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Definition of «Thiazolidinedione»

Thiazolidinedione: (Pronounced THIGH-ah-ZO-li-deen-DYE-own.) A class of drugs for type 2 diabetes that lower the blood sugar by increasing the sensitivity of cells to insulin. Insulin can then move glucose from the blood into cells for energy. These drugs also increase the HDL ("good") cholesterol.

Rezulin (troglitazone) was the first drug in this class in the US but was taken off the market because of liver toxicity. Sister compounds now available with a better safety profile include Actos (pioglitazone) and Avandia (rosiglitazone). The main contraindications to the use of these medications include liver disease and heart failure. These drugs can cause a significant increase in fluid retention and thereby increase the risk of heart failure by about 70%.

Avandia has been associated with an increased risk of heart attack and stroke, and experts have debated the severity of these concerns. On September 23, 2010, the U.S. Food and Drug Administration (FDA) announced that it will significantly restrict the use of the diabetes drug rosiglitazone (Avandia) to patients with type 2 diabetes who cannot control their diabetes on other medications such as pioglitazone (Actos). These new restrictions are in response to data that suggest an elevated risk of cardiovascular events, such as heart attack and stroke, in patients treated with Avandia. Also, GlaxoSmithKline (the manufacturer of Avandia) will be required to establish a Risk Evaluation and Mitigation Strategy (REMS) program in which patients, their doctors, and their pharmacists must participate in order to receive, prescribe, or sell Avandia.

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