapy. Avandamet may start to work within the first week or two after you begin taking it, but it can take up to 3 months before the drug's full effects are seen. Be sure to check your blood sugar as your doctor recommends.

What should I avoid while taking Avandamet?

Avoid drinking too much alcohol while taking Avandamet.

What are possible food and drug interactions associated with Avandamet?

If Avandamet is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Avandamet with the following: alcohol; amiloride; calcium channel blockers (heart medications) such as nifedipine and verapamil hydrochloride; cimetidine; decongestant, airway-opening drugs such as Albuterol sulfate and pseudoephedrine; hydrochloride; digoxin; estrogens such as conjugated estrogens; furosemide; isoniazid, a drug used for tuberculosis; morphine; niacin; nifedipine; oral contraceptives; phenytoin; procainamide; quinidine; quinine; ranitidine; steroids such as prednisone; thyroid hormones such as levothyroxine; tranquilizers such as chlorpromazine; triamterene;

Trimethoprim; vancomycin; and water pills (diuretics) such as amiloride, hydrochlorothiazide, and triamterene.

What are the possible side effects of Avandamet?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.

Side effects may include: accidental injury, anemia, back pain, diarrhea, fatigue, headache, joint pain, nausea, sinus inflammation, swelling, upper respiratory infection, upset stomach, viral infection

Symptoms of lactic acidosis may include: dizziness, extreme weakness or tiredness, light-headedness, low body temperature, slow or irregular heartbeat, rapid breathing or trouble breathing, sleepiness, unexpected or unusual stomach discomfort (especially after you have been taking Avandamet for a while), unusual muscle pain

Can I receive Avandamet if I am pregnant or breastfeeding?

The effects of Avandamet during pregnancy and breastfeeding are unknown. Tell your doctor immediately if you are pregnant, plan to become pregnant, or are breastfeeding.

What should I do if I miss a dose of Avandamet?

Take the forgotten dose as soon as you remember. However, if it is almost time for your next dose, skip the one you missed and return to your regular schedule. Do not take two doses at once.

How should I store Avandamet?

Store at room temperature in a tight, light-resistant container.