Medication Guide App

Troglitazone Side Effects

It is possible that some side effects of troglitazone 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 troglitazone: oral tablet

Stop taking troglitazone and seek emergency medical attention if you experience an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives).

In rare cases, troglitazone has caused severe liver damage resulting in death or liver transplant. Notify your doctor immediately if you develop nausea, vomiting, abdominal pain, unusual fatigue, loss of appetite, yellow skin or eyes, itching, clay-colored stools, or dark urine. These symptoms may be early signs of liver damage.

Although troglitazone does not usually cause hypoglycemia (low blood sugar), hypoglycemia may result from skipped meals, excessive exercise, or alcohol consumption. Know the signs and symptoms of hypoglycemia, which include headache, drowsiness, weakness, dizziness, fast heartbeat, sweating, tremor, and nausea. Carry a piece of hard candy or glucose tablets with you to treat episodes of low blood sugar.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

For Healthcare Professionals

Applies to troglitazone: oral tablet


During clinical trials, 1.9% of patients experienced reversible elevations in alanine transaminase (ALT) greater than 3 times the upper normal limit. Approximately 5% of patients had ALT levels greater than 1.5 times the upper limit of normal. Hyperbilirubinemia was found in 0.7% of patients (however, this incidence was less than that of patients receiving placebo).[Ref]

Hepatic side effects including severe idiosyncratic hepatocellular injury have been reported. Troglitazone has been removed from the market by its manufacturer after the FDA found that the risk of severe liver toxicity associated with the use of troglitazone was unacceptably high compared with the relatively low risk of hepatotoxicity associated with the use of two similar and safer alternatives, rosiglitazone and pioglitazone.

Hepatotoxicity associated with the use of troglitazone has usually been reversible. Hepatic failure leading to liver transplant or death has very rarely been reported.

It is recommended that clinicians choose alternative therapy and that patients who are taking troglitazone discontinue troglitazone therapy after consulting with their prescribing health care provider.[Ref]


Troglitazone is generally well tolerated with the incidence of adverse effects similar to placebo. Headache, asthenia, dizziness, back pain and nausea are reported slightly more frequently than placebo in clinical trials.[Ref]


Endocrine side effects including hypoglycemia may occur when troglitazone is used in combination with other hypoglycemic agents such as insulin or sulfonylureas. However, it has not been reported with troglitazone monotherapy.[Ref]


Hematologic effects include small decreases in hemoglobin, hematocrit, and neutrophil counts. These effects typically occur in the first four to eight weeks of therapy and may be related to an increase in plasma volume.[Ref]


Metabolic side effects including small changes in lipid levels may occur in patients receiving troglitazone.[Ref]


1. NeuschwanderTetri BA, Isley WL, Oki JC, Ramrakhiani S, Quiason SG, Phillips NJ, Brunt EM "Troglitazone-induced hepatic failure leading to liver transplantation - A case report." Ann Intern Med 129 (1998): 38-41

2. Neuschwander-Tetre BA, Isley WL, Oki JC, et al. "Troglitazone-induced hepatic failure leading to liver transplantation: a case report." Ann Intern Med 129 (1998): 38-41

3. Gitlin N, Julie NL, Spurr CL, Lim KN, Juarbe HM "Two cases of severe clinical and histologic hepatotoxicity associated with troglitazone." Ann Intern Med 129 (1998): 36-8

4. Watkins PB, Whitcomb RW "Hepatic dysfunction associated with troglitazone." N Engl J Med 338 (1998): 916-7

5. "Product Information. Rezulin (troglitazone)." Parke-Davis, Morris Plains, NJ.

6. Matsumoto K, Miyake S, Yano M, Ueki Y, Tominaga Y "Increase of lipoprotein (a) with troglitazone." Lancet 350 (1997): 1748-9

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