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Calm Urged for Avandia Patients

No Urgent Need to Stop Avandia, Some Experts Say; More Study Needed
By
WebMD Health News
Reviewed by Louise Chang, MD

Avandia Follow-Up

May 24, 2007 - There's no urgent need for type 2 diabetes patients to stop taking Avandia -- even if the drug really does increase the risk of heart attack, some medical experts caution.

Experts -- including the doctor who sounded the Avandia alarm -- tell WebMD there's no need for patients to panic.

The concern comes from the early release of a report in The New England Journal of Medicine(NEJM) suggesting that Avandia increases a diabetes patient's already high risk of heart attack by 43%.

Researcher Steven Nissen, MD, is chairman of Cleveland Clinic's cardiovascular medicine department. Nissen, past president of the American College of Cardiology, was one of the first doctors to raise the alarm about the heart risks posed by Vioxx.

Nissen says his findings are valid, but he warns that the data are not definitive and must be confirmed by further studies.

"What patients need to know is there is some evidence of cardiovascular harm from Avandia -- but there is not any reason to panic," Nissen tells WebMD.

Since news of the Nissen study broke on Monday, frightened diabetes patients have flooded their doctors' phone lines, says Luigi F. Meneghini, MD, MBA, director of the diabetes treatment center at the University of Miami.

"The way this has been presented has been completely out of proportion. It has created a lot of hysteria," Meneghini tells WebMD. "Patients have stopped taking their medications. They don't want to be on this medication any more."

Andrew Drexler, MD, director of UCLA's Gonda Diabetes Center, is seeing the same reaction.

"We're definitely getting flooded with calls. Everybody wants to know what to do," Drexler tells WebMD.

So here's what these experts say you should do:

  • If you are currently taking Avandia, do not stop taking the drug.
  • If you are taking Avandia and have already had a heart attack or heart trouble, call your doctor to schedule an appointment as soon as possible.

If you don't already have a heart problem, the risk from Avandia -- if there truly turns out to be one -- is not so great that you have to see a doctor right away. But do make an appointment to discuss the issue.

Calls for Calm in Wake of Avandia Alarm

At least since 2005, the FDA has been aware of the possible heart attack risk of Avandia. But there's conflicting evidence, including a study of more than 30,000 diabetes patients in a large health maintenance organization (HMO) that found no extra heart attacks among Avandia patients.

For this reason, the FDA has decided not to pull Avandia from the market. Instead, the FDA is working as fast as it can to pull together an expert advisory panel to weigh all the available data.

The FDA warns patients not to stop taking Avandia on their own. Drexler agrees.

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If the level is below 70 and you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.

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Your blood sugar level may be high, depending on when you last ate. If you have not eaten for at least 8 hours, your blood sugar should be less than 100. If you've eaten within the last 2 hours, your blood sugar should be less than 140. You should call your health care provider and ask if you need laboratory tests to check for diabetes. If you are pregnant always consult with your health care provider.

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Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

Your blood sugar level is high. You should call your health care provider and ask if laboratory tests to check for diabetes are needed. If you are pregnant always consult with your health care provider.

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