# Do I have the right
**URL:** https://boards.straightdope.com/t/do-i-have-the-right/9090
**Category:** Factual Questions
**Created:** [March 2, 2000, 8:17pm UTC](https://boards.straightdope.com/t/do-i-have-the-right/9090 "2000-03-02T20:17:00Z")
**Posts on this page:** 11
**Page:** 1
### Author:  [@Ayesha](https://boards.straightdope.com/u/Ayesha)
#### Post date: [March 2, 2000, 8:17pm UTC](https://boards.straightdope.com/t/do-i-have-the-right/9090/1 "2000-03-02T20:17:00Z")
to demand that my Doctor change my diabetes medication ?
I have been taking Rezulin for type 2 diabetes for a couple of years now.
There was a story in the newspaper this morning on Rezulin being linked to liver failure, leading to death.
This is very frightening to me. I was diagnosed with Hep. C a couple of years ago.
I just finished a 2 year treatment of interferon in December.
I tossed a coin on where to post this one, mipsims won. GQ lost. If the moderator want to move this it’s fine with me.
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" The opposite of love isn’t hate, it’s indifference."
Elie Wiesel
Winner SDMB Biggest Flirt (Female) and Least Shy (No Mom, I have no idea why they think that)
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### Author:  [@bizerta](https://boards.straightdope.com/u/bizerta)
#### Post date: [March 2, 2000, 8:28pm UTC](https://boards.straightdope.com/t/do-i-have-the-right/9090/2 "2000-03-02T20:28:00Z")
You can demand anything that you want. For example, I demand that Congress eliminate the income tax. Too bad they don’t heed my demands.
No one is holding a gun to your head. If you don’t want to take the medicine, don’t. I do believe, however, that the doctor is under no obligation to issue you a prescription based upon your orders. If they could, many a drug addict would “demand” heroin as the medicine-of-choice for athelete’s foot.
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### Author:  [@Nightingale](https://boards.straightdope.com/u/Nightingale)
#### Post date: [March 2, 2000, 10:25pm UTC](https://boards.straightdope.com/t/do-i-have-the-right/9090/3 "2000-03-02T22:25:00Z")
Sounds like you need to talk to your MD about your concerns. You can’t force him to give you a different prescription, but you certainly don’t have to use the one you have. Most MD’s are willing to work with you to find a medication that controls your condition AND gives you peace of mind.
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“There are more things you don’t know than there are things that I do know. I despair of the imbalance.” – Dr. Morgenes, _The Dragonbone Chair_
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### Author:  [@C3](https://boards.straightdope.com/u/C3)
#### Post date: [March 2, 2000, 10:31pm UTC](https://boards.straightdope.com/t/do-i-have-the-right/9090/4 "2000-03-02T22:31:00Z")
Of course you have the right, Ayesha. If you have concerns about the medication you’re taking now, talk to your doctor about them. I saw a report on Dateline or 20/20 (can’t remember which) on that drug. It seems the drug company was not notifying doctors of the severity of the side effects. Your doctor may not know about the recent questions that have arisen about this drug.
If I were you and I went to my doctor and he acted like what I was saying wasn’t worthwhile/valid/etc., I would go get a second opinion from someone else.
It’s your body and your health…a lot of doctors are overworked and overbooked and they are not infallible. NEVER let your concerns about your health go unanswered.
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### Author:  [@BoBettie](https://boards.straightdope.com/u/BoBettie)
#### Post date: [March 3, 2000, 12:29am UTC](https://boards.straightdope.com/t/do-i-have-the-right/9090/5 "2000-03-03T00:29:00Z")
Ayesha,
Pull up a chair, girlie. We need to chat a bit 🙂
You have the right to refuse ANY AND ALL treatements prescribed by your Dr. both in and out of the hospital. I do mean any and all. I found this out when I was hospitalized for back surgery. They said I was getting an enema. I said “no fucking way” or something to that effect. They simply noted in my chart that I refused- end of story.
(I base the following on my own experience looking for a good pain killer to take daily for my chronic pain)
The same holds true for your regular Dr. You are concerned about how this drug will affect your liver- and rightfully so. It sounds to me like you’re anticipating a “fight” from him/her. This is a bad thing. If your doctor isn’t willing to take your opinion into account along with his/her own, shop for a new one. Taking any drug long term is a calculated risk, and you have the right to decide what ones to take.
I had several doctors that implied that I should “tough it out”, and that it was “in my head”. Needless to say, I dropped them. It was not in my head and I needed help.
In the end, your doctor/patient relationship should be open enough that you don’t feel nervous asking about taking a different drug. They are there to help you, and if you feel chastised or wrong for asking questions, look for a new doc.
Zette
PS- don’t stop taking your blood sugar drug BEFORE asking, as you could end up sick. Get in there and chat with him/her and get on a new drug BEFORE stopping the old one. 🙂
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“If I had to live your life, I’d be begging to have someone pop out both my eyes. Just in case I came across a mirror.” - android209 (in the Pit)
[Zettecity](http://www.angelfire.com/ny3/zettecity/index.html)
Voted “Most Empathetic”- can you believe that?
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### Author:  [@system](https://boards.straightdope.com/u/system)
#### Post date: [March 3, 2000, 4:27am UTC](https://boards.straightdope.com/t/do-i-have-the-right/9090/6 "2000-03-03T04:27:00Z")
Short answer: Yes, but it probably isn’t the most constructive way of handling the situation.
Long answer:
1. I’m somewhat surprized anyone taking Rezulin (troglitazone) hasn’t already heard about this. Rezulin was approved for treating diabetes in March 1997. Around Oct/Nov 1997, reports of liver failure necessitating liver transplant or proving fatal first were released. This is not anything new.
2. The good news is that almost all of the cases of liver toxicity occurred early in treatment. This is reflected in FDA & manufacturer recommendations for monitoring liver lab tests monthly for 8 months, bimonthly for the next 4 months, and after a year of therapy “periodically thereafter”.
3. Rezulin, it turns out, is actually a very good drug for treatment of type 2 diabetes because it improves the body’s ability to respond to insulin rather than drowning the body in more insulin like many older drugs. It gets at the insulin resistance which is the root cause of type 2 diabetes.
4. There are 2 new drugs available in the same class, called Avandia (rosiglitazone) and Actos (pioglitazone). To date, Avandia has been reported to have been associated with two cases of _reversible_ liver toxicity. At least one of these was later determined to probably NOT have been caused by the Avandia. These cases, btw, are out of about 300,000 patients taking Avandia. Actos has, to date, not been associated with any liver toxicity, but has not been heavily marketed until about 2 months ago.
5. Bottom line, Ayesha, is that if you’ve been taking Rezulin for a few years & have had no trouble, you are unlikely to now. Also the fact that you are still on it would suggest that you & your doctor are happy with it’s effect on the diabetes. Logically, it probably does make sense to stay on it.
6. **BUT** if you feel like you’re putting poison in your mouth every time you’re taking it, no amount of facts or reason are going to change your mind. Make sure, if this is the case, that you let your doc know just how strongly you feel about this. There are alternatives.
7. OTOH, if this is mainly a shocked reaction to learning that a medicine you’re taking could cause problems since you also have Hepatitis C, get informed.
[http://www.diabetes.com/news/20000225-3500.html](http://www.diabetes.com/news/20000225-3500.html)
[http://www.diabetes.org/ada/diabetesinfo.asp](http://www.diabetes.org/ada/diabetesinfo.asp)
8. If your Hep C is not currently active, it probably is quite safe to stay on the Rezulin, but this is something for you & your doc to ultimately decide. Hope this helps!
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Sue from El Paso
Experience is what you get when you didn’t get what you wanted.
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### Author:  [@Jinx](https://boards.straightdope.com/u/Jinx)
#### Post date: [March 3, 2000, 1:59pm UTC](https://boards.straightdope.com/t/do-i-have-the-right/9090/7 "2000-03-03T13:59:00Z")
If your doctor is not receptive and/or responsive to your concerns about controlling your diabetes and related medications, I’d go hunting for a new doctor and ask such direct questions. Ultimately, it is YOUR life, and you cannot afford to sit back and let the doctors run the show alone.
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### Author:  [@Ayesha](https://boards.straightdope.com/u/Ayesha)
#### Post date: [March 3, 2000, 8:25pm UTC](https://boards.straightdope.com/t/do-i-have-the-right/9090/8 "2000-03-03T20:25:00Z")
Thanks everyone. Yes Majormd, that did help .
I am so freaked out about this because my last liver test results were high.
I had blood drawn for new tests Tuesday, it will be at least 10 days before I hear from the doctor again.
This does concern me, but I will talk to her, if I feel she doesn’t take my concerns seriously I will find a new doctor.
* * *
" The opposite of love isn’t hate, it’s indifference."
Elie Wiesel
Winner SDMB Biggest Flirt (Female) and Least Shy (No Mom, I have no idea why they think that)
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### Author:  [@ASPA](https://boards.straightdope.com/u/ASPA)
#### Post date: [March 20, 2000, 4:06am UTC](https://boards.straightdope.com/t/do-i-have-the-right/9090/9 "2000-03-20T04:06:00Z")
> [@](#):
>
> Originally posted by Ayesha:
> [B… if I feel she doesn’t take my concerns seriously I will find a new doctor.
> \*\*
You should explore different modalities, as well. Advice often tends to be the same, between various doctors, within one tight modality.
One trend is for a marriage of different modalities–or WAYS of addressing the body.
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### Author:  [@system](https://boards.straightdope.com/u/system)
#### Post date: [March 23, 2000, 6:32am UTC](https://boards.straightdope.com/t/do-i-have-the-right/9090/10 "2000-03-23T06:32:00Z")
Ayesha - Just wanted to make sure you knew that Rezulin had been recalled as of 3/21 & that you need to talk to talk with your doctor ASAP about changing meds.
There is not really any new bad news about Rezulin; just that in spite of labelling & testing requirements, there are still liver toxicity problems occurring. I’m not sure how many are due to poor follow-up/inadequate monitoring, but whatever it is, deaths are still occurring in some cases.
The withdrawal of Rezulin from the market is less about problems with Rezulin however (believe it or not, the benefit of good sugar control DOES outweigh the risk of liver problems when it is used in the right patients) as it is about the availability of newer safer alternatives that provide the same benefit.
Ayesha, keep taking the Rezulin until you can talk to your doc, but do talk to her soon, Okay? And e-mail me, please with any questions. I’m off the board after this…
Here’s a copy of an e-mail I got from the Endocrine Society today - it has some links:
> [@](#):
>
> To: All Endocrine Society Members
> From: Dr. Larry Jameson, President
> Re: Withdrawal of Rezulin from U.S. Market
>
> On Tuesday, March 21, 2000, following additional reports of hepatic and
> other toxicities of Rezulin (troglitazone), the Food and Drug Administration
> (FDA) asked Warner-Lambert to withdraw the drug from the market. In the
> interest of patient safety, The Endocrine Society supports the actions of
> the FDA and Warner-Lambert in withdrawing Rezulin.
>
> Rezulin is a member of the thiazolidinediones class of drugs. Although these
> drugs, as a class, offer many benefits to patients, the risks associated
> with these drugs must also be considered. In the case of Rezulin, the FDA
> has found that the risks outweigh the benefits for patients. Current data
> suggests that the other FDA-approved thiazolidinediones, Avandia
> (rosiglitazone) and Actos (pioglitazone) provide similar efficacy as
> Rezulin, but with less hepatic toxicity. Nonetheless, pending further
> safety studies, we recommend that all patients taking thiazolidinediones
> interact closely with their physicians to monitor their liver function.
> Furthermore, we strongly encourage diabetes patients who are currently
> taking Rezulin to consult their physician as soon as possible to find
> alternative therapies.
>
> We hope that this announcement will alert you to the need to work with your
> patients who are taking Rezulin and help them find alternative treatments.
> It is also important to reassure patients who are taking other drugs in the
> thiazolidinedione class and may have been frightened by the recent news
> reports about these drugs.
>
> A copy of The Endocrine Society’s statement on thiazolidinediones is
> available on the web site ([http://www.endo-society.org/pubaffai/032000.htm](http://www.endo-society.org/pubaffai/032000.htm)
> \<[http://www.endo-society.org/pubaffai/032000.htm](http://www.endo-society.org/pubaffai/032000.htm)\> ). In addition, press
> releases from the Department of Health and Human Services and Warner-Lambert
> can be found on these web sites: [http://www.fda.gov/bbs/topics/NEWS/NEW00721.html](http://www.fda.gov/bbs/topics/NEWS/NEW00721.html)
> \<[http://www.fda.gov/bbs/topics/NEWS/NEW00721.html](http://www.fda.gov/bbs/topics/NEWS/NEW00721.html)\>
> andhttp://www.warnerlambert.com/press/release.asp?release=109
> \<[http://www.warnerlambert.com/press/release.asp?release=109](http://www.warnerlambert.com/press/release.asp?release=109)\> .
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Sue from El Paso
Experience is what you get when you didn’t get what you wanted.
**UnBan Melin**
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### Author:  [@Ayesha](https://boards.straightdope.com/u/Ayesha)
#### Post date: [March 24, 2000, 3:42am UTC](https://boards.straightdope.com/t/do-i-have-the-right/9090/11 "2000-03-24T03:42:00Z")
Thanks Sue, I saw this in the news paper, I will be calling my doctor Monday morning.
* * *
" The opposite of love isn’t hate, it’s indifference."
Elie Wiesel
Voted SDMB Biggest Flirt (Female) and Least Shy (No Mom, I have no idea why they think that)