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Glimepiride/​Rosiglitazone

    DEA Class; Rx

    Common Brand Names; Avandaryl

    • Antidiabetics, Sulfonylureas/Thiazolidinediones

    Combination of glimepiride, a sulfonylurea, and rosiglitazone, a thiazolidinedione.
    Used for treatment of type 2 diabetes mellitus; combination may increase risk of hypoglycemia vs monotherapy.

    Indicated for the treatment of type 2 diabetes mellitus uncontrolled by diet and exercise alone.
    NOTE: Patients treated with glimepiride; rosiglitazone should be monitored for cardiovascular adverse events. The use of combination glimepiride; rosiglitazone with insulin has not been studied and is not recommended by the manufacturer.
    NOTE: When adding rosiglitazone to glimepiride in patients with or without symptomatic heart disease and diabetes, monitor closely for signs of weight gain, peripheral edema, or congestive heart failure. In general, rosiglitazone should be initiated at the lowest dose and increased gradually after at least 3 months of therapy. The risk of these symptoms is increased when higher doses of rosiglitazone are used in combination with a sulfonylurea or insulin in patients at risk of congestive heart failure. Rosiglitazone should not be added to glimepiride therapy in patients with New York Heart Association Class III or IV heart failure. Discontinue the drug if any deterioration in cardiac status occurs during therapy.

    History of a hypersensitivity reaction to rosiglitazone or glimepiride or any of the product’s ingredients

    History of allergic reaction to sulfonamide derivatives

    Diabetic ketoacidosis, with or without coma

    Heart failure NYHA Class III-IV

    • Edema (3%)
    • Myocardial infarction (≤3%)
    • Cerebrovascular accident (≤2%)
    • Cardiac failure (≤3%)
    • Headache (3-6%)
    • Hypoglycemia (4-6%)
    • Bone fracture (≤8%)
    • Nasopharyngitis (4-5%)
    • Weight gain
    • Cardiac failure
    • Increased serum ALT
    • Thrombocytopenia and thrombocytopenic purpura

    Edema; thiazolidinediones, which are peroxisome proliferator-activated receptor (PPAR) gamma agonists, can cause dose-related fluid retention, particularly when used in combination with insulin

    Hypersensitivity reactions reported in patients treated with glimepiride, including serious reactions such as anaphylaxis, angioedema, and Stevens-Johnson syndrome; if hypersensitivity reaction suspected, promptly discontinue therapy, assess for other potential causes for the reaction, and institute alternative treatment for diabetes

    Hemolytic anemia may occur with glucose 6-phosphate dehydrogenase (G6PD) deficiency when treated with sulfonylurea agents

    Pregnancy Category: C

    Lactation: not known if crosses into breast milk, avoid

    Adults

    4 mg/day PO glimepiride with 8 mg/day PO rosiglitazone.

    Elderly

    4 mg/day PO glimepiride with 8 mg/day PO rosiglitazone.

    Adolescents

    Safety and efficacy have not been established.

    Children

    Safety and efficacy have not been established.

    Glimepiride/rosiglitazone

    tablet

    • 4mg/1mg
    • 4mg/2mg
    • 4mg/4mg
    • 8mg/2mg
    • 8mg/4mg