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Rezulin (troglitazone) Disease Interactions

There are 2 disease interactions with Rezulin (troglitazone):

Major

Troglitazone (Includes Rezulin) ↔ liver disease

Severe Potential Hazard, High plausibility. Applies to: Liver Disease, Alcoholism

The initiation of troglitazone therapy is contraindicated in patients who have a history of liver disease or alcohol abuse; exhibit clinical evidence of active liver disease; or demonstrate increased serum transaminase levels (ALT > 1.5 times the upper limit of normal). The use of troglitazone has been associated with significant elevations in serum ALT levels as well as severe idiosyncratic hepatocellular injury, which has generally been reversible but, in a few cases, led to liver transplant or death. Injury has occurred after both short- and long-term treatment. Patients who receive troglitazone therapy should have serum transaminase levels checked at the start of therapy, at least monthly for the first year, and at least quarterly thereafter. If signs or symptoms suggestive of liver injury occur, liver function tests should be performed. Moderate elevations (ALT > 1.5 to 2 times ULN) require immediate re-testing and weekly monitoring until levels return to normal. Troglitazone should be withdrawn if ALT rises above 3 times ULN or jaundice develops.

References

  1. 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
  2. Prendergast KA, Berg CL, Wisniewski R "Troglitazone-associated hepatotoxicity treated successfully with steroids." Ann Intern Med 133 (2000): 751
  3. "Product Information. Rezulin (troglitazone)." Parke-Davis, Morris Plains, NJ.
  4. 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
  5. St. Peter JV, Neafus KL, Khan MA, Vessey JT, Lockheart SK "Factors associated with the risk of liver enzyme elevation in patients with type 2 diabetes treated with a thiazolidinedione." Pharmacotherapy 21 (2001): 183-88
  6. Watkins PB, Whitcomb RW "Hepatic dysfunction associated with troglitazone." N Engl J Med 338 (1998): 916-7
  7. Nightingale SL "Rezulin labeling updated to recommend more frequent patient monitoring." JAMA 279 (1998): 9
  8. 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
View all 8 references
Moderate

Thiazolidinediones (Includes Rezulin) ↔ macular edema

Moderate Potential Hazard, Moderate plausibility. Applies to: Diabetes Mellitus, Diabetic Macular Edema

New onset or worsening diabetic macular edema with decreased visual acuity have been reported in postmarketing reports in some diabetic patients who were taking thiazolidinedione drugs. Some patients presented with blurred vision or decreased visual acuity, but some patients appear to have been diagnosed on routine ophthalmologic examination. Most patients had peripheral edema at the time macular edema was diagnosed. Some patients had improvement in their macular edema after discontinuation of their thiazolidinedione. Patients with diabetes should have regular eye exams by an ophthalmologist according to current standards of care. Additionally, any diabetic who reports any kind of visual symptom should be promptly referred to an ophthalmologist, regardless of the patient's underlying medications or other physical findings.

Rezulin (troglitazone) drug interactions

There are 936 drug interactions with Rezulin (troglitazone)

Rezulin (troglitazone) alcohol/food interactions

There is 1 alcohol/food interaction with Rezulin (troglitazone)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No information available.

Do not stop taking any medications without consulting your healthcare provider.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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