What Is Avandia?

Avandia (rosiglitazone) is used to lower blood sugar levels in people who have type 2 diabetes. It is in a class of medications called thiazolidinediones.

People with type 2 diabetes have trouble controlling blood sugar (glucose) because their body does not respond to insulin. Insulin is a hormone that brings sugar levels down in your body.

Thiazolidinedione medications help lower blood sugar levels by making your body respond to insulin, allowing sugar to enter your tissues instead of staying in the blood.

You can get Avandia by prescription, and it is available as a tablet taken by mouth.

What Is Avandia Used For?

The Food and Drug Administration (FDA) approved Avandia to lower blood sugar levels, specifically for adults with type 2 diabetes. It is not meant to be used in people with type 1 diabetes or for diabetic ketoacidosis, a complication of diabetes. It should also not be used in combination with insulin.

Drug Facts

Generic Name: Rosiglitazone

How to Take Avandia

Take Avandia as instructed by your healthcare provider. Avandia is prescribed as a tablet taken by mouth with water. You can take it with or without food. The typical dosing is between 4 and 8 milligrams (mg) of rosiglitazone every 24 hours as a single dose or two half doses. Do not take more than 8 mg per day.

While taking Avandia, continue monitoring your sugar levels to make sure they are in the proper range.

Storage

Store your medication at room temperature (between 68 and 77 degrees F), away from moisture. Storing your medication in extremely hot or cold temperatures can prevent the medication from working correctly.

As always, ensure your medication is kept secure and out of the reach of children and pets to prevent accidental consumption. Contact your pharmacy or healthcare provider to request a refill if you need more medication.

 Off-Label Uses

Healthcare providers may prescribe rosiglitazone for off-label uses, meaning for conditions not specifically indicated by the FDA.

Other than lowering your blood sugar levels, your healthcare provider can prescribe Avandia to help treat other diseases, such as:

  • Renarrowing of blood vessels after stenting
  • Prevention of type 2 diabetes
  • Polycystic ovary syndrome (PCOS)

What Are the Side Effects of Avandia?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at www.fda.gov/medwatch or 800-FDA-1088.

How Long Does Avandia Take to Work?

The rate at which Avandia can lower your blood sugar levels can vary from person to person. Listed below is the onset of action and peak in plasma of rosiglitazone:

Common Side Effects

The following side effects are commonly reported while taking Avandia:

  • Cold-like symptomsHeadache

Severe Side Effects

Do not hesitate to contact your healthcare provider right away if you are experiencing any of these serious side effects. Call 911 immediately if you feel your life is at risk or you believe you need medical assistance.

Severe side effects associated with Avandia include:

  • Allergic reaction, which can manifest as hives, itching, or closing of the throat
  • Macular edema (swelling in the back of the eye), which can cause vision changes
  • Low blood sugar (hypoglycemia), with signs such as shaking, rapid heart rate, or confusion
  • Heart attack, with symptoms such as chest discomfort, shortness of breath, cold sweat, nausea or vomiting, and lightheadedness
  • Heart failure, which includes symptoms such as chest pain, fainting, cold sweats, leg swelling
  • Swelling (edema) caused by fluid retention
  • Weight gain
  • Liver problems, which can cause symptoms such as nausea or vomiting, stomach pain, unusual or unexplained fatigue, appetite loss, dark urine, and yellowing of the skin or whites of the eyes (jaundice)
  • Broken bones
  • Low red blood cell count (anemia)

Additionally, when taking rosiglitazone, there is a potential risk of an unexpected pregnancy in premenopausal women as the medication can increase ovulation.

Long-Term Side Effects

While Avandia can help you lower your blood sugar levels, long-term use of rosiglitazone can put you at risk of having a heart attack or experiencing heart failure. It is important to talk to your healthcare provider if you notice unwanted effects such as chest pain, swelling of the leg, or difficulty breathing.

Dosage: How Much Avandia Should I Take?

Modifications

Before starting this medication, talk to your healthcare provider about whether you should adjust your dosage for any reason. Common reasons you may need to modify your Avandia dose include:

Report Side Effects

Avandia may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the FDA’s MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

The dose of this medicine will be different for different patients. Follow your doctor’s orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):

  • For type 2 diabetes:

  • Adults—At first, 4 milligrams (mg) per day, taken as a single dose or divided into two doses. Your doctor may adjust your dose as needed. However, the dose is usually not more than 8 mg per day.

  • Children—Use and dose must be determined by your doctor.

  • For type 2 diabetes:

  • Adults—At first, 4 milligrams (mg) per day, taken as a single dose or divided into two doses. Your doctor may adjust your dose as needed. However, the dose is usually not more than 8 mg per day.

  • Children—Use and dose must be determined by your doctor.

  • Adults—At first, 4 milligrams (mg) per day, taken as a single dose or divided into two doses. Your doctor may adjust your dose as needed. However, the dose is usually not more than 8 mg per day.

  • Children—Use and dose must be determined by your doctor.

  • If you are 65 years or older, your healthcare provider may not need to adjust the dosage for Avandia.If you have liver problems, your provider will first run tests to see if you’re a good fit to take Avandia.There is limited information on the appropriate dose of Avandia in children; however, your healthcare provider will choose another medication that best suits your child.

If you have mild or moderate kidney problems, it is safe to take Avandia at its regular dosage.

Missed Dose

If you miss a dose, take the missed dose as soon as you remember.  If it is almost time for the next dose, skip the missed dose and continue your normal dosing schedule. It is important that you only take one dose at a time, so do not take two doses at the same time to make up for the missed dose. Taking more Avandia than instructed can cause your blood pressure to drop dangerously low.

Overdose: What Happens If I Take Too Much Avandia?

Due to limited information, there is no set amount of Avandia reported that can cause an overdose. However, it is important not to go over 8 mg of Avandia within 24 hours. Taking any amount greater than that daily can put you at risk of dangerously low blood sugar levels.

Common symptoms of extremely low blood sugar are:

  • UnresponsivenessSlow heart rateSlow breathing rateConfusion

Whether taking excess Avandia was intentional or accidental, an overdose of rosiglitazone can lead to detrimental health effects. So, it is crucial that if you are experiencing or see someone who is experiencing these symptoms after taking Avandia, call 911 or contact the Poison Control Center immediately.

Precautions

What Are Reasons I Shouldn’t Take Avandia?

You should not take Avandia if any of the following apply to you:

What Happens If I Overdose on Avandia?

If you think you or someone else may have overdosed on Avandia, call a healthcare provider or the Poison Control Center (800-222-1222).

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

Call your doctor right away if you have chest pain or discomfort, nausea, pain or discomfort in the arms, jaw, back, or neck, shortness of breath, sweating, or vomiting. These may be symptoms of a heart attack.

If you are rapidly gaining weight or having shortness of breath, chest pain or discomfort, extreme tiredness or weakness, irregular breathing, irregular heartbeat, or excessive swelling of the hands, wrist, ankles, or feet, check with your doctor right away. These may be symptoms of a heart problem or edema (fluid retention).

If you have abdominal or stomach pain, dark urine, a loss of appetite, nausea or vomiting, unusual tiredness or weakness, or yellow eyes or skin, check with your doctor right away. These may be symptoms of a serious liver problem.

Check with your doctor right away if blurred vision, difficulty in reading, or any other change in vision occurs while you are taking this medicine. Your doctor may want you to have your eyes checked by an ophthalmologist (eye doctor).

This medicine may increase the risk for bone fractures in women. Ask your doctor about ways to keep your bones strong to help prevent fractures.

Certain women may be at an increased risk for pregnancy while taking this medicine. If you had problems ovulating and had irregular periods in the past, this medicine may cause you to ovulate. This could increase your chance of becoming pregnant. If you are a woman of childbearing potential, you should discuss birth control options with your doctor.

Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain medical tests.

It is very important to carefully follow any instructions from your doctor about:

  • Alcohol—Drinking alcohol may cause severe low blood sugar. Discuss this with your doctor.
  • Other medicines—Do not take other medicines unless they have been discussed with your doctor. This especially includes nonprescription medicines such as aspirin, and medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems.
  • Counseling—Other family members need to learn how to prevent side effects or help with side effects if they occur. Also, diabetic patients may need special counseling about diabetes medicine dosing changes that might occur because of lifestyle changes, such as changes in exercise and diet. Furthermore, counseling on contraception and pregnancy may be needed because of the problems that can occur in patients with diabetes during pregnancy.
  • Travel—Keep a recent prescription and your medical history with you. Be prepared for an emergency as you would normally. Make allowances for changing time zones and keep your meal times as close as possible to your usual meal times.
  • In case of emergency—There may be a time when you need emergency help for a problem caused by your diabetes. You need to be prepared for these emergencies. It is a good idea to wear a medical identification (ID) bracelet or neck chain at all times. Also, carry an ID card in your wallet or purse that says that you have diabetes and a list of all of your medicines.
  • Symptoms of fluid retention—Know what to do if you start to retain fluid. Fluid retention may worsen or lead to heart problems.

This medicine does not cause hypoglycemia (low blood sugar). However, low blood sugar can occur if you delay or miss a meal or snack, exercise more than usual, drink alcohol, cannot eat because of nausea or vomiting, or take rosiglitazone with another type of diabetes medicine. The symptoms of low blood sugar must be treated before they lead to unconsciousness (passing out). Different people feel different symptoms of low blood sugar. It is important that you learn which symptoms of low blood sugar you usually have so that you can treat it quickly.

  • Symptoms of low blood sugar include anxiety, behavior change similar to being drunk, blurred vision, cold sweats, confusion, cool, pale skin, difficulty in thinking, drowsiness, excessive hunger, fast heartbeat, headache (continuing), nausea, nervousness, nightmares, restless sleep, shakiness, slurred speech, or unusual tiredness or weakness.
  • If symptoms of low blood sugar occur, eat glucose tablets or gel, corn syrup, honey, or sugar cubes, or drink fruit juice, non-diet soft drinks, or sugar dissolved in water to relieve the symptoms. Also, check your blood for low blood sugar. Glucagon is used in emergency situations when severe symptoms such as seizures (convulsions) or unconsciousness occur. Have a glucagon kit available, along with a syringe and needle, and know how to use it. Members of your family also should know how to use it.

Hyperglycemia (high blood sugar) may occur if you do not take enough or skip a dose of your medicine, overeat or do not follow your meal plan, have a fever or infection, or do not exercise as much as usual.

  • Symptoms of high blood sugar include blurred vision, drowsiness, dry mouth, flushed, dry skin, fruit-like breath odor, increased urination (frequency and amount), ketones in the urine, loss of appetite, sleepiness, stomachache, nausea, or vomiting, tiredness, troubled breathing (rapid and deep), unconsciousness, or unusual thirst.

  • If the symptoms of high blood sugar occur, check your blood sugar level and call your doctor for instructions.

  • Allergies to rosiglitazone

  • Heart failure

  • Type 1 diabetes

  • Pregnancy

  • Current insulin or nitrate use

What Other Medications Interact With Avandia?

When taking Avandia, you must be aware that taking other medications or supplements can make your side effects worse or even lower the effectiveness of the treatment due to interactions.

Do not take any of the following medications with rosiglitazone:

  • Medications that prevent the liver protein called CYP3A4 from working well (e.g., CYP3A4 inhibitors), such as Lopid (gemfibrozil)
  • Medications that encourage the breakdown of CYP3A4 (e.g., CYP3A4-inducing medications), such as rifampin
  • Insulin

CYP3A4 is a liver protein responsible for breaking down and clearing out certain drugs, like Avandia. CYP3A4-inhibiting drugs prevent CYP3A4 from working as well, which can lead to higher levels of rosiglitazone, as the drug isn’t cleared out of the body quickly enough. This may enhance its side effects.

CYP3A4-inducing drugs, on the other hand, cause CYP3A4 to break down rosiglitazone more quickly. This can reduce how well rosiglitazone works.

Taking Avandia and insulin together can cause an increased risk of heart failure.

Talk with your pharmacist or provider for more detailed information about medication interactions with Avandia. Tell them about any other medicines you take or plan to take, including over-the-counter (OTC) nonprescription products, vitamins, herbs, supplements, and plant-based medicines.

What Medications Are Similar?

Another drug belonging to the thiazolidinedione class is Actos (pioglitazone). Like Avandia, Actos is used to lower blood sugar levels.

Both Avandia and Actos work equally well. The main advantage pioglitazone has over Avandia is a lower risk of developing adverse heart-related effects.

Even though thiazolidinediones can help lower your blood sugar levels, they are not a first-line treatment for high blood sugar. Instead, medications called biguanides, such as Glumetza (metformin), are first-line treatments for blood sugar control.

Due to its risk of causing heart failure, other medications may be more appropriate to use in people with or at risk of heart disease. These include:

  • Glucagon-like peptide 1 receptor agonists, such as Victoza (liraglutide) and Ozempic (semaglutide)
  • Sodium-glucose cotransporter 2 inhibitors, such as Jardiance (empagliflozin) and Farxiga (dapagliflozin)

This is a list of drugs also prescribed for to help control blood sugar levels. It is not a list of drugs recommended to take with Avandia. You should not take these drugs together. Talk to your pharmacist or a healthcare provider if you have questions.

How Can I Stay Healthy While Taking Avandia?

If you have been prescribed Avandia, you are likely navigating how to care for yourself with type 2 diabetes. Keeping your blood sugar levels under control is important to prevent further complications.

Frequently Asked Questions

  • Can I take Avandia if I have type 1 diabetes?
  • No, Avandia is not recommended for those with type 1 diabetes. This is because people who have type 1 diabetes do not produce insulin. Avandia stimulates your cells to respond to insulin already present in the body.
  • If I had previous experience with heart failure, should I take Avandia?
  • No, you should not take Avandia if you have heart failure or have a history of heart disease. Talk to your healthcare provider if this is the case.
  • How can I afford Avandia?
  • Unfortunately, there is no generic product available for a more affordable price. How much you pay for your medication will depend on your health insurance. If you have any financial concerns, contact your healthcare provider or pharmacist about your options. Patient assistance programs are sometimes available for eligible individuals.

No, Avandia is not recommended for those with type 1 diabetes. This is because people who have type 1 diabetes do not produce insulin. Avandia stimulates your cells to respond to insulin already present in the body.

No, you should not take Avandia if you have heart failure or have a history of heart disease. Talk to your healthcare provider if this is the case.

Unfortunately, there is no generic product available for a more affordable price. How much you pay for your medication will depend on your health insurance. If you have any financial concerns, contact your healthcare provider or pharmacist about your options. Patient assistance programs are sometimes available for eligible individuals.

Continue to take your medication as instructed, even if you feel fine. In addition, lifestyle changes can help improve insulin resistance, such as light exercise and a low-carb diet. It might be difficult to change your lifestyle, but it does not hurt to start small and gradually work your way up. Your healthcare provider can let you know what level of activity and lifestyle change would be right for you.

The author would like to recognize and thank Alexya Rosas for contributing to this article.

Medical Disclaimer

Verywell Health’s drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.