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Contraindications and Precautions Thiazolidinediones are contraindicated in patients with (8): Heart failure Moderate to severe hepatic impairment Active or history of bladder cancer Pregnancy High-risk fracture Cytochrome CYP 2C8 and CYP 3A4 Adverse Effects and Black Box Warnings Thiazolidinediones have several adverse effects, including (8): Edema Congestive heart failure Weight gain Decreased bone density, leading to fractures Bladder cancer Hepatotoxicity Diabetic macular edema Increased ovulation and teratogenic effects Thiazolidinediones have a black box warning of congestive heart failure and myocardial ischemia

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