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Common uses
Avandamet is a combination of two oral diabetes medicines that help control blood sugar levels.
Avandamet is for people with type 2 diabetes who do not use daily insulin injections. This medication is not for treating type 1 diabetes.
Avandamet may also be used for other purposes not listed in this medication guide.
Before using
Before taking Avandamet, tell your doctor if you have congestive heart failure or heart disease, a history of heart attack or stroke, liver disease, or eye problems caused by diabetes. You may need a dose adjustment or special tests during treatment.
Directions
Do not take more or less of this medication than directed by your doctor. Avandamet should be taken in divided doses with meals to reduce the possibility of nausea or diarrhea, especially during the first few weeks of therapy. Avandamet may start to work within the first week or two after you begin taking it, but it can take up to 3 months before the drug's full effects are seen. Be sure to check your blood sugar as your doctor recommends.
-If you miss a dose...
Take the forgotten dose as soon as you remember. However, if it is almost time for your next dose, skip the one you missed and return to your regular schedule. Do not take two doses at once.
-Storage instructions...
Store at room temperature in a tight, light-resistant container.
Cautions
Do not use Avandamet if you have kidney disease, or if you are in a state of diabetic ketoacidosis (call your doctor for treatment with insulin).
Some women using Avandamet have started having menstrual periods, even after not having a period for a long time due to a medical condition. You may be able to get pregnant if your periods restart. Talk with your doctor about the need for birth control. Women may also be more likely than men to have bone fractures in the upper arm, hand, or foot while taking Avandamet. Talk with your doctor if you are concerned about this possibility. FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether Avandamet passes into breast milk or if it could harm a nursing baby. Do not take Avandamet without first talking to your doctor if you are breast-feeding a baby.
Possible side effects
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.
• Low blood glucose level (hypoglycaemia).
• Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain.
• Metallic taste.
• Excessive fluid retention in the body tissues, resulting in swelling (oedema).
• Increase in the level of fats such as cholesterol in the blood.
• Low red blood cell count (anaemia).
• Weight gain.
• Changes in appetite.
• Headache.
• Dizziness.
• Muscle pain.
• Fatigue.
• Heart failure.
• Liver disorders.
• Fluid in the lungs (pulmonary oedema).
• Swelling of the back of the eye (macular oedema).
• Skin reactions such as rash or itching.
• Decrease in the body's absorption of vitamin B12.
The side effects listed above may not include all of the side effects reported by the drug's manufacturer.
For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
If you take too much
Seek emergency medical attention if you think you have used too much of this medicine. You may have signs of low blood sugar, such as hunger, headache, confusion, irritability, drowsiness, weakness, dizziness, tremors, sweating, fast heartbeat, seizure (convulsions), fainting, or coma. An overdose of Avandamet may cause a life-threatening condition called lactic acidosis. Get emergency medical help if you have any of these symptoms of lactic acidosis: weakness, increasing sleepiness, slow heart rate, cold feeling, muscle pain, shortness of breath, stomach pain, feeling light-headed, and fainting.
Additional information
Avandamet is processed primarily by the kidneys, and can build up to excessive levels in the body if the kidneys aren't working properly. It should be avoided if you have kidney disease or your kidney function has been impaired by a condition such as shock, blood poisoning, or a heart attack.
You should not use Avandamet if you need to take medicine for congestive heart failure.
Do not take Avandamet if you have ever had an allergic reaction to rosiglitazone or metformin.
Do not take Avandamet if you have metabolic or diabetic ketoacidosis (a life-threatening medical emergency caused by insufficient insulin and marked by excessive thirst, nausea, fatigue, pain below the breastbone, and fruity breath).
You should not use Avandamet if you have type 1 (insulin-dependent) diabetes, or if you are already taking insulin.
Drug interactions
You may be more likely to have hyperglycemia (high blood sugar) if you are taking Avandamet with other drugs that raise blood sugar. Drugs that can raise blood sugar include:
• isoniazid;
• diuretics (water pills);
• steroids (prednisone and others);
• phenothiazines (Compazine and others);
• thyroid medicine (Synthroid and others);
• birth control pills and other hormones;
• seizure medicines (Dilantin and others); and
• diet pills or medicines to treat asthma, colds or allergies.
You may be more likely to have hypoglycemia (low blood sugar) if you are taking Avandamet with other drugs that lower blood sugar. Drugs that can lower blood sugar include:
• some nonsteroidal anti-inflammatory drugs (NSAIDs);
• aspirin or other salicylates (including Pepto-Bismol);
• sulfa drugs (Bactrim and others);
• a monoamine oxidase inhibitor (MAOI);
• beta-blockers (Tenormin and others); or
• probenecid (Benemid).
Some medications may interact with Avandamet. Tell your doctor if you are using any of the following drugs:
• gemfibrozil (Gemcor);
• rifampin (Rifater, Rifadin, Rimactane);
• nifedipine (Adalat, Procardia);
• cimetidine (Tagamet) or ranitidine (Zantac);
• amiloride (Midamor) or triamterene (Dyrenium);
• digoxin (Lanoxin);
• morphine (MS Contin, Kadian, Oramorph);
• procainamide (Procan, Pronestyl, Procanbid);
• quinidine (Cardioquin, Quinidex, Quinaglute);
• trimethoprim (Proloprim, Primsol, Bactrim, Cotrim, Septra); or
• vancomycin (Vancocin, Lyphocin).
This list is not complete and there may be other drugs that can interact with Avandamet . Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor
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