How is hyperthyroidism treated in pregnancy?
How is hyperthyroidism treated in pregnancy?
The available drugs include methimazole (MMI) and its prodrug carbimazole (CMZ) as well as propylthiouracil (PTU). The drugs are equally effective in the treatment of hyperthyroidism, and they all pass the placenta, which may lead to fetal hypothyroidism in late pregnancy (see “Late pregnancy” section).
Which of the following drug is the 1st line treatment for hyperthyroidism in pregnancy?
Thioamide drug therapy (propylthiouracil, methimazole, carbimazole) is the first line therapy, indicated for moderate or severe hyperthyroidism.
What is the first line treatment for hyperthyroidism?
Pharmacologic Treatment of Hyperthyroidism
| First-line agents | Dosage |
|---|---|
| Propranolol | Immediate release: 10 to 40 mg orally every eight hours Extended release: 80 to 160 mg orally once per day |
| Antithyroid medications | |
| Methimazole (Tapazole) | 5 to 120 mg orally per day (can be given in divided doses) |
How is subclinical hyperthyroidism treated in pregnancy?
Treatment is generally not required for subclinical hyperthyroidism in pregnancy. In fact, most instances of a low TSH in early pregnancy are not pathological and are due to TSH suppressive effects of β-human chorionic gonadotrophin (β-HCG).
Is Neomercazole safe in pregnancy?
The drug is permitted to be used during pregnancy. Please note that the use of Neo-Mercazole during breast-feeding is not permitted.
What is the most common treatment for hyperthyroidism?
Hyperthyroidism caused by overproduction of thyroid hormones can be treated with antithyroid medications (methimazole and propylthiouracil), radioactive iodine ablation of the thyroid gland, or surgical thyroidectomy. Radioactive iodine ablation is the most widely used treatment in the United States.
What is the best treatment for subclinical hyperthyroidism?
Your doctor will likely prescribe radioactive iodine therapy or anti-thyroid medications, such as methimazole. Radioactive iodine therapy and anti-thyroid medications can also be used to treat subclinical hyperthyroidism due to multinodular goiter or thyroid adenoma.
Why is carbimazole used in pregnancy?
It is important that normal thyroid function is maintained during pregnancy as the effects of an overactive thyroid can be harmful to both mother and unborn child. For some women carbimazole or methimazole may be considered the best medicines to maintain normal thyroid function during pregnancy.
What is the treatment for hyperthyroidism in pregnancy?
When hyperthyroidism is severe enough to require therapy, anti-thyroid medications are the treatment of choice, with PTU being preferred in the first trimester. The goal of therapy is to keep the mother’s free T4 in the high-normal to mildly elevated range on the lowest dose of antithyroid medication.
When is PTU indicated in the treatment of hyperthyroidism during pregnancy?
When ATDs are required, PTU is preferred until week 16 of pregnancy. It is recommended that the lowest possible dose of ATD be used to control maternal hyperthyroidism in order to minimize the development of hypothyroidism in the baby.
What causes transient hyperthyroidism in early pregnancy?
In addition to other usual causes of hyperthyroidism (see Hyperthyroidism brochure), very high levels of hCG, seen in severe forms of morning sickness (hyperemesis gravidarum), may cause transient hyperthyroidism in early pregnancy. The correct diagnosis is based on a careful review of history, physical exam and laboratory testing.
What is the prevalence of hyperthyroidism in pregnant women?
Context: Clinical hyperthyroidism is not uncommon in pregnancy, with a reported prevalence of 0.1 to 0.4%. The available antithyroid drugs are propylthiouracil and methimazole/carbimazole.
