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Avandaryl

Generic Name: glimepiride and rosiglitazone (glye MEP ir ide and ROE si GLI ta zone)
Brand Names: Avandaryl
Avandaryl (glimepiride / rosiglitazone) is a diabetic medication for people with type 2 diabetes who do not use daily insulin injections. Includes Avandaryl side effects, interactions and indications.
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Drug Information:
Avandaryl contains a combination of glimepiride and rosiglitazone, two oral diabetes medicines that help control blood sugar levels. Avandaryl is for people with type 2 diabetes. This medication is not for treating type 1 diabetes. Avandaryl is not recommended for use with insulin. Taking Avandaryl while you are using insulin may increase your risk of serious heart problems. You should not use Avandaryl if you have severe or uncontrolled heart failure, or if you are allergic to sulfa drugs. Do not use this medicine if you are in a state of diabetic ketoacidosis (call your doctor for treatment with insulin). Learn more

Avandaryl Side Effects

Avandaryl Side Effects

Note: This document contains side effect information about glimepiride / rosiglitazone. Some of the dosage forms listed on this page may not apply to the brand name Avandaryl.

Applies to glimepiride/rosiglitazone: oral tablet

Endocrine

Frequency not reported: Resumption of ovulation in premenopausal, anovulatory women, hormonal imbalance

Cardiovascular

Major Adverse Cardiovascular Events:

Overall data from rosiglitazone long-term trials including the RECORD, ADOPT, and DREAM trials (rosiglitazone n=6311; control n=7756) showed no difference in overall mortality or major adverse cardiovascular events; however, a meta-analysis of shorter-term trials suggests and increased risk for myocardial infarction with rosiglitazone compared with placebo.

The RECORD trial (Rosiglitazone evaluated for Cardiac Outcomes and Regulation of Glycemia in Diabetes; mean age 58 years; 52% male) revealed no significant difference in cardiovascular hospitalization or cardiovascular death (primary outcome) among patients with type 2 diabetes receiving rosiglitazone add-on therapy (n=2220) compared with active control (n=2227); however, there was a significant difference in the incidence of congestive heart failure (secondary endpoint). Patients who had failed metformin or sulfonylurea monotherapy were randomized to add-on rosiglitazone or active control (add-on metformin for those inadequately controlled on sulfonylurea or add-on sulfonylurea for those inadequately controlled on metformin). Patients were treated to a target glycosylated hemoglobin (HbA1c) of 7% or less. Heart failure was reported in 61 patients receiving add-on rosiglitazone and 29 patients receiving active control.

In a retrospective analysis of 42 clinical trials (mean duration 6 months), rosiglitazone was associated with an increased risk of myocardial ischemia compared with combined active or placebo control (2% versus 1.53%). These events included angina pectoris, angina dyspnea, myocardial infarction, coronary thrombosis, myocardial ischemia, coronary artery disease, and coronary artery disorder. There was an increased risk with combination insulin therapy and in patients receiving nitrates for known coronary heart disease.

Cardiovascular Events in Patients with NYHA Class I and II Heart Failure:

An increased risk of cardiovascular events was observed in a 52-week trial in patients with NYHA Class I and II Heart Failure receiving rosiglitazone (n=110) compared with placebo (n=114). These events included: cardiovascular deaths (5% vs 4%), worsening CHF (6% vs 4%), new or worsening edema (25% vs 9%), new or worsening dyspnea (26% vs 17%), increases in CHF medication (33% vs 18%), and cardiovascular hospitalization (19% vs 13%).

Edema:

-Dose-related edema was reported in rosiglitazone clinical trials. In patients receiving rosiglitazone 8 mg in combination with a sulfonylurea, the incidence of edema was 12.4%. In monotherapy trials, edema was reported in 4.8% of patients receiving rosiglitazone (dose not specified). Healthy volunteers receiving rosiglitazone 8 mg once daily for 8 weeks experienced a statistically significant increase in median plasma volume compared with placebo.

Concomitant Administration with Insulin:

-Edema was reported with higher frequency in the rosiglitazone plus insulin combination trials (insulin, 5.4%; and rosiglitazone with insulin 14.7%). Reports of new onset or exacerbation of congestive heart failure occurred at a rate of 1% for insulin alone, 2% (4 mg) and 3% (8 mg) for insulin in combination with rosiglitazone. The coadministration of rosiglitazone and insulin is not recommended.

Glimepiride-Rosiglitazone:

Common (1% to 10%): Edema, hypertension

Uncommon (0.1% to 1%): Congestive heart failure

Glimepiride: Common (1% to 10%): Edema, hypertension

Rosiglitazone:

Common (1% to 10%): Edema, hypertension

Uncommon (0.1% to 1%): Congestive heart failure

Frequency not reported: Cardiovascular deaths, myocardial infarction, angina, angina pectoris, angina dyspnea, myocardial infarction, coronary thrombosis, myocardial ischemia, coronary artery disease, coronary artery disorder

Respiratory

Glimepiride-Rosiglitazone:

Common (1% to 10%): Nasopharyngitis

Rosiglitazone:

Common (1% to 10%): Upper respiratory infection

Postmarketing reports: Pulmonary edema, pleural effusions

Nervous system

Glimepiride-Rosiglitazone:

Common (1% to 10%): Headache, dizziness

Glimepiride:

Common (1% to 10%): Headache, dizziness

Rosiglitazone:

Common (1% to 10%): Headache

Frequency not reported: Stroke

General

The most commonly reported adverse reports included headache, hypoglycemia, and nasopharyngitis.

Gastrointestinal

Glimepiride:

Common (1% to 10%): Nausea

Rare (less than 0.1%): Vomiting, gastrointestinal pain, diarrhea

Rosiglitazone:

Common (1% to 10%): Diarrhea

Hepatic

Glimepiride:

Rare (less than 0.1%): Liver enzyme elevations,

Frequency not reported: Liver function impairment, e.g., cholestasis, jaundice, hepatitis, hepatic porphyria reactions and disulfiram-like reactions

Rosiglitazone:

Postmarketing reports: Hepatitis, hepatic enzyme elevations greater than 3 times the upper limit of normal, hepatic failure

Hypersensitivity

Rosiglitazone:

Postmarketing reports: Anaphylactic reaction

Dermatologic

Glimepiride:

Rare (less than 0.1%): Allergic skin reactions, e.g. pruritus, erythema, urticaria, and morbilliform or maculopapular eruptions

Frequency not reported: Porphyria cutanea tarda, photosensitivity reactions, allergic vasculitis

Rosiglitazone:

Postmarketing reports: Rash, pruritus, urticaria, angioedema, Stevens-Johnson syndrome

Hematologic

Anemia was reported in 1.9% of patients receiving rosiglitazone as monotherapy. When taken in combination with metformin, a sulfonylurea, or metformin plus a sulfonylurea, the incidence of anemia was 7.1%, 2.3%, and 6.7%, respectively. Laboratory findings have shown dose-related decreases in hemoglobin and hematocrit; mean decreases in hemoglobin were 1 g/dL and up to 3.3% in hematocrit. These changes primarily occurred during the first 3 months or following a dose increase. They may be related to increased plasma volume.

Glimepiride:

Frequency not reported: Leukopenia, agranulocytosis, thrombocytopenia, hemolytic anemia, aplastic anemia, pancytopenia

Rosiglitazone:

Common (1% to 10%): Anemia

Frequency not reported: Decrease in WBC counts

Metabolic

Glimepiride-Rosiglitazone:

Common (1% to 10%): Hypoglycemia

Frequency not reported: Weight gain

Glimepiride:

Common (1% to 10%): Hypoglycemia

Frequency not reported: Hyponatremia, syndrome of inappropriate antidiuretic hormone (SIADH) secretion, changes in serum lipids

Rosiglitazone:

Uncommon (0.1% to 1%): Hypoglycemia

The mechanism of weight gain is unclear, although it probably is due to a combination of fluid retention and fat accumulation. Dose-related weight gain was observed in trials with the combination glimepiride / rosiglitazone and rosiglitazone alone. Mean weight gain in patients receiving the combination glimepiride 4 mg/rosiglitazone 4 mg was 2.2 kg and 2.9 kg for patients receiving glimepiride 4 mg/rosiglitazone 8 mg.

Ocular

Glimepiride:

Uncommon (0.1% to 1%): Blurred vision

Rosiglitazone:

Postmarketing reports: Diabetic macular edema with decreased visual acuity

Musculoskeletal

Rosiglitazone:

Common: Back pain, arthralgia,

Frequency not reported: Fractures, bone mineral density decreases

Large long-term clinical trials have shown an increased incidence of bone fracture in patients receiving rosiglitazone in combination with sulfonylurea or metformin as rosiglitazone alone. This increased incidence appeared after the first year and persisted. The majority of fractures were observed in women and occurred in the upper arm, hand, and foot.

Other

Glimepiride:

Common (1% to 10%): Asthenia

Rosiglitazone:

Common (1% to 10%): Injury

Editorial References and Review

Medically reviewed by BestRx Medical Team Last updated on 1/1/2020.

Source: Drugs.com Avandaryl