Continue TZD and I dose
D/C TZD and continue diuretics until edema resolved as appropriate continue diuretics continue surveillance for edema/CHF
FIGURE 4 Proposed algorithm to treat edema associated with the use of thiazolidinediones.
pulmonary edema, clinical improvement did not occur with diuretics and inotropes, while the thiazolidinedione agent was still continued (32). In those with peripheral edema who do not respond to conventional doses of diuretics, it may be wise to discontinue the thiazolidinedione agent permanently and use other oral agents or insulin. As yet, treatment of thiazolidinedione-associated edema has not been systematically evaluated and treatment must be guided by clinical judgment.
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