The Association of British Clinical Diabetologists: recommendations following suspension of rosiglitazone (Avandia)

Abstract

For all new prescriptions of thiazolidinediones, pioglitazone must be used Patients already taking rosiglitazone should have a medication review in order to consider alternative therapy Replacement therapy should be tailored according to the clinical needs of the individual patient and should be in line with existing NICE guidance when possible. Those patients whose glycaemic control requires consideration of alternatives to sulphonylureas and metformin should have an assessment of cardiovascular risk status, heart failure, osteoporosis fracture risk, weight, hepatic and renal function, hypoglycaemia and pancreatitis risk Patients already taking rosiglitazone who do not wish to change to alternative therapy should be advised that it is not possible to continue rosiglitazone as this therapy has been suspended and will be withdrawn Prior evidence of heart failure or impairment of left ventricular function remains a strict contraindication for the use of any thiazolidinediones. Osteoporosis and previous fracture may also be considered a contraindication to a thiazolidinedione