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
Therapeutic class
Combination Oral Hypoglycemic Preparations
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.
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
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
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
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.
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.
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.
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