dissipate [1%:2.5 times the upper limit of normal (ULN) at baseline; evaluate patients with ALT 2.5 times ULN at baseline or during therapy for cause of enzyme elevation. During therapy, if ALT >3 times ULN, reevaluate levels promptly and discontinue if elevation persists or if jaundice occurs at any time during use. Idiosyncratic hepatotoxicity has been reported with another thiazolidinedione agent (troglitazone); avoid use in patients who previously experienced jaundice during troglitazone therapy. Ischemic heart disease: Do not initiate rosiglitazone in patients with stable ischemic heart disease due to an increased risk of cardiovascular complications (Fihn 2012). Stress-related states: It may be necessary to discontinue therapy and administer insulin if the patient is exposed to stress (fever, trauma, infection, surgery). Concurrent drug therapy issues: Drug-drug interactions: Potentially significant interactions may exist, requiring dose or frequency adjustment, additional monitoring, and/or selection of alternative therapy. Consult drug interactions database for more detailed information. Special populations: Premenopausal/anovulatory females: Use rosiglitazone with caution in premenopausal, anovulatory women; may result in a resumption of ovulation, increasing the risk of pregnancy. Use of adequate contraception in premenopausal women is recommended. Other warnings/precautions: Secondary failure: Loss of efficacy may be observed following prolonged use as a result of the progression of type 2 diabetes mellitus which results in continued beta cell destruction. In patients who were previously responding to sulfonylurea therapy, consider additional factors which may be contributing to decreased efficacy (eg, inappropriate dose, nonadherence to diet and exercise regimen). If no contributing factors can be identified, consider discontinuing use of the sulfonylurea due to secondary failure of treatment. Additional antidiabetic therapy (eg, insulin) will be required. Monitoring Parameters Hemoglobin A 1c (at least twice yearly in patients who have stable glycemic control and are meeting treatment goals; quarterly in patients not meeting treatment goals or with therapy change [ADA 2017a]), fasting serum glucose Liver enzymes (prior to initiation of therapy, then periodically thereafter); evaluate patients with ALT 2.5 times ULN at baseline or during therapy for cause of enzyme elevation. Patients with an elevation in ALT >3 times ULN should be rechecked as soon as possible. If the ALT levels remain >3 times ULN, therapy should be discontinued. Blood pressure; signs and symptoms of fluid retention or heart failure, weight gain; signs and symptoms of hypoglycemia (fatigue, excessive hunger, profuse sweating, numbness of extremities); ophthalmic exams Pregnancy Risk Factor C Pregnancy Considerations Animal reproduction studies have not been conducted with this combination. See individual agents. Patient Education Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?) Patient may experience cold-like symptoms, headache, or weight gain. Have patient report immediately to prescriber signs of heart problems (cough or shortness of breath that is new or worse, swelling of the ankles or legs, abnormal heartbeat, weight gain of more than five pounds in 24 hours, dizziness, or passing out), signs of liver problems (dark urine, feeling tired, lack of appetite, nausea, abdominal pain, light-colored stools, vomiting, or yellow skin or eyes), signs of severe cerebrovascular disease (change in strength on one side is greater than the other, trouble speaking or thinking, change in balance, or change in eyesight), bone pain, vision changes, dysphagia, tachycardia, arrhythmia, loss of strength and energy, severe dizziness, passing out, menstrual changes, signs of Stevens-Johnson syndrome/toxic epidermal necrolysis (red, swollen, blistered, or peeling skin [with or without fever]; red or irritated eyes; or sores in mouth, throat, nose, or eyes), signs of low blood sugar (dizziness, headache, fatigue, feeling weak, shaking, a fast heartbeat, confusion, hunger, or sweating), or signs of a heart attack (angina; pain in arms, back, neck, jaw, or stomach; shortness of breath; cold sweats; severe dizziness; passing out; severe nausea or vomiting) (HCAHPS). Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions. Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for healthcare professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience and judgment in diagnosing, treating and advising patients. Next Interactions Print this page Add to My Med List More about glimepiride/rosiglitazone Side Effects During Pregnancy Drug Interactions Support Group 1 Review Add your own review/rating Drug class: antidiabetic combinations Consumer resources Rosiglitazone and Glimepiride Rosiglitazone and glimepiride (Advanced Reading) Professional resources Other brands: Avandaryl Related treatment guides Diabetes, Type 2] Drug Status Rx Availability Prescription only C Pregnancy Category Risk cannot be ruled out N/A CSA Schedule Not a controlled drug Approval History Drug history at FDA Glimepiride / rosiglitazone Rating 1 User Review 9.0 /10 1 User Review 9.0 Rate it! 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