Rosiglitazone (Avandia)

Rosiglitazone (Avandia) is an anti-diabetes drug that works by re-sensitising the body to the hormone insulin. It is usually used in patients who do not respond to metformin hydrochloride (Glucophage / Glucophage SR), or who cannot take metformin. It is available alone, or in combination with metformin as Avandamet or with glimepride as Avaglim.

Rosiglitazone is usually given with food, and the dose adjusted to give the best control of blood sugar levels.

Side-effects of rosiglitazone can include anaemia, liver toxicity, swelling, weight gain and heart problems. It may also affect the eyesight by causing swelling of the eye.

In HIV-positive patients, rosiglitazone can not only improve the insulin resistance seen as a side-effect of antiretroviral therapy, but can also improve body fat redistribution, by increasing levels of fat under the skin.1 2 However, this has not been observed in all studies, and some have found that rosiglitazone can also worsen the fat accumulation around the organs that may be a side-effect of treatment with protease inhibitors.3 4 5 Its use may also be limited by unfavourable changes in blood cholesterol levels.6

Rosiglitazone does not interact with any currently available protease inhibitors. However, it may reduce the levels of the non-nucleoside reverse transcriptase inhibitor (NNRTI) nevirapine (Viramune) in the blood.7

References

  1. Feldt T et al. Evaluation of safety and efficacy of rosiglitazone in the treatment of HIV-associated lipodystrophy syndrome. Infection 34: 55-61, 2006
  2. Hadigan C et al. Effects of rosiglitazone on metabolic indices and fat in HIV lipodystrophy: a randomized controlled trial. Ann Intern Med 140: 786-794, 2004
  3. Carr A et al. No effect of rosiglitazone for treatment of HIV-1 lipoatrophy: randomised, double-blind, placebo-controlled trial. Lancet 363: 429-438, 2004
  4. Sutinen J et al. Rosiglitazone in the treatment of HAART-associated lipodystrophy - a randomized double-blind placebo-controlled study. Antivir Ther 8: 199-207, 2003
  5. Van Wijk JPH et al. Comparison of rosiglitazone and metformin for treating HIV lipodystrophy: a randomized controlled trial. Ann Intern Med 143: 337-346, 2005
  6. Tomazic J et al. Effect of metformin and rosiglitazone on lipid metabolism in HIV infected patients receiving protease inhibitor containing HAART. Acta Dermatovenerol Alp Panonica Adriat 14: 99-105, 2005
  7. Oette M et al. Impact of rosiglitazone treatment on the bioavailability of antiretroviral compounds in HIV-positive patients. J Antimicrob Chemother 56: 416-419, 2005

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Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap
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This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.