To highlight continuing concerns about the safety of rosiglitazone, from 1 July 2011 all PBS listings of rosiglitazone (Avandia) and rosiglitazone with metformin (Avandamet) will no longer be streamlined.1 Instead the listings will revert to conventional Authority status, and prescribers will be required to telephone Medicare for approval of any new or repeat prescription.
Rosiglitazone is a third-line choice. It may be considered as part of dual therapy when either metformin or a sulfonylurea is contraindicated or not tolerated. Insulin, exenatide, pioglitazone or a gliptin should also be considered instead of rosiglitazone in these scenarios.
Rosiglitazone is not indicated in combination with insulin or for triple oral therapy.
Do not use rosiglitazone in people with heart failure. Rosiglitazone may increase the risk of myocardial infarction, fractures and macular oedema.2–9 Avoid using rosiglitazone in people with ischaemic heart disease and take particular care when prescribing it to people with a high risk of cardiovascular events.
