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Avandia

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Rosiglitazone was associated with a significant increase in the risk of myocardial infarction and with an increase in the risk of death from cardiovascular causes
New England Journal of Medicine, 2007

Avandia is the trademarked name of a drug manufactured by GlaxoSmithKline for the treatment of type II diabetes.  It’s generic name is rosiglitazone and it belongs to a class of drugs called thiazolidinediones.  There are three drugs in this class which have been released to the market; troglitazone, which was later withdrawn due to the damage it caused the liver, pioglitazone (also known as Actos) and rosiglitazone or Avandia.

These drugs work by increasing the sensitivity of cells to the body’s own insulin in peripheral tissues, an action which would appear useful in the treatment of insulin resistance related to PCOS or metabolic syndrome.  Unfortunately, however, although the drug does increase the body’s insulin sensitivity, thus lowering elevated blood sugar and insulin levels it also appears to increase the risk of heart attack, stroke and other cardiovascular disease – some of the very problems it is intended to prevent.

One of the most important reasons to keep blood sugar levels within the normal range is to prevent one of the most serious complications of diabetes: cardiovascular disease.  Over 65% of deaths of people with diabetes are due to cardiovascular causes such as heart attack and stroke.  As insulin resistance progresses into diabetes in later years if not treated this is a caution that all women with PCOS should take quite seriously.

A meta-analysis published in the New England Journal of Medicine in 2007 found that the risk of death from cardiovascular disease was 64% higher in those taking Avandia than a control group taking other similar drugs.  Chances of having a heart attack were 46% higher in those taking Avandia.  Avandia was found to have a negative effect on serum lipid levels (blood fats), raising LDL cholesterol (the ‘bad’ kind) by nearly 20% in just six months of treatment with 8mg per day.  It is possible that this would be a contributing factor to its’ effect on the risk of cardiovascular death and heart attack occurrence.

Clearly, this is not ideal.  Fortunately, there are plenty of alternatives to these drugs.  In 2010, a study published in the journal Phytomedicine suggested that Bitter Melon (Momordica charantia) might be a more effective treatment for diabetes, especially in relation to the complications that occur with it, than rosiglitazone.  The dosages compared in the study were 4mg per day of rosiglitazone or 55ml of Bitter Melon.  More generically, there are of course a myriad of natural substances which similarly affect insulin and blood sugar control, such as magnesium, chromium, manganese, vanadium, cinnamon, gymnema sylvestre and green tea to name but a few.  You can find further information on the Natural Treatments page: http://mypcos.info/1/treatments/natural/

On a side note, GlaxoSmithKline has a very shady history when it comes to ethics.  It is the world’s third largest pharmaceutical company in terms of revenue, and has its’ headquarters in London, UK.  Since 2004, they have paid around $12 billion dollars in criminal fines and civil settlements.  They have just agreed to pay a settlement of $3 billion dollars to settle several criminal and civil charges brought against it in relation to many different immoral and illegal acts including in relation to Avandia and their covering up of information regarding cardiovascular risk.  This is all barely a year after they were forced to pay out $750 million dollars to settle civil and criminal charges brought against it in relation to some very dangerous manufacturing processes in one of their plants in Cidra, Mexico.  Again, they had been trying to cover it all up and carry on as usual until a very courageous informant, who lost her job in the process, notified the FDA.

More Information:

Nissen SE, Wolski K. Effect of rosiglitazone on the risk of myocardial infarction and death from cardiovascular causes. N Engl J Med. 2007 Jun 14;356(24):2457-71. Epub 2007 May 21.  http://www.nejm.org/doi/full/10.1056/NEJMoa072761

http://en.wikipedia.org/wiki/GlaxoSmithKline#Controversies

Connor M. GSK to Pay $750M Fine; Whistleblower to Get $96m. Business Ethics 2010 Oct 26 http://business-ethics.com/2010/10/26/1740-glaxosmithkline-to-pay-750-million-fine-whistleblower-to-get-96-million/

http://www.omsj.org/corruption/glaxo-pays-another-750-million-for-bad-products

Inayat-ur-Rahman, Malik SA, Bashir M, Khan R, Iqbal M Serum sialic acid changes in non-insulin-dependant diabetes mellitus (NIDDM) patients following bitter melon (Momordica charantia) and rosiglitazone (Avandia) treatment. Phytomedicine. 2009 May;16(5):401-5. Epub 2009 Apr 10.  http://www.phytomedicinejournal.com/article/S0944-7113(09)00010-5/abstract

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