Document Detail


Pharmacological treatment of hyperthyroidism during lactation: review of the literature and novel data.
MedLine Citation:
PMID:  21037541     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Antithyroid drugs (ATD) are used as a first line treatment in thyrotoxicosis. Propylthiouracil (PTU), carbimazole (CMZ) and methimazole (MMI) are available. During absorption CMZ is bioactivated to MMI. Initially, mothers were not allowed to breastfeed during treatment with ATD. Newer studies minimized the risk for mother and infant. PTU should be preferred over MMI due to its lower milk concentration. Recent studies have shown severe hepatic dysfunction for both ATD, but especially for PTU, in hyperthyroid patients. Most of those cases were idiosyncratic, not-dose related and presented a latent period of occurrence. No biomarkers could predict hepatic damage. The American Thyroid Association (ATA) has recommended that PTU should not be prescribed as the first line agent in children and adolescents. Its use might be accepted in the first trimester of pregnancy for severe thyrotoxicosis or for patients with previous MMI adverse reactions. Considering the potential harmful effects of PTU, MMI should be used instead during lactation.
Authors:
Spiros Karras; Themistoklis Tzotzas; Themistoklis Kaltsas; Gerasimos E Krassas
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Pediatric endocrinology reviews : PER     Volume:  8     ISSN:  1565-4753     ISO Abbreviation:  Pediatr Endocrinol Rev     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-11-01     Completed Date:  2010-12-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101202124     Medline TA:  Pediatr Endocrinol Rev     Country:  Israel    
Other Details:
Languages:  eng     Pagination:  25-33     Citation Subset:  IM    
Affiliation:
Department of Endocrinology, Diabetes and Metabolism, Panagia General Hospital, Thessaloniki, Greece. krassas@the.forthnet.gr
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MeSH Terms
Descriptor/Qualifier:
Adult
Antithyroid Agents / adverse effects,  therapeutic use*
Breast Feeding*
Carbimazole / adverse effects,  therapeutic use
Child Development / drug effects,  physiology
Female
Humans
Hyperthyroidism / drug therapy*,  metabolism*
Infant
Lactation
Methimazole / adverse effects,  therapeutic use
Milk, Human / chemistry
Mothers
Propylthiouracil / adverse effects,  therapeutic use
Chemical
Reg. No./Substance:
0/Antithyroid Agents; 22232-54-8/Carbimazole; 51-52-5/Propylthiouracil; 60-56-0/Methimazole

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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