Avandamet and Lactic Acidosis
The most serious side-effect of Avandamet, rare as it is, is the development of a life-threatening condition known as lactic acidosis. Lactic acidosis is a metabolic complication caused by the accumulation of lactic acid in the body and the concurrent decrease in alkali. In general, lactic acidosis occurs when the cells of the body produce acid faster than it can be metabolized. Thus, the liver cannot convert this lactate buildup into glucose in a normal way.
One of the factors triggering the development of this dangerous condition when the blood gets too acidic is anti-diabetic medications. The other one which often works in conjunction with the medications exerting its adverse effect is the complication of diabetic nephropathy or the conditions of congestive heart failure and liver dysfunction. For that reason Avandamet is strongly contraindicated for patients with these diseases. Among other important contraindications are the conditions of dehydration, whatever the reason for it is - fever, vomiting, or diarrhea, surgeries that you have recently undergone, a heart attack, a stroke, or a severe infection, and episodes of "binge" drinking.
The symptoms of lactic acidosis are non-specific and include nausea, vomiting, irregular heartbeat, abdominal pain, and hyperventilation as a result of which there may appear dizziness, increasing sleepiness, low body temperature, sudden weakness or tiredness, respiratory distress, stomach discomfort, twinges in the limbs and the lips. Lactic acidosis can be hard to diagnose at early stages of its development because the symptoms look like the symptoms of many other health problems. Lactic acidosis can also be detected by the presence of ketones in the urine.
Usually the treatment for lactic acidosis includes intravenous saline solution and sodium bicarbonate intake in order to neutralize the acid. Kidney dialysis is also helpful for drug clearance. Among the latest treatments resorted to if lactic acidosis shows itself are such medications as Thiamine and Naloxon.
Avandamet is an oral anti-hyperglycemic agent which noticeably decreases total mortality levels in patients with type 2 diabetes due to the combination of properties of two efficacious anti-diabetic agents: Rosiglitazone and Metformin. However, Metformin, a constituent of Avandamet, is thought to increase the risk of lactic acidosis which can be both fatal and nonfatal. Metformin, being a member of the drug class of biguanides, is capable of causing an increase in production and a decrease in clearance of lactate leading to higher cellular lactate levels. At the same time there is clinical evidence showing that Metformin is less likely than any other biguanide agent to produce the effect of lactic acidosis. But it is still considered potentially dangerous, that is why if you have developed symptoms of lactic acidosis and the diagnosis has been confirmed, the course of treatment usually involves the drug withdrawal and sufficient fluid intake. Patients with type 2 diabetes should switch over from Avandamet to insulin to avoid potentially fatal consequences of lactic acidosis.