Rosiglitazone Side Effects

It is possible that some side effects of rosiglitazone may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

For the Consumer

Applies to rosiglitazone: oral tablet

As well as its needed effects, rosiglitazone may cause unwanted side effects that require medical attention.

If any of the following side effects occur while taking rosiglitazone, check with your doctor immediately:

Less common
  • Abdominal or stomach pain
  • blurred vision
  • chest pain or discomfort
  • decrease in the amount of urine
  • dry mouth
  • flushed, dry skin
  • fruit-like breath odor
  • increased hunger
  • increased thirst
  • increased urination
  • irregular heartbeat
  • nausea
  • noisy, rattling breathing
  • pain in the shoulders, arms, jaw, or neck
  • pale skin
  • rapid or unusual weight gain
  • sweating
  • swelling of the fingers, hands, feet, or lower legs
  • trouble breathing
  • unexplained weight loss
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • vomiting
  • Anxiety
  • chills
  • cold sweats
  • coma
  • confusion
  • dark urine
  • depression
  • dizziness
  • fast heartbeat
  • headache
  • loss of appetite
  • nightmares
  • seizures
  • shakiness
  • slurred speech
Incidence not known
  • Blue lips and fingernails
  • changes in vision
  • coughing that sometimes produces a pink frothy sputum
  • hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • itching or skin rash
  • light-colored stools
  • redness of the skin
  • yellow eyes or skin

Some rosiglitazone side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

More common
  • Ear congestion
  • fever
  • general feeling of discomfort or illness
  • hoarseness or other voice changes
  • injury
  • joint pain
  • muscle aches and pains
  • runny or stuffy nose
  • shivering
  • sneezing
  • sore throat
  • trouble sleeping
Less common
  • Back pain
  • cough
  • diarrhea
  • lightheadedness
  • pain or tenderness around the eyes and cheekbones

For Healthcare Professionals

Applies to rosiglitazone: oral tablet


Rosiglitazone is generally well tolerated with the incidence of adverse effects similar to placebo. Upper respiratory tract infections, injury, headache, back pain and hypoglycemia were reported slightly more frequently than placebo in clinical trials.


Healthy volunteers receiving rosiglitazone 8 mg once daily for 8 weeks experienced a statistically significant increase in median plasma volume compared to placebo. Patients with ongoing edema are more likely to have adverse events associated with edema if started on combination therapy with insulin and rosiglitazone.

Dose-related weight gain was seen with rosiglitazone alone and in combination with other hypoglycemic agents. The mechanism is unclear but probably involves a combination of fluid retention and fat accumulation.

In a 26-week study, 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, and 2% (4 mg) and 3% (8 mg) for insulin in combination with rosiglitazone.

In postmarketing experience, there have been rare reports of usually rapid increases in weight. Patients should be assessed for fluid accumulation and volume-related events such as edema and congestive heart failure.

Cardiovascular side effects have included mild to moderate edema. Patients with congestive heart failure have experienced new or worsening edema. Hypertension has also been reported.


Hematologic side effects have included decreases in hemoglobin and hematocrit. White blood cell counts also decreased slightly.

These changes may be related to the increased plasma volume observed during treatment with rosiglitazone and have not been associated with any significant hematologic clinical effects.


Hepatic side effects have included postmarketing reports of hepatitis and of hepatic enzyme elevations to three or more time the upper limit of normal. Very rarely, reports have involved hepatic failure with and without fatal outcome. Rosiglitazone is structurally related to troglitazone, a thiazolidinedione no longer marketed in the United States, which was associated with idiosyncratic hepatotoxicity and rare cases of liver failure, liver transplants, and death during clinical use. It is recommended that liver enzymes be checked in all patients prior to the initiation of therapy and every two months for the first twelve months and periodically thereafter.


Metabolic side effects have included increases in total cholesterol, LDL, and HDL and decreases in free fatty acids. These changes were statistically significantly different from placebo or glyburide controls. Dose related weight gain has been reported in patients treated with rosiglitazone alone and in combination with other hypoglycemic agents.


Endocrine side effects have included the resumption of ovulation in premenopausal, anovulatory women with insulin resistance. These patients may be at risk for pregnancy if adequate contraception is not used.


Hypersensitivity side effects have included rare postmarketing reports of urticaria and angioedema. Postmarketing experience has included rare reports of anaphylactic reactions.


Ocular side effects have included rare postmarketing reports of new onset or worsening (diabetic) macular edema with decreased visual acuity. In some cases, symptoms improved following discontinuation of rosiglitazone. Physicians should consider the possibility of macular edema if a patient reports decreased visual acuity. There is a case report of rosiglitazone induced proptosis.


Dermatologic side effects have included angioedema and urticaria. Rash, pruritus, and Stevens-Johnson syndrome have been reported rarely postmarketing.


Respiratory side effects have included new or worsening dyspnea in patients with congestive heart failure.


Gastrointestinal side effects have included diarrhea.


Reductions in femoral neck, total hip, and lumbar spine bone mineral density and increased bone turnover markers were observed in a randomized, double-blind study of postmenopausal women with type 2 diabetes mellitus who were treated with rosiglitazone for 52 weeks.

Musculoskeletal side effects have included arthralgia and fractures of the upper arm, hand and foot in women.

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