Patient/caregiver was educated on contraindications for Avandia use as follows:
- Avandia should be avoided in individuals with history of serious allergic reactions to avandia use.
- Liver dysfunction: Avandia is extensively metabolized in the liver and all the inactive metabolites are mainly excreted in urine by the kidneys. If liver function is deficient, the metabolism of this medication could suffer. This can lead to increased blood levels of the medication for longer periods of time, resulting in toxicity and consequent side effects. Avandia could be avoided for a safer alternative in individuals with such health history. Individuals with history of compromised liver function must discuss with their physician regarding safety with avandia use. While using avandia, periodical labs for evaluation of liver function could be ordered in individuals with compromised liver function.
- Osteoporosis: Bone remodeling is a continuous lifetime process involving removal of the mature bone tissue from the skeletal framework (bone resorption) and deposition of new bone into the skeletal framework. Avandia use can result in increased resorption of the existing bone framework and decreased new bone formation. This contributes to weakening of the skeletal framework, resulting in episodes of sharp bone pain and pathological fractures. Individuals with history of osteopenia and osteoporosis must be increasingly cautious while taking avandia, as it enhances the risk for further weakening of bones. They must maintain a close watch for any episodes of sharp bone pain & tenderness and report to the physician on the same. Avandia use could be avoided in osteoporotic patients for a safer alternative to prevent progression of osteoporosis and development of fractures.
