Information about Avandia (Rosiglitaaone Maleate)

Information about Avandia (Rosiglitaaone Maleate)

What is Avandia?
Avandia is one product in a class of prescription drugs called thiazolidinediones (thigh-a-zol-a-deen-die-owns) or TZDs. It is used to treat Type 2 diabetes by helping the body use the insulin that it is already making. Avandia, comes as pills that can be taken either once a day or twice a day to help improve blood sugar levels.

How does Avandia Treat Type 2 Diabetes?
If you have Type 2 diabetes, your body probably still produces insulin but it is not able to use the insulin efficiently. Insulin is needed to allow sugar to be carried from the blood-stream into many cells of the body for energy. If insulin is not being used correctly, sugar does not enter the cells very well and builds up in the blood. If not controlled, the high blood sugar level can lead to serious medical problems, including kidney damage, blindness and amputation. Avandia helps your body use insulin by making the cells more sensitive to insulin so that the sugar can enter the cell.

How Quickly Will Avandia Begin to Work?
Avandia begins to reduce blood sugar levels within two weeks. However, since Avandia works to address an important underlying cause of Type 2 diabetes, insulin resistance, it may take 8 to 12 weeks to see the full effect. If you do not respond adequately to your starting dose of Avandia, your physician may increase your daily dose to improve your blood sugar control.

How should I Take Avandia?
Your doctor may tell you to take Avandia once a day or twice a day (in the morning and evening). It can be taken with or without meals. Food does not affect how Avandia works. To help you remember to take Avandia, you may want to take it at the same time every day.

What If I Miss a Dose?
If your doctor has prescribed Avandia for use once a day:

If your doctor has prescribed Avandia for use twice a day:

Do I Need to Test My Blood for Sugar While Using Avandia?

Yes, you should follow your doctor's instructions about your at-home testing schedule.

Does Avandia Cure Type 2 Diabetes?
Currently there is no cure for diabetes. The only way to reduce the effects of the disease is to maintain good blood sugar control by following your doctor's advice for diet, exercise, weight control, and medication. Avandia, alone or in combination with other antidiabetic drugs (i.e., sulfonylureas, metformin, or insulin), may improve these other efforts by helping your body make better use of the insulin it already produces.

Can I Take Avandia with Other Medications?
Avandia has been taken safely by people using other medications, including other antidiabetic medications, birth control pills, warfarin (a blood thinner), Zantac (ranitidine, an antiulcer product from GIaxoSmithKline), certain heart medications, and some cholesterol-lowering products. You should discuss with your doctor the most appropriate plan for you.

If you are taking prescription or over-the-counter products for your diabetes or for conditions other than diabetes, be sure to tell your doctor. Sometimes a patient who is taking two antidiabetic medications each day can become irritable, lightheaded or excessively tired. Tell your doctor if this occurs; your blood sugar levels may be dropping too low, and the dose of your medication may need to be reduced.

What are The Possible Side Effects of Avandia?
Avandia was generally well tolerated in clinical trials. The most common side effects reported by people taking Avandia were upper respiratory infection (cold-like symptoms) and headache. When taking Avandia with sulfonylureas or insulin, patients may be at increased risk for low blood sugar. Ask your doctor whether you need to lower your sulfonylurea or insulin dose.

Some people may experience tiredness, weight gain, or swelling with Avandia.

Avandia may cause fluid retention or swelling which could lead to or worsen heart failure, so you should tell your doctor if you have a history of these conditions. If you experience an unusually rapid increase in weight, swelling or shortness of breath while taking Avandia, talk to your doctor immediately. In combination with insulin, Avandia may increase the risk of other heart problems. Ask your doctor about important symptoms and if the combination continues to work for you. Avandia is not for everyone. Avandia is not recommended for patients with severe heart failure or active liver disease.

Also, blood tests to check for serious liver problems should be conducted before and during therapy. Tell your doctor if you have liver disease, or if you experience unexplained tiredness, stomach problems, dark urine or yellowing of skin while taking Avandia.

If you are nursing, pregnant or thinking about becoming pregnant, or premenopausal and not ovulating, talk to your doctor before taking Avandia, as Avandia may increase your chance of becoming pregnant.

Who Should Not Use Avandia?
You should not take Avandia if you are in the later stages of heart failure or if you have active liver disease. The following people should also not take Avandia: People with Type 1 diabetes, people who experienced yellowing of the skin with Rezulin R (troglitazone, Parke-Davis), people who are allergic to Avandia or any of its components and peo-ple with diabetic ketoacidosis.

Why are Laboratory Tests Recommended?
Your doctor may conduct blood tests to measure your blood sugar control. Blood tests to check for serious liver problems should be conducted before starting Avandia, every two months during the first year, and periodically thereafter.

It is important that you call your doctor immediately if you experience unexplained symptoms of nausea, vomiting, stomach pain, tiredness, anorexia, dark urine, or yellow-ing of the skin.

How should I Store Avandia?

Avandia should be stored at room temperature in a child-proof container out of the reach of children. Store Avandia in its original container.

Prescribing Notes
Bulking Agents consist of plant fibre leg bran, ispaghula, sterculia) or synthetic alternatives (eg methylcellulose). They increase the volume of stool by absorbing water and so softening the faeces. Onset of action is generally 12 to 24 hours after oral administration. They are safe except in patients with strictures when obstruction may be precipitated. They may be of value in treating irritable bowel syndrome and diverticular disease if dietary manipulation has failed. Adequate hydration should be maintained. Sodium containing agents should perhaps be avoided in patients with heart or renal failure.

Faecal Softeners ease straining and are useful in patients with painful anal or rectal conditions (eg fissure in ano, haemorrhoids, proctitis). Paraffin lubricates the passage of faeces. It is hardly absorbed and is relatively safe, rarely being aspirated and causing lipoid pneumonia.

However, its use should be restricted to the temporary relief of constipation, repeated use is not recommended, and caution is advised in patients with swallowing difficulties. It is contraindicated in children under three years old. Docusate sodium has a detergent action which reduces surface tension. It may enhance absorption of drugs (especially paraffin).

Osmotic laxatives whether taken orally or rectally draw fluid into the bowel and so ease constipation. They should always be given with plenty of water, and are useful for initiating therapy on specific occasions. The dose should be adjusted to individual needs. Magnesium salts are hardly absorbed and are preferable to sodium salts, oral administration of which must be avoided in renal, heart or hepatic failure. Glycerol suppositories are gentle and useful in the elderly. Lactulose has a microbial and pH effect as well as an osmotic action which increases stool output. It is often used in chronic hepatic insufficiency. Polyethylene glycol rapidly cleanses the bowel prior to radiography or colonoscopy. Total evacuation can usually be achieved within four hours.

Stimulant laxatives increase colonic motility. They may cause colicky pain and in the long term hypokalaemia or "cathartic colon." They should only be used on specific occasions and avoided in children or pregnancy. Onset of action is generally 6 to 12 hours after oral administration. In some preparations they are combined with softeners. Senna has the gentlest action of the group. Dose adjustment of bisacodyl can be difficult. Danthron is absorbed in the small intestine and is therefore less potent. Sodium picosulphate is very powerful, but the liquid preparation allows fine dose adjustment. Stimulant laxatives are used for bowel clearance in surgery and instrumentation, or to initiate therapy in severe constipation, provided obstruction, impaction or colonic dilatation have been excluded. They may be administered orally or rectally as appropriate.

Faecal Softner

Faecal Softenerlsiimulan. Poloxamer '188'200 mg, danthron 25 mg per 5 ml (co-danthramer); susp.

Indications : Treatment or prophylaxis of analgesic induced constipation in the terminally ill; constipation in elderly, cardiac failure, coronary thrombosis.

Adults : 5-10 ml at night.

Children : 2-5-5 ml at night.

Adults : 5 ml at night.

Children : Not recommended.

Contraindications : Intestinal obstruction, acute painful conditions of abdomen. Infants in nappies. Pregnancy.

Special Precaution : Incontinence.

Adverse Drug Reaction : Colouring of urine and perianal skin.

Bisacodyl

Stimulant. Bisacodyl 5 mg tabs. Also Bisacodyl Suppositories Bisacodyl 5 mg and 10 mg.

Indications : Constipation. Bowel clearance before surgery, labour or radiological examination.

Adults : 2tabs. at night or 1 x 10 mg suppos. in the morning.

Children : Under 10 years, 1 tab. at night or 1 x 5 mg suppos. in the morning; over 10 years, same as adult.

Sodium Bicarbonate

Sodium Bicarb. 1.08 g, anhydrous sodium acid phos. 1.30 g (equiv. to 1 69 g sodium acid pries.); suppos.

Indications : Constipation, local anal conditions. Pre- and post-operatively in radiology and sigmoidoscopy.

Adults : 1 suppos. 30 mins. before evacuation required.

Children : Not applicable.

Osmotic Laxative

Osmotic laxative. Magnesium citrate 17.7 g; efferv. powder in sachet.

Indications : Total bowel evacuation prior to radiological examination or colorectal surgery.

Adults : Single dose of 1 sachet in 200 ml water orally the day before procedure.

Children : Not recommended.

Special Precaution : Renal failure. Elderly. Instruct patient to take high fluid, low residue diet.

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