Brand Name (Generic Name)
Note: Troglitazone (Rezulin) was withdrawn from the market in March 2000.
In June 2011, the FDA warned that use of Actos for more than 1 year may be associated with an increased risk of bladder cancer. The FDA recommended that people receiving treatment for bladder cancer should not take Actos, and Actos should be used with caution in people with a history of bladder cancer. This warning also applies to the combination diabetes pills containing pioglitazone—Actoplus Met, Actoplus Met XR, and Duetact.In September 2010, the FDA announced that access to Avandia would be restricted because of studies linking Avandia to an increased risk of cardiovascular events, such as heart attacks. In May 2011, the FDA announced new restrictions on the use and distribution of Avandia and combination diabetes pills containing rosiglitazone.
After November 18, 2011, Avandia and the combination diabetes pills Avandamet and Avandaryl will no longer be available through retail pharmacies. Health care providers and patients must enroll in a special program in order to prescribe and receive these medicines.
What are thiazolidinediones?
A class of medications that treat type 2 diabetes by activating PPARs (nuclear receptors) to increase insulin resistance.
Who can take them? Who can't?
Adults with type 2 diabetes can take them. They are not made to treat people with type 1, and should be avoided by those with diabetic ketoacidosis.
What dosage can I take and how should I take it?
The initial dose is 15-30 mg daily for Actos and 4 mg daily for Avandia. Both are taken orally.
How often should I take pioglitazone or rosiglitazone?
- Pioglitazone(py-oh-GLIT-uh-zone): Usually once a day.
- Rosiglitazone (rose-ee-GLIT-uh-zone): Either once or twice a day.
When should I take pioglitazone or rosiglitazone?
- Pioglitazone: At about the same time each day, with or without a meal.
- Rosiglitazone: At about the same time each day, usually in the morning, with or without a meal. Or in the morning and in the evening, with or without meals.
What are the possible side effects of pioglitazone or rosiglitazone?
- If you take pioglitazone or rosiglitazone, it is important for your health care provider to check your liver enzyme levels regularly. Call your doctor right away if you have any signs of liver disease: nausea, vomiting, stomach pain, lack of appetite, tiredness, yellowing of the skin or whites of the eyes, or dark-colored urine.
- Medicines in this group don't cause blood glucose to drop too low. But if you take other diabetes medicines along with medicines in this group, your blood glucose might drop too low.
- If you take birth control pills, medicines in this group might make your birth control pills less effective in preventing pregnancy. These medicines may increase your chances of getting pregnant.
- You may gain weight while taking these medicines.
- You may be at risk for developing anemia, which will make you feel tired. Anemia causes your blood to carry less oxygen than normal.
- You may have swelling in your legs or your ankles, also called edema.
Are other diabetes medicines used with thiazolidinediones?
Yes, your health care provider may ask you to take another diabetes medicine along with a thiazolidinedione. Or you may take a thiazolidinedione as your only diabetes medicine. These combinations work well together to control blood glucose:
- pioglitazone with a sulfonylurea,
- metformin, or insulin
- rosiglitazone with metformin
What should I tell my doctor before taking thiazolidinediones?
Tell your doctor about other medications you are taking, as well as general allergies or allergies you have to the ingredients of Actos and Avandia. Also, notify your doctor if you have diabetic ketoacidosis.
Reviewed by James A. Bennett 5/13.
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