NovoLog PenFill and Rosiglitazone

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Using rosiglitazone together with insulin aspart may increase the risk and/or severity of side effects such as hypoglycemia (low blood sugar), fluid retention, swelling, and possibly heart failure. Talk to your doctor if you have any questions or concerns. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if you experience hypoglycemia, symptoms of which may include headache, dizziness, drowsiness, nervousness, confusion, tremor, nausea, hunger, weakness, perspiration, palpitation, and rapid heartbeat. Also seek medical attention if you develop sudden, unexplained weight gain; swelling of the hands, ankles, or feet; chest pain; or difficulty breathing during treatment with these medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

ADJUST DOSE: Coadministration of a thiazolidinedione in combination with insulin may increase the risk of edema compared to insulin alone. The mechanism is unknown but may involve enhancement of the antinatriuretic and/or peripheral vasodilatory effects of insulin. In a retrospective study of 79 patients who were initially on a thiazolidinedione or insulin separately but were subsequently given both in combination, 20 patients (25.3%) developed edema during the combination, compared to 7 of 71 patients (9.9%) during insulin alone and 1 of 8 patients (12.5%) during thiazolidinedione alone. In a study of 319 type 2 diabetic patients inadequately controlled on twice-daily insulin monotherapy, edema occurred in 13.1% and 16.2% of the patients coadministered rosiglitazone 4 mg/day and 8 mg/day, respectively, compared to 4.7% of those coadministered a matching placebo. The specific combination of rosiglitazone and insulin has also been associated with an increased incidence of heart failure and other cardiovascular adverse events compared to insulin and placebo. Data are derived from three 26-week trials involving 876 patients with type 2 diabetes, including those with longstanding diabetes and a high prevalence of preexisting medical conditions (peripheral neuropathy, retinopathy, ischemic heart disease, vascular disease, and congestive heart failure). An increased incidence of edema, heart failure, and other adverse effects occurred in the patients receiving the combination compared to patients receiving insulin alone. In the studies, patients who experienced heart failure with the combination were on average older, had a longer duration of diabetes, and were mostly on the higher 8 mg daily dosage of rosiglitazone. However, 3 of 10 had no known prior evidence of any underlying cardiac condition. A subsequent study involving 220 type 2 diabetes patients with chronic renal failure found no difference in cardiovascular adverse events among patients receiving the combination and controls receiving insulin with placebo.

MANAGEMENT: When used with insulin, the manufacturer recommends that rosiglitazone dosage not exceed 4 mg/day and that patients be monitored for cardiovascular adverse effects. The combination should be discontinued if there is a lack of response (defined as a reduction in HbA1c or insulin dose after 4 to 5 months) or significant adverse effects occur. Patients should be advised to notify their physician immediately if they experience signs and symptoms of heart failure such as fluid retention, edema, rapid weight gain, or shortness of breath. Patients should also be apprised of the increased risk of hypoglycemia and be alert to potential signs and symptoms of hypoglycemia such as headache, dizziness, drowsiness, nausea, hunger, tremor, weakness, sweating, palpitations.

NovoLog PenFill

Generic Name: insulin aspart

Brand name: Fiasp, NovoLog, NovoLog FlexPen, NovoLog PenFill, NovoLOG FlexTouch, Fiasp PenFill, Fiasp FlexTouch

Synonyms: n.a.

What is NovoLog PenFill?

Rosiglitazone

Generic Name: rosiglitazone

Brand name: Avandia

Synonyms: n.a.

What is Rosiglitazone?