When is the use of TZDs contraindicated

TZDs are contraindicated when hepatic insufficiency exists or when the initial level of the serum transaminases is higher than 2.5 times the upper limit of normal. They one also contraindicated when there is cardiac insufficiency of any stage (although some authors recommend that they are not given only in stages III and IV of cardiac insufficiency). TZDs are not contraindicated when there is moderate renal insufficiency, but only when the creatinine clearance is < 10 ml/min. Because of the findings in experimental animals that speculate a neoplastic action of the TZDs, it has been proposed that they are avoided in individuals with a family history of adenomatous polypodiasis or other cancers. They are also contraindicated in pregnancy, because there is no experience of their use in humans, and studies in animals have shown a delay in foetal growth.

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