Avandia is the trade name of the type 2 diabetes medication rosiglitazone. The primary abnormality with type 2 diabetes is insulin resistance. The body tissues do not respond normally to circulating insulin. Avandia improves responsiveness to insulin, especially in muscle, fat and liver cells. It is most commonly used in combination with other type 2 diabetes medications. Avandia is associated with some potentially dangerous side effects involving the heart. If you are taking Avandia and have questions about side effects, talk with your doctor.
Heart Failure
Avandia can cause fluid retention, an abnormal accumulation of water in the body. Fluid retention increases the heart’s workload. This may lead to new onset heart failure or worsening of preexisting heart failure. In a 2007 study published in “The New England Journal of Medicine,” Dr. Philip Home and his colleagues reported people taking a sulfonylurea or metformin plus Avandia were significantly more likely to experience heart failure compared to people taking metformin and a sulfonylurea. A 2009 follow-up report on the same group of study participants published in the journal “Lancet” confirmed the earlier finding of increased risk of heart failure associated with the use of Avandia.
The U.S. Food and Drug Administration (FDA) has mandated a black box warning for Avandia advising of the increased risk of heart failure associated with use of this medication. The warning notes that Avandia is not recommended for people with preexisting, symptomatic heart failure. It further states that Avandia should not be used in people with severe heart failure wherein fatigue, shortness of breath, chest pain or heart palpitations occur at rest or with minimal activity.
Angina and Heart Attack
When the blood supply to the heart is abnormally low, the heart tissues do not receive sufficient oxygen. This is called ischemia. Mild to moderate heart ischemia often causes chest pain, known as angina. With severe ischemia, heart cells die from lack of oxygen. This is a heart attack. Research studies examining whether Avandia increases the risk of angina and heart attack have reached conflicting conclusions. Some studies have shown an increased level of risk associated with Avandia–taken alone or in combination with other oral diabetes medications–while other studies did not. Although the data are inconclusive, the FDA has mandated a black box warning advising of the possibility of increased risk for angina and heart attack associated with the use of Avandia.
Edema
Avandia may cause edema–tissue swelling caused by increased retention of water by the kidneys. Edema can be dangerous in people with heart disease, as it may lead to new onset heart failure. The development of shortness of breath and fatigue along with edema may indicate the development of heart failure. In addition, edema may complicate the management of chronic kidney disease, which occurs commonly in people with long-standing diabetes.
About this Author
Tina Andrews has been a medical writer and editor since 2000. She has published in “Cancer,” “Ethnicity & Disease,” and “Liver Health Today,” and was formerly a medical officer with the Centers for Disease Control and Prevention. Andrews holds a Doctor of Medicine degree and a Bachelor of Arts in chemistry.
