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Patient Information Sheet for Avandia

Please click on the following link to open the updated Patient Information sheet.
http://www.fda.gov/cder/drug/InfoSheets/patient/rosiglitazonePIS.htm

Avandia Case Evaluation Form

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YOUR CONTACT INFORMATION

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CASE INFORMATION

Why Was Avandia Prescribed?: *

What Dosage, in Milligrams?:

How Frequently Was Avandia Taken?:

Date Patient Began Taking Avandia:

Stopped Taking Avandia:

What Symptoms Were Experienced?: *

Heart Attack
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Other
PPH

If "Other", Please Describe:

How Long Was it From the Last Dose to the Problems Appearing?:

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More Than 3 Days Don't Know

Questions/Comments:

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