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Avandamet
rosiglitazone, metformin

Medicinal product no longer authorised

PACKAGE LEAFLET: INFORMATION FOR THE USER


AVANDAMET 1 mg/500 mg film-coated tablets AVANDAMET 2 mg/500 mg film-coated tablets AVANDAMET 2 mg/1000 mg film-coated tablets AVANDAMET 4 mg/1000 mg film-coated tablets rosiglitazone/metformin HCl


Read all of this leaflet carefully before you start taking this medicine.


In this leaflet:

  1. What Avandamet is and what it is used for

  2. Before you take Avandamet

  3. How to take Avandamet

  4. Possible side effects

5 How to store Avandamet

6. Further information


  1. WHAT AVANDAMET IS AND WHAT IT IS USED FOR


    Avandamet tablets are a combination of two different medicines called rosiglitazone and

    metformin. These two medicines are used to treat type 2 diabetes.


    People with type 2 diabetes either don’t make enough insulin (a hormone that controls blood sugar levels), or don’t respond normally to the insulin their body makes. Rosiglitazone and metformin work together so your body makes better use of the insulin it produces, and this helps reduce your blood sugar to a normal level. Avandamet can be used alone or with a sulphonylurea, another medicine for diabetes.


  2. BEFORE YOU TAKE AVANDAMET


    To help manage your diabetes, it is important that you follow any diet and lifestyle advice from your doctor as well as taking Avandamet.


    Don’t take Avandamet:

    • if you are allergic (hypersensitive) to rosiglitazone or metformin or any of the other ingredients of Avandamet (listed in Section 6)

    • if you have had a heart attack or severe angina, that’s being treated in hospital

    • if you have heart failure, or have had heart failure in the past

    • if you have severe breathing difficulties

    • if you have liver disease

    • if you are a heavy drinker of alcohol – if you regularly drink a lot, or if you have occasional sessions of heavy drinking (binge drinking)

    • if you have had diabetic ketoacidosis (a complication of diabetes causing rapid weight loss, nausea or vomiting)

    • if you have kidney disease

      Medicinal product no longer authorised

    • if you are very dehydrated or have a severe infection (see ‘While you take Avandamet your doctor needs to know’ later in Section 2)

    • if you are going to have an X-ray using an injected dye (see ‘While you take Avandamet your doctor needs to know’ later in Section 2)

    • if you are breast-feeding (see ‘Pregnancy and breast-feeding’ later in Section 2).


      -+ Check with your doctor if you think any of these apply to you. Don’t take Avandamet. Take special care with Avandamet

      Avandamet is not recommended for people aged under 18, as the safety and effectiveness are not known.


      If you have been diagnosed with angina (chest pain), or peripheral arterial disease (reduced blood flow to the legs):


      -+ Check with your doctor, as Avandamet may not be suitable for you.


      Conditions to look out for

      Avandamet and other medicines for diabetes can make some existing conditions worse, or cause serious side effects. You must look out for certain symptoms while you are taking Avandamet, to reduce the risk of any problems. See ‘Conditions you need to look out for’ in Section 4.


      Ovulation may restart

      Women who are infertile due to a condition affecting their ovaries (such as Polycystic Ovarian Syndrome), may start ovulating again when they start taking Avandamet. If this applies to you, use appropriate contraception to avoid the possibility of an unplanned pregnancy (see ‘Pregnancy and breast-feeding’ later in Section 2).


      Your kidney function will be checked

      Your kidneys should be checked at least once a year – more often if you are over 65, or if your kidney function is close to abnormal.


      While you take Avandamet your doctor needs to know:


      • if you become dehydrated – for example, after severe vomiting, diarrhoea or fever. These can lead to severe loss of water (dehydration). Speak to your doctor, as you may need to stop taking Avandamet for a short while.


      • if you are going to have an operation under general anaesthetic. Your doctor will advise you to stop taking Avandamet for at least 48 hours before and after the operation.


      • if you are going to have an X-ray using an injected dye. Your doctor will advise you to stop taking Avandamet before the X-ray and for 48 hours after it. The doctor will check your kidney function before restarting treatment.

        Medicinal product no longer authorised

        Taking other medicines

        Tell your doctor or pharmacist if you are taking any other medicines, if you’ve taken any recently, or if you start taking new ones. This includes herbal medicines and other medicines you bought without a prescription.


        Certain medicines are especially likely to affect the amount of sugar in your blood:

      • steroids (used to treat inflammation) such as prednisolone or dexamethasone

      • beta-2-agonists (used to treat asthma), such as salbutamol or salmeterol

      • diuretics (used to get rid of water), such as furosemide or indapamide

      • ACE inhibitors (used to treat high blood pressure), such as enalapril or captopril

      • gemfibrozil (used to lower cholesterol)

      • rifampicin (used to treat tuberculosis and other infections)

      • cimetidine (used to reduce stomach acid).

        -+ Tell a doctor or pharmacist if you are taking any of these. Your blood sugar will be checked, and your dose of Avandamet may need to be changed.


        Pregnancy and breast-feeding

      • Avandamet is not recommended during pregnancy. If you are pregnant or could be pregnant, tell your doctor before you take Avandamet.


      • Don’t breast-feed while you are taking Avandamet. The ingredients may pass into breast milk and so may harm your baby.


        Driving and using machines

        This medicine should not affect your ability to drive or use machines.


        Avandamet contains lactose

        Avandamet tablets contain a small amount of lactose. Patients who are intolerant to lactose or have a rare hereditary problem of galactose intolerance, the Lapp lactase deficiency, or glucose-galactose malabsorption should not take this medicine.


  3. HOW TO TAKE AVANDAMET


    Always take Avandamet tablets exactly as your doctor has told you. Do not take more than the recommended dose. Check with your doctor or pharmacist if you are not sure.


    How much to take

    The usual starting dose is one combined tablet (2 mg rosiglitazone and 1000 mg metformin), taken twice a day, morning and evening. (You can also take this dose as two 1 mg/500 mg tablets, twice a day.)


    After about 8 weeks your doctor may need to increase your dose. The maximum dose is 4 mg rosiglitazone and 1000 mg metformin, taken twice a day. (You can also take this dose as two 2 mg/500 mg tablets, twice a day.)


    How to take

    Swallow the tablets with some water.


    It is best to take Avandamet with food, or just after food. This helps to reduce any problems with your stomach (including indigestion, nausea, vomiting and diarrhoea).


    Take your tablets around the same time every day and follow any dietary advice that your doctor has given you.


    If you take more Avandamet than you should

    Medicinal product no longer authorised

    If you accidentally take too many tablets, contact your doctor or pharmacist for advice.


    If you forget to take Avandamet

    Don’t take extra tablets to make up for a missed dose. Just take your next dose at the usual time.


    Don’t stop taking Avandamet

    Take Avandamet for as long as your doctor recommends. If you stop taking Avandamet, your blood sugar will not be controlled, and you may become unwell. Talk to your doctor if you want to stop.


  4. POSSIBLE SIDE EFFECTS


    Like all medicines, Avandamet can cause side effects, but not everybody gets them.


    Conditions you need to look out for


    Allergic reactions: These are very rare in people taking Avandamet. Signs include:

    • raised and itchy rash (hives)

    • swelling, sometimes of the face or mouth (angioedema), causing difficulty in breathing

    • collapse.

      -+ Contact a doctor immediately if you get any of these symptoms. Stop taking Avandamet.


      Lactic acidosis: An increase in the amount of lactic acid in the blood (lactic acidosis) is a very rare side effect of metformin. This most often affects people who have severe kidney disease. Symptoms of lactic acidosis include:

    • rapid breathing

    • feeling cold

    • stomach pain, nausea and vomiting.

      -+ Contact a doctor immediately if you get these symptoms. Stop taking Avandamet.


      Fluid retention and heart failure: Avandamet can cause you to retain water (fluid retention) which leads to swelling and weight gain. Extra body fluid can make some existing heart problems worse or lead to heart failure. This is more likely if you are also taking other medicines for your diabetes (like insulin), if you have kidney problems, or if you are over 65. Check your weight regularly; if it goes up rapidly, tell your doctor. Symptoms of heart failure include:

    • shortness of breath, waking up short of breath at night

    • getting tired easily after light physical activity such as walking

    • rapid increase in your weight

    • swollen ankles or feet.

    -+ Tell your doctor as soon as possible if you get any of these symptoms - either for the first time or if they get worse.


    Low blood sugar (hypoglycaemia): If you are taking Avandamet with other medicines for diabetes, it is more likely that your blood sugar could fall below the normal level. Early symptoms of low blood sugar are:

    • shaking, sweating, faintness

    • nervousness, palpitations

    • hunger.

    The severity can increase, leading to confusion and loss of consciousness.

    -+ Tell your doctor as soon as possible if you get any of these symptoms. The dose of your medicines may need to be reduced.


    Liver problems: Before you start taking Avandamet you will have a blood sample taken to check your liver function. This check may be repeated at intervals. These may be signs of liver problems:

    • nausea and vomiting

    • stomach (abdominal) pain

      Medicinal product no longer authorised

    • loss of appetite

    • dark-coloured urine.

      -+ Tell your doctor as soon as possible if you get these symptoms.


      Eye problems: Swelling of the retina at the back of the eye which can cause blurred vision (macular oedema) can be a problem for people with diabetes. New or worse cases of macular oedema have occurred on rare occasions in people taking Avandamet and similar medicines.

      -+ Discuss with your doctor any concerns about your eyesight.


      Broken bones: Bone fractures can occur in people with diabetes. The chances of this happening may be higher in people, particularly women, taking rosiglitazone for more than one year. The most common are breaks in feet, hands and arms.


      Very common side effects

      These may affect more than 1 in 10 people:

      • stomach pain, feeling sick (nausea), vomiting, diarrhoea or loss of appetite.


        Common side effects

        These may affect up to 1 in 10 people:

      • chest pain (angina)

      • broken bones

      • reduction in blood count (anaemia)

      • small increases in blood cholesterol, increased amount of fats in the blood

      • increased weight, increased appetite

      • dizziness

      • constipation

      • lower blood sugar than normal (hypoglycaemia)

      • swelling (oedema) due to water retention

      • metallic taste in the mouth.


        Rare side effects

        These may affect up to 1 in 1,000 people:

      • fluid in the lungs (pulmonary oedema) causing breathlessness

      • heart failure

      • swelling of the retina at the back of the eye (macular oedema)

      • liver doesn’t function as well as it should (increase in liver enzymes).


        Very rare side effects

        These may affect up to 1 in 10,000 people:

      • allergic reactions

      • inflammation of the liver (hepatitis)

      • decrease in amount of vitamin B12 in the blood

      • rapid and excessive weight gain caused by fluid retention

      • increase of lactic acid in the blood.


    If you get side effects

    -+ Tell your doctor or pharmacist if any of the side effects listed gets severe or troublesome, or if you notice any side effects not listed in this leaflet.


  5. HOW TO STORE AVANDAMET


    Keep out of the reach and sight of children.


    Do not use Avandamet after the expiry date shown on the pack.

    Medicinal product no longer authorised

    This medicine does not require any special storage conditions.


    If you have any unwanted tablets, don’t put them in waste water or household rubbish. Ask your pharmacist how to dispose of tablets you don’t need. This will help to protect the environment.


  6. FURTHER INFORMATION


What Avandamet contains

The active substances are rosiglitazone and metformin. Avandamet tablets come in different strengths. Each tablet contains either: 1 mg rosiglitazone and 500 mg metformin; 2 mg rosiglitazone and 500 mg metformin; 2 mg rosiglitazone and 1000 mg metformin or 4 mg rosiglitazone and 1000 mg metformin.


The other ingredients are: sodium starch glycollate, hypromellose (E464), microcrystalline cellulose (E460), lactose monohydrate, povidone (E1201), magnesium stearate, titanium dioxide (E171), macrogol, iron oxide yellow or red (E172).


What Avandamet looks like and contents of the pack

Avandamet 1 mg/500 mg tablets are yellow and marked "gsk" on one side and "1/500" on the other. Avandamet 2 mg/500 mg tablets are pale pink, marked "gsk" on one side and "2/500" on the other. These strengths are supplied in blister packs containing 28, 56, 112, 3x112 or 360 film-coated tablets.


Avandamet 2 mg/1000 mg tablets are yellow, marked "gsk" on one side and "2/1000" on the other. Avandamet 4 mg/1000 mg tablets are pink, marked "gsk" on one side and "4/1000" on the other. These strengths are supplied in blister packs containing 14, 28, 56, 2x56, 3x56 or 180 film-coated tablets.


Not all pack sizes or tablet strengths may be available in your country.


Marketing Authorisation Holder: SmithKline Beecham Ltd, 980 Great West Road, Brentford, Middlesex, TW8 9GS, United Kingdom.


Manufacturer: Glaxo Wellcome S.A., Avenida de Extremadura 3, 09400 Aranda de Duero, Burgos, Spain.


For any information about this medicine, please contact the local representative of the Marketing Authorisation Holder.

Medicinal product no longer authorised

België/Belgique/Belgien GlaxoSmithKline s.a./n.v. Tél/Tel: + 32 (0)2 656 21 11

Luxembourg/Luxemburg GlaxoSmithKline s.a./n.v. Belgique/Belgien

Tél/Tel: + 32 (0)2 656 21 11


България ГлаксоСмитКлайн ЕООД Teл.: + 359 2 953 10 34

Magyarország GlaxoSmithKline Kft. Tel.: + 36 1 225 5300


Česká republika GlaxoSmithKline s.r.o. Tel: + 420 222 001 111

gsk.czmail@gsk.com

Malta GlaxoSmithKline Malta Tel: + 356 21 238131


Danmark

GlaxoSmithKline Pharma A/S Tlf: + 45 36 35 91 00

dk-info@gsk.com

Nederland GlaxoSmithKline BV Tel: + 31 (0)30 6938100

nlinfo@gsk.com


Deutschland

GlaxoSmithKline GmbH & Co. KG Tel.: + 49 (0)89 36044 8701

produkt.info@gsk.com

Norge GlaxoSmithKline AS Tlf: + 47 22 70 20 00

firmapost@gsk.no


Eesti

GlaxoSmithKline Eesti OÜ Tel: + 372 6676 900

estonia@gsk.com

Österreich

GlaxoSmithKline Pharma GmbH Tel: + 43 (0)1 97075 0

at.info@gsk.com


Ελλάδα

GlaxoSmithKline A.E.B.E.

Τηλ: + 30 210 68 82 100

Polska

GSK Commercial Sp. z o.o. Tel.: + 48 (0)22 576 9000


España GlaxoSmithKline, S.A. Tel: + 34 902 202 700

es-ci@gsk.com

Portugal

GlaxoSmithKline – Produtos Farmacêuticos, Lda. Tel: + 351 21 412 95 00

FI.PT@gsk.com


France

Laboratoire GlaxoSmithKline Tél.: + 33 (0)1 39 17 84 44

diam@gsk.com

România

GlaxoSmithKline (GSK) S.R.L. Tel: + 4021 3028 208


Ireland

GlaxoSmithKline (Ireland) Limited Tel: + 353 (0)1 4955000

Slovenija GlaxoSmithKline d.o.o. Tel: + 386 (0)1 280 25 00

medical.x.si@gsk.com


Ísland GlaxoSmithKline ehf. Sími: + 354 530 3700

Slovenská republika GlaxoSmithKline Slovakia s. r. o. Tel: + 421 (0)2 48 26 11 11

recepcia.sk@gsk.com

Medicinal product no longer authorised

Italia

GlaxoSmithKline S.p.A. Tel: + 39 (0)45 9218 111

Suomi/Finland GlaxoSmithKline Oy Puh/Tel: + 358 (0)10 30 30 30

Finland.tuoteinfo@gsk.com


Κύπρος

GlaxoSmithKline Cyprus Ltd

Τηλ: + 357 22 39 70 00

Sverige GlaxoSmithKline AB Tel: + 46 (0)8 638 93 00

info.produkt@gsk.com


Latvija

GlaxoSmithKline Latvia SIA Tel: + 371 67312687

lv-epasts@gsk.com

United Kingdom GlaxoSmithKline UK Tel: + 44 (0)800 221441

customercontactuk@gsk.com


Lietuva

GlaxoSmithKline Lietuva UAB Tel: + 370 5 264 90 00

info.lt@gsk.com


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