How do doctors decide which medications, or which combination of medications to use?
For the treatment of PCOS, especially among women trying to conceive, most doctors would start with the older and safer metformin therapy and only switch to or add one of the glitazones if metformin alone is not working, or if the side effects are intolerable. In patients with kidney problems, one of the glitazones may be the first course of treatment. Other considerations include the fact that the safety of Rezulin is currently being questioned in the U.S., and ACTOS and Avandia are Pregnancy Category C medications that should be stopped when pregnancy is achieved.
