Avandaryl is for people with type 2 diabetes who do not use daily insulin injections. This medication is not for treating type 1 diabetes.

Avandaryl may also be used for other purposes not listed in this medication guide.

Important information about Avandaryl

Avandaryl should not be used together with nitrate medication, such as nitroglycerin (Nitro-Dur, Nitrolingual, Nitrostat, Transderm-Nitro, and others), isosorbide dinitrate (Dilatrate, Isordil, Isochron), or isosorbide mononitrate (Imdur, ISMO, Monoket). Tell your doctor if you regularly use this type of medication.

Before taking Avandaryl, tell your doctor if you have congestive heart failure or heart disease, a history of heart attack or stroke, liver disease, kidney or adrenal gland disorders, or eye problems caused by diabetes.

Avandaryl is only part of a complete program of treatment that also includes diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely. Changing any of these factors can affect your blood sugar levels.

Take care not to let your blood sugar get too low, causing hypoglycemia. You may have hypoglycemia if you skip a meal, exercise too long, drink alcohol, or are under stress.

Some women using Avandaryl have started having menstrual periods, even after not having a period for a long time due to a medical condition. You may be able to get pregnant if your periods restart. Talk with your doctor about the need for birth control. Women may also be more likely than men to have bone fractures in the upper arm, hand, or foot while taking Avandaryl. Talk with your doctor if you are concerned about this possibility. Certain oral diabetes medications may increase your risk of serious heart problems. However, not treating your diabetes can damage your heart and other organs. Talk to your doctor about the risks and benefits of treating your diabetes with Avandaryl.
Before taking Avandaryl

Do not use Avandaryl if you have advanced heart failure if you are in a state of diabetic ketoacidosis (call your doctor for treatment).

Avandaryl should not be used together with nitrate medication, such as nitroglycerin (Nitro-Dur, Nitrolingual, Nitrostat, Transderm-Nitro, and others), isosorbide dinitrate (Dilatrate, Isordil, Isochron), or isosorbide mononitrate (Imdur, ISMO, Monoket). Tell your doctor if you regularly use this type of medication.

If you have any of these other conditions, you may need to adjust your dose of Avandaryl or have special tests:

congestive heart failure or heart disease;
a history of heart attack or stroke;
an enzyme deficiency called glucose-6-phosphate dehydrogenase deficiency (G6PD);
liver disease;
kidney or adrenal gland disorders; or
eye problems caused by diabetes.

Certain oral diabetes medications may increase your risk of serious heart problems. However, not treating your diabetes can damage your heart and other organs. Talk to your doctor about the risks and benefits of treating your diabetes with Avandaryl.

Some women using Avandaryl have started having menstrual periods, even after not having a period for a long time due to a medical condition. You may be able to get pregnant if your periods restart. Talk with your doctor about the need for birth control.

Women may also be more likely than men to have bone fractures in the upper arm, hand, or foot while taking Avandaryl. Talk with your doctor if you are concerned about this possibility.

FDA pregnancy category C. It is not known whether Avandaryl will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. It is not known whether glimepiride or rosiglitazone passes into breast milk or if it could harm a nursing baby. Do not use Avandaryl without telling your doctor if you are breast-feeding a baby.

How should I take Avandaryl?

Take Avandaryl with your first meal of the day.

Avandaryl is only part of a complete program of treatment that also includes diet, exercise, and weight control. It is important to use this medicine regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

Your blood sugar will need to be checked often, and you may need other blood tests and eye exams at your doctor's office. Visit your doctor regularly.

Your dosage needs may change if you become sick or injured, if you have a serious infection, or if you have any type of surgery. Your doctor may want you to stop taking Avandaryl for a short time if any of these situations affect you.

Low blood sugar (hypoglycemia) can occur if you skip a meal, exercise too long, drink alcohol, or are under stress. Symptoms include headache, hunger, sweating, tremor, irritability, or trouble concentrating. Carry hard candy or glucose tablets with you in case you have low blood sugar. Other sugar sources include orange juice and milk. Be sure your family and close friends know how to help you in an emergency.

If you have severe hypoglycemia and cannot eat or drink, use an injection of glucagon. Your doctor can give you a prescription for a glucagon emergency injection kit and tell you how to give the injection.

Store Avandaryl at room temperature, protected from moisture, heat, and light.

What happens if I miss a dose?

What happens if I overdose?

What should I avoid while taking Avandaryl?

Avandaryl side effects

feeling short of breath, even with mild exertion
swelling or rapid weight gain;
pale skin, feeling light-headed, rapid heart rate, trouble concentrating;
vision problems;
chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;
sudden numbness or weakness, especially on one side of the body;
sudden headache, confusion, problems with speech or balance; or
nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious Avandaryl side effects may include:

sneezing, runny nose, cough or other signs of a cold;
headache;
dizziness;
vomiting, diarrhea, stomach pain; or
mild itching or skin rash.

What other drugs will affect Avandaryl?

gemfibrozil (Gemcor);
phenytoin (Dilantin);
rifampin (Rifater, Rifamate, Rimactane); or
fluconazole (Diflucan) or miconazole (Monistat).

You may be more likely to have hyperglycemia (high blood sugar) if you take Avandaryl with other drugs that can raise blood sugar, such as:

isoniazid;
diuretics (water pills);
steroids (prednisone and others);
phenothiazines (Compazine and others);
thyroid medicine (Synthroid and others);
birth control pills and other hormones;
seizure medicines (Dilantin and others); and
diet pills or medicines to treat asthma, colds or allergies.

You may be more likely to have hypoglycemia (low blood sugar) if you take Avandaryl with other drugs that can lower blood sugar, such as:

a nonsteroidal anti-inflammatory drugs (NSAID) such as diclofenac (Arthrotec, Cataflam, Voltaren, Flector Patch, Solareze), ibuprofen (Advil, Motrin), naproxen (Naprosyn, Aleve), mefenamic acid (Ponstel), and others;
aspirin or other salicylates (including Pepto-Bismol);
sulfa drugs (Bactrim and others);
a monoamine oxidase inhibitor (MAOI);
beta-blockers (Tenormin and others); or
probenecid (Benemid).

This list is not complete and other drugs may interact with Avandaryl. Tell your doctor about all medications you use. This includes prescription, over the counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?