1 What is Avandaryl?

Brand: Avandaryl

Generic: Rosiglitazone And Glimepiride

Rosiglitazone and Glimepiride combination is used to treat type 2 diabetes mellitus (noninsulin-dependent diabetes). It is used together with diet and exercise. Rosiglitazone reduces your blood sugar by improving the muscle, fat and liver's sensitivity to insulin. Glimepiride works by causing the pancreas to release insulin and thereby, lowering the blood sugar levels.

2 What to Know Before Using

Before taking this medication, tell your healthcare professional first if you are allergic to Rosiglitazone and Glimepiride combination or to any other medications. Safety and effectiveness of this medication in children have not been established.

Although this medicine have not demonstrated geriatric-specific problems, older patients are more likely to have age-related kidney problems, which may require caution and an adjustment in the dose for patients receiving Rosiglitazone and Glimepiride combination.

Pregnancy category C – The use of Rosiglitazone and Glimepiride combination during pregnancy is warranted only if benefits justify risks to the fetus and only when no alternative management is appropriate. There are no adequate studies whether Rosiglitazone and Glimepiride combination can pass through breast milk or if it could cause harmful effects to the infant. Discuss with your doctor if you are breastfeeding a baby.

Taking this medicine with any of the following medications is usually not recommended, but with exception in some cases. Dosage or frequency of one or both of your medicines may be changed if both medicines are prescribed together.

  • Balofloxacin
  • Besifloxacin
  • Ceritinib
  • Ciprofloxacin
  • Dabrafenib
  • Disopyramide
  • Dulaglutide
  • Enoxacin
  • Entacapone
  • Fleroxacin
  • Flumequine
  • Gatifloxacin
  • Gemifloxacin
  • Insulin
  • Insulin Aspart, Recombinant
  • Insulin Bovine
  • Insulin Degludec
  • Insulin Detemir
  • Insulin Glulisine
  • Insulin Lispro, Recombinant
  • Isoniazid
  • Lanreotide
  • Levofloxacin
  • Lomefloxacin
  • Metreleptin
  • Miconazole
  • Moxifloxacin
  • Nadifloxacin
  • Norfloxacin
  • Octreotide
  • Ofloxacin
  • Pasireotide
  • Pazufloxacin
  • Pefloxacin
  • Pixantrone
  • Prulifloxacin
  • Rufloxacin
  • Sparfloxacin
  • Tosufloxacin
  • Voriconazole

Taking this medicine with any of the following medications may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. Dosage or frequency of one or both of your medicines may be changed if both medicines are prescribed together.

  • Acebutolol
  • Atenolol
  • Betaxolol
  • Bisoprolol
  • Bitter Melon
  • Carteolol
  • Carvedilol
  • Celiprolol
  • Colesevelam - take Avandaryl at least 4 hours before taking colesevelam.
  • Esmolol
  • Fenofibrate
  • Fenofibric Acid
  • Fenugreek
  • Furazolidone
  • Gemfibrozil
  • Glucomannan
  • Guar Gum
  • Iproniazid
  • Isocarboxazid
  • Labetalol
  • Levobunolol
  • Linezolid
  • Methylene Blue
  • Metipranolol
  • Metoprolol
  • Moclobemide
  • Nadolol
  • Nebivolol
  • Nialamide
  • Oxprenolol
  • Penbutolol
  • Phenelzine
  • Pindolol
  • Practolol
  • Procarbazine
  • Propranolol
  • Psyllium
  • Rasagiline
  • Rifampin
  • Safinamide
  • Selegiline
  • Sotalol
  • Timolol
  • Tranylcypromine
  • Trimethoprim

Some medical conditions can interact with this medication. Tell your doctor if you have any of the following conditions:

3 Proper Usage

Take this medicine exactly as prescribed by your doctor. Excessive use of medication is not recommended. This medicine should be taken with breakfast. You should do regular exercises. Special diet from your doctor should be followed as well.
For adult patients who are already taking glimepiride or rosiglitazone alone, starting dose is 4 mg of rosiglitazone plus 1 mg of glimepiride or 4 mg of rosiglitazone plus 2 mg of glimepiride once a day.

Your doctor may adjust your dose to 8 mg of rosiglitazone plus 4 mg of glimepiride per day. For adult patients switching from a combination of glimepiride and rosiglitazone as separate tablets, the dose is the same as the dose you are already taking. Your doctor may adjust your dose to 8 mg of rosiglitazone plus 4 mg of glimepiride per day.

If you miss a dose of this medicine, take it as soon as possible. However, if it is near for your next dose, skip the missed dose and start again to your regular dosing schedule. Do not take a double dose to make up for a missed one. Store the medication in a closed container at room temperature, away from heat, moisture, and direct light. Keep out of reach of children. Do not keep expired medications.

4 Precautions to Take

Check with your doctor if:

  • If you have chest pain or discomfort, nausea, pain or discomfort in the arms, jaw, back, or neck, shortness of breath, sweating, or vomiting. These may be symptoms of a heart attack.
  • If you are rapidly gaining weight or having shortness of breath, chest pain or discomfort, extreme tiredness or weakness, irregular breathing, irregular heartbeat, or excessive swelling of the hands, wrist, ankles, or feet, check with your doctor right away. These may be symptoms of a heart problem or edema.
  • If you have abdominal or stomach pain, dark urine, a loss of appetite, nausea or vomiting, unusual tiredness or weakness, or yellow eyes or skin. These may be symptoms of a serious liver problem.
  • If blurring of vision, difficulty in reading, or any other change in vision occurs while you are taking this medicine. Your doctor may want you to have your eyes checked by an ophthalmologist.

Your doctor will be checking you regularly to monitor the effectiveness of the medication. Blood tests may be ordered for undesirable effects. Tell your doctor that you are using this medicine before undergoing any kind of surgery or medical procedures. Avoid sunlight exposure, sunlamps and tanning beds. This medicine may make your skin more sensitive to sunlight. Use a sunscreen when you are outdoors.

Some pregnant women who are taking this medicine can be at risk. This medicine may cause ovulation for women who are having ovulation problems or those who had irregular periods in the past. This may increase their chance of becoming pregnant. Discuss birth control options with your doctor if you are a woman of childbearing potential.

Rosiglitazone and Glimepiride combination may increase the risk for bone fractures in women. Discuss with your doctor the ways to keep your bones strong to help prevent fractures. Drinking alcohol while using this medication may cause severe low blood sugar. Discuss with your doctor if you have any concerns with this matter. Avoid using any other medication without discussing it first with your doctor.

Discuss with your doctor the ways on how to prevent side effects of this medication. In addition, diabetic patients may need special counseling regarding pregnancy as well as diabetes medicine dosing changes that might occur due to lifestyle changes. When are planning to travel, you should keep your recent prescription as well as your medical history with you. You should make allowances for changing time zones and keep your meal times as close as possible to your usual meal times.

Carrying a medical identification card stating that you have diabetes can be helpful in emergency cases. Fluid retention may lead to heart problems if worsened. You should know what to do if fluid retention occurs. Rosiglitazone and Glimepiride combination can cause low blood sugar. Symptoms of low blood sugar include:

  • Anxiety
  • Behavior change similar to being drunk
  • Blurred vision
  • Cold sweats
  • Confusion
  • Cool
  • Pale skin
  • Difficulty in thinking
  • Drowsiness
  • Excessive hunger
  • Fast heartbeat
  • Persistent headache
  • Nausea
  • Nervousness
  • Nightmares
  • Restless sleep
  • Shakiness
  • Slurred speech
  • Unusual tiredness or weakness

Management for low blood sugar include eating glucose tablets or gel, corn syrup, honey, or sugar cubes, or drink fruit juice, non-diet soft drinks, or sugar dissolved in water. You should also monitor your blood sugar levels. In addition, you should always have a Glucagon kit with you if severe symptoms of low blood sugar occur.

Members of your family also should know how to use it. If you are not taking this medication correctly, high blood sugar can occur. Symptoms of high blood sugar include:

  • Blurred vision
  • Drowsiness
  • Dry mouth
  • Flushed
  • Dry skin
  • Fruit-like breath odor
  • Increased urination (frequency and amount)
  • Ketones in the urine
  • Loss of appetite
  • Sleepiness
  • Stomachache
  • Nausea or Vomiting
  • Tiredness
  • Troubled breathing (rapid and deep)
  • Unconsciousness
  • Unusual thirst

Check your blood sugar level and consult with your doctor for instructions.

5 Potential Side Effects

If any of the following side effects occur, check with your doctor right away:

  • Body aches or pain
  • Chills
  • Cough
  • Difficulty with breathing
  • Ear congestion
  • Fever
  • Headache
  • Injury
  • Loss of voice
  • Nasal congestion
  • Runny nose
  • Sneezing
  • Sore throat
  • Unusual tiredness or weakness
  • Anxiety
  • Blurred vision
  • Chest pain or discomfort
  • Cold sweats
  • Coma
  • Confusion
  • Cool, pale skin
  • Decreased urine output
  • Depression
  • Dilated neck veins
  • Dizziness
  • Extreme fatigue
  • Fast heartbeat
  • Increased hunger
  • Irregular breathing
  • Irregular heartbeat
  • Nausea
  • Nightmares
  • Seizures
  • Shakiness
  • Slurred speech
  • Swelling of the face, fingers, feet, or lower legs
  • Tightness in the chest
  • Troubled breathing with exertion
  • Unusual bleeding or bruising
  • Weight gain
  • Abdominal or stomach pain or tenderness
  • Agitation
  • Back, leg, or stomach pains
  • Bleeding gums
  • Bloody, black, or tarry stools
  • Blue lips and fingernails
  • Coughing that sometimes produces a pink frothy sputum
  • Dark urine
  • Decreased appetite
  • Difficult, fast, or noisy breathing
  • Fluid-filled skin blisters
  • General body swelling
  • Hostility
  • Increased sweating
  • Increased thirst
  • Irritability
  • Itching or skin rash
  • Large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • Light-colored stools
  • Loss of appetite
  • Muscle pain or cramps
  • Muscle twitching
  • Nosebleeds
  • Pain or discomfort in the arms, jaw, back, or neck
  • Redness of the skin
  • Seizures
  • Sensitivity to the sun
  • Skin thinness
  • Sores, ulcers, or white spots on the lips or in the mouth
  • Stupor
  • Sweating
  • Swollen glands
  • Vomiting
  • Yellow eyes or skin

Less serious side effects:

  • Lack or loss of strength
  • Burning, stinging, itching, or redness of the skin not present before treatment
  • Diarrhea

Not all side effects are listed above. If you notice any other effects, check with your healthcare professional.