via abcnews.go.com
"Why would we use a drug that might be harmful, even though it's not conclusive when there are so many other choices?" said Dr. David Nathan of Massachusetts General Hospital in Boston. The package insert for Avandia warns about dose-related edema (swelling), an average weight gain of 3.5 kg after four years and anemia -- problems that have plagued Avandia and Actos users along with increased fracture risk. Both drugs also carry a black-box warning about the risk of heart failure. "The first question is not whether to switch someone from Avandia to Actos, but whether they should be on either one at all," said Dr. Lee Green of the University of Michigan in Ann Arbor, who called the evidence convincing enough for him. 
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