Generic
Metformin Hydrochloride + Rosiglitazone
9 brands available in the market
At a glance
Metformin Hydrochloride + Rosiglitazone is a combination medicine used to improve glycemic control in type 2 diabetes mellitus. Metformin reduces glucose production and absorption, and Rosiglitazone increases insulin sensitivity.
Description
Metformin is a biguanide that decreases hepatic glucose production, intestinal glucose absorption, and improves insulin sensitivity by increasing peripheral glucose uptake. Rosiglitazone is a thiazolidinedione that activates nuclear PPARγ receptors to influence gene products involved in glucose and lipid metabolism, improving target cell response to insulin.
Indications
- Type 2 diabetes mellitus - as an adjunct to diet and exercise to improve glycemic control
Pharmacological class
Biguanide + Thiazolidinedione
Pharmacology
Metformin reduces glucose production and absorption; Rosiglitazone activates PPARγ receptors to improve insulin sensitivity and glucose/lipid metabolism.
Mechanism of action
Controls blood sugar by reducing glucose production and absorption and increasing insulin sensitivity.
Dosage
Adult Dose (Oral):
- Initial: 2/500 mg once or twice daily
- HbA1c >11% or FPG >270 mg/dL: 500/2 mg twice daily may be considered
- Titrate by 500/2 mg at 2-week intervals; max 2000/8 mg/day
- Switching from metformin monotherapy: Rosiglitazone 4 mg/day + current metformin dose
- Switching from rosiglitazone monotherapy: Metformin 1000 mg/day + current rosiglitazone dose
Administration
- Swallow tablet whole; do not chew, crush or break
- Take with food
- Take at the same time each day
Missed dose
If you miss a dose, take it as soon as you remember; skip if it's almost time for next dose; do not double the dose.
Drug interactions
- Additive effect with sulfonylureas
- Thiazide diuretics, corticosteroids, OCs may worsen glycemic control
- ACE inhibitors may reduce fasting blood glucose
- Cimetidine may increase serum levels
- Increased risk of lactic acidosis with iodinated contrast agents (potentially fatal)
Food interactions
Alcohol consumption with Metformin + Rosiglitazone is unsafe.
Contraindications
- Renal disease or dysfunction (males Cr >1.5 mg/dL, females >1.4 mg/dL)
- Acute or chronic metabolic acidosis (including diabetic ketoacidosis)
- Hypersensitivity to components
Side effects
Common Side Effects:
- Nausea
- Loss of appetite
- Taste change
- Abdominal pain
- Diarrhea
- Edema (peripheral edema)
- Weight gain
- Bone fracture
- Blurred vision
- Respiratory tract infection
Use in pregnancy
Use in Pregnancy: Metformin + Rosiglitazone may be unsafe during pregnancy (Category C); animal studies have shown harmful effects on the fetus. Consult your doctor.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Information regarding use during breastfeeding is not available; consult your doctor.
Precautions & warnings
- Inform doctor if symptoms of lactic acidosis occur (deep/rapid breathing, persistent nausea, vomiting, abdominal pain)
- Monitor blood sugar regularly to avoid hypoglycemia
- Avoid alcohol
- Monitor liver function regularly
- Inform doctor if weight gain, shortness of breath, irregular heartbeat, or abnormal swelling occurs
Pediatric use
Safety and efficacy not established in children.
Geriatric use
Elderly require dose adjustment due to potential decreased renal function; monitor renal function.
Renal / hepatic impairment
Renal Impairment: eGFR <30: contraindicated; eGFR 30-45: not recommended to initiate; discontinue if eGFR falls below 30; monitor renal function regularly.
Hepatic Impairment: Caution in liver disease; not recommended in severe liver disease.
Overdose effects
Overdose may cause lactic acidosis; symptomatic and supportive treatment; hemodialysis is effective.
Therapeutic class
Combination Oral Hypoglycemic Preparations
Storage conditions
Store in a cool and dry place, away from light and moisture; keep out of reach of children.
Chemical structure
Metformin Hydrochloride + Rosiglitazone