WASHINGTON — Diabetes patients who were taking the pill Rezulin--which is being pulled from the market--should have no problem switching to an alternative drug, experts said Friday.
"It would be a relatively seamless transition because there are other choices," said Dr. Norman Lavin, director of the Diabetes Center at Tarzana Medical Center in Los Angeles.
Rezulin was one of about a dozen drugs available for treatment of adult-onset Type 2 diabetes. The drug lowers blood-sugar levels in patients.
The Food and Drug Administration said that two drugs in the same chemical class as Rezulin, Avandia and Actos, "offer the same benefits as Rezulin without the same risk." The FDA has linked Rezulin use to 90 liver failures, including 63 deaths and seven nonfatal organ transplants.
Doctors are advising Rezulin patients not to worry and are upbeat that alternative drugs are safer and carry fewer side effects.
"Go to your doctor, get a prescription for a new drug and they [patients] will do just as well, if not better," said Dr. David S. H. Bell, a professor and diabetes specialist at the University of Alabama at Birmingham School of Medicine. "There is no reason to be nervous and have any fear."
Bell, who has done extensive research on helping patients make the transition from Rezulin to alternative drugs, transferred all 150 of his Rezulin patients to Avandia or Actos last summer when the two drugs were approved for use. Bell conducts chemical trials for manufacturers of both drugs.
A Week's Delay Before New Regimen Suggested
"There was no deterioration in control of diabetes--they had no side effects whatsoever," said Bell, who suggests that patients wait one week before starting a different drug.
Dr. Riccardo Perfetti, director of the diabetes program at Cedars-Sinai Medical Center in Los Angeles, warned that Avandia and Actos appear to be less toxic than Rezulin but said that all medications can carry risks.
"Patients want to make sure there are no side effects. Unfortunately such a thing doesn't exist," Perfetti said. He said that patients making the switch should continue to undergo regular liver monitoring.
"Unfortunately, I have seen many patients who came to me on Rezulin that were not monitored at all," Perfetti said. "There was big confusion and mismanagement of how the drug was administered to patients. It was so poorly done at all levels."
