Health Centres - Avandamet
How does it work?
Avandamet tablets contain two active ingredients, rosiglitazone maleate and metformin hydrochloride. These are both medicines that are used to help control blood sugar levels in people with type 2 or non-insulin dependent diabetes (NIDDM).
People with diabetes mellitus have a deficiency or absence of a hormone produced by the pancreas called insulin. Insulin is the main hormone responsible for the control of sugar in the blood. In type 2 diabetes the pancreas does not produce sufficient insulin and the cells of the body are resistant to the low levels of insulin circulating in the blood. Insulin would normally make the cells remove sugar from the blood, hence in type 2 diabetes blood sugar levels can rise too high.
Rosiglitazone maleate is a type of antidiabetic medicine known as a thiazolidinedione or glitazone. It helps to control blood sugar levels by increasing the sensitivity of liver, fat and muscle cells to insulin. This enables these cells to remove sugar from the blood more effectively. Rosiglitazone also preserves the functioning of the cells in the pancreas (beta cells) that produce insulin.
Metformin hydrochloride is a type of antidiabetic medicine known as a biguanide. It works in a number of ways to decrease the amount of sugar in the blood. Firstly, it reduces the amount of sugar produced by cells in the liver. Secondly, it increases the sensitivity of muscle cells to insulin. This enables these cells to remove sugar from the blood more effectively. Finally, it also delays absorption of sugar from the intestines into the bloodstream after eating.
This combination of medicines helps people with type 2 diabetes control their blood sugar levels both directly after meals and between meals.
What is it used for?
-
Type 2 (non-insulin dependent) diabetes.
It is used for people with type 2 diabetes, particularly overweight people, whose blood sugar is not controlled by the maximum tolerated dose of metformin alone. It may also be used in combination with a sulphonylurea medicine, such as gliclazide, for people whose blood sugar is not controlled on the maximum tolerated dose of metformin plus a sulphonylurea.
Warning!
- People taking this medicine should also have regular blood tests to monitor their kidney function.
- This medicine can cause weight gain. You should stick to a calorie controlled diet and monitor your weight closely. Consult your doctor if your weight increases.
- Rosiglitazone may rarely cause fluid retention that may cause heart failure. For this reason you should consult your doctor immediately if you experience shortness of breath, swollen ankles, or rapid and excessive weight gain (which may be due to fluid retention) while taking this medicine.
- This medicine may cause women who have stopped ovulating, for example due to polycystic ovary syndrome, to start ovulating again. These women will therefore need to use contraception to prevent pregnancy. If you get pregnant or wish to become pregnant you should tell your doctor, as you will need to stop taking this medicine.
- If you notice any problems with your eyesight while taking this medicine, in particular any new or worsening problems with blurred vision or seeing fine detail, you should let your doctor know. He may want you to have an eye test.
- Consult your doctor if your experience the following symptoms while taking this medicine, as they may be indicative of a rare but serious side effect of metformin, called lactic acidosis: nausea, vomiting, abdominal pain, general feeling of illness, loss of appetite, weight loss, rapid and/or weak breathing, weakness.
- You should avoid drinking alcohol while you are taking this medicine, as it can increase the risk of low blood sugar (hypoglycaemia) and lactic acidosis.
- Consult your doctor about your diabetes treatment if you are due to have surgery under a general anaesthetic. In these situations blood sugar is normally controlled by insulin, so your doctor may ask you to stop taking this medicine 48 hours before surgery.
- Your doctor will ask you to stop taking this medicine temporarily if you are going to have a certain type of X-ray involving an injection of iodinated dye. Tell your doctor that you are taking this medicine if you are due to have this type of X-ray. You should not start taking this medicine again until 48 hours after the X-ray, and only after your kidney function has been tested and found to be normal.
Use with caution in
- Elderly people
- People with low levels of haemoglobin in their blood
- Swelling of the back of the eye (macular oedema).
Not to be used in
- Decreased kidney function
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Kidney failure
- Decreased liver function
- Dehydration
- Alcohol intoxication
-
Alcoholism
- History of heart failure
- People who have recently had a heart attack
- Reduced blood flow to vital internal organs (shock)
- Severe breathing difficulties
- Severe infections
-
Diabetic keto-acidosis
-
Pregnancy
-
Breastfeeding
- Rare hereditary disorders of galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption (Avandamet tablets contain lactose).
- This medicine is not recommended for children and adolescents under 18 years of age, as there is no information regarding its safety and efficacy in this age group.
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
Pregnancy and breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
- This medicine should not be used during pregnancy because its safety has not been established. Diabetes is usually controlled using insulin during pregnancy, because this provides a more stable control of blood sugar. If you get pregnant while taking this medicine, or are planning a pregnancy, you should seek medical advice from your doctor.
- There is no information available about the safety of this medicine during breastfeeding. For this reason, the manufacturer states that it should not be used by women who are breastfeeding. Seek medical advice from your doctor.
Label warnings
- Take this medication with or after food.
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