Before you begin taking a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take this medication.
Fluid retention and heart failure: Rosiglitazone can cause fluid buildup in the body, which may lead to heart failure. Your doctor will monitor you for these problems. If you develop fluid buildup or swelling, shortness of breath, fatigue, or excessive weight gain while taking this medication, contact your doctor immediately. If you have a history of heart failure, you should not take rosiglitazone. Since the risk of heart failure and fluid buildup increases when rosiglitazone is used with other antidiabetes medications, rosiglitazone - metformin should not be used by people who are also taking a sulfonylurea (e.g., glyburide, gliclazide) or insulin.
Fractures: Women taking rosiglitazone may be at an increased risk of bone fractures, especially of the upper arm, hand, and foot. Discuss the risk and benefits of using this medication with your doctor.
Heart attack and chest pain: Rosiglitazone can increase the risk of chest pain (angina) and heart attacks. If you have underlying heart disease, or are at a high risk of heart attack, discuss the risks and benefits of using this medication with your doctor. This medication is not recommended for people who take nitrates (e.g., nitroglycerin, isosorbide mononitrate, isosorbide dinitrate), which are used to relieve chest pain.
Kidney function: Kidney disease or reduced kidney function may cause this medication to build up in the body, causing side effects. If you have reduced kidney function or kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Lactic acidosis: Lactic acidosis is a rare but serious problem that occurs when the body doesn’t get rid of metformin fast enough. It mostly occurs in people who have impaired kidney function. Excessive alcohol intake can also increase the risk of lactic acidosis. When it does occur (very rarely), it is fatal in 50% of cases. If you notice symptoms of lactic acidosis (including diarrhea, unusual nausea or vomiting, fast shallow breathing, muscle pain or cramping, unusual sleepiness, unusual tiredness or weakness, feeling cold, dizziness or lightheaded, slow or irregular heartbeat), get emergency medical attention immediately.
Liver: Rosiglitazone may cause liver damage which in some cases, has caused death. If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.
Loss of blood glucose control: Loss of blood glucose control can occur during times of acute stress such as fever, trauma, infection, or surgery. During these times, your doctor may temporarily stop this medication and use insulin until you have recovered.
Ovulation: Some women using rosiglitazone may start having menstrual periods, even after not having a period due to a medical condition (e.g., polycystic ovary syndrome). As a result, there may be a risk that you could get pregnant if adequate contraception is not used. Talk to your doctor about the need for birth control.
Surgery: This medication should be stopped 2 days before any surgical procedure (except minor procedures with no restrictions on food or fluid intake).
Vision: Rosiglitazone may cause swelling of the retina in the eye. If you experience any vision changes while taking rosiglitazone, contact your doctor immediately.
Vitamin B12 and folic acid: Some people may not be able to absorb enough vitamin B12 and folic acid while they are taking this medication. People using this medication should have their levels of vitamin B12 and folic acid checked at least every 1 to 2 years.
Pregnancy: This medication should not be used during pregnancy. Usually, insulin is used to control high blood glucose during pregnancy. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: It is not known if rosiglitazone and metformin pass into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of this medication have not been established for children under 18 years of age.
Seniors: Seniors may be more at risk for serious side effects from this medication due to age-related changes in kidney function. Lower doses of this medication may be needed.