Rosiglitazone Dosage

The information at Drugs.com is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist.

Usual Adult Dose for:

Additional dosage information:

Usual Adult Dose for Diabetes Type 2

Initial dose: 4 mg orally once a day
Maintenance dose: If inadequate response is not achieved after 8 to 12 weeks, increase to 8 mg once a day
Maximum dose: 8 mg per day

Comments:
-May take as a single daily dose or in 2 divided doses.
-Monitor closely for fluid related adverse events with initiation and dose titration.

Use: To improve glycemic control in adult patients with type 2 diabetes mellitus as an adjunct to diet and exercise.

Renal Dose Adjustments

No adjustment recommended.

Liver Dose Adjustments

Not recommended in patients with active liver disease or in patients with ALT elevations 2.5 times the upper limit of normal (2.5 x ULN).

-If ALT elevations greater than 3 x ULN develop during therapy, recheck as soon as possible; if ALT remains greater than 3 x ULN, treatment should be discontinued.
-If symptoms suggestive of liver dysfunction develop, liver enzymes should be checked; if jaundice develops, treatment should be discontinued.

Dose Adjustments

-If signs or symptoms of heart failure develop, dose reduction or drug discontinuation should be considered.

-If hypoglycemia develops, dose reduction of concomitant agent may be necessary.

Precautions

The US FDA requires a Risk Evaluation and Mitigation Strategy (REMS) for rosiglitazone. It includes a medication guide, elements to assure safe use, and an implementation system. For additional information: www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm111350.htm

US BOXED WARNING: Congestive Heart Failure
-Thiazolidinediones, including rosiglitazone, may cause or exacerbate congestive heart failure.
-After initiation of therapy and with any dosage increase, observe patients carefully for signs and symptoms of heart failure including excessive, rapid weight gain, dyspnea, and/or edema; if signs and symptoms of heart failure develop, manage in accordance to current standards of care.
-Drug discontinuation or dosage reduction should be considered in patients showing signs and symptoms of heart failure; this drug is not recommended in patients with symptomatic heart failure.
-Initiation in patients with established NYHA Class II or IV heart failure is contraindicated.

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Hemodialysis: No adjustment recommended.
Peritoneal dialysis: Data not available

Other Comments

Administration advice:
-Take with or without food

General:
-Coadministration with insulin is not recommended.
-This drug should not be used in patients with symptomatic heart failure.
-A reduction in blood glucose may be seen in 2 weeks, however it may be 2 to 3 months to realize the full therapeutic effect.
-Hypoglycemia may occur if used in combination with other hypoglycemic agents; dose reduction of concomitant drug may be necessary.
-This drug should not be used in patients with type 1 diabetes or diabetic ketoacidosis.

Monitoring:
-Observe closely for signs and symptoms of heart failure
-Hepatic: Monitor liver enzymes baseline and periodically
-Monitor glycemic control

Patient advice:
-This drug may cause edema; patients experiencing rapid weight gain, shortness of breath or other symptoms of heart failure should notify their health care professional promptly.
-Premenopausal anovulatory women may be at risk for pregnancy while on this drug; patients should be informed of risk and adequate contraception should be offered.
-Patients with unexplained nausea, vomiting, abdominal pain, fatigue, anorexia, or dark urine should be advised to report these symptoms to their health care professional.

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