The Safety of Methimazole and Propylthiouracil in Pregnancy

Hackmon, Rinat; Blichowski, Monica; Koren, Gideon

doi:10.1097/01.ogx.0000428159.59063.2b

Cited by 15 publications

(19 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It follows that when PTU is not readily available or contraindicated (i.e., allergy, side effects or incomplete efficacy in controlling hyperthyroidism), MMI treatment should be started. Moreover, considering the rare but possible hepatotoxic effect of PTU [34,44], it is reasonable to move to MMI during the second and third trimester of pregnancy, when a potential MMI embryopathy cannot be any longer produced.…”

Section: Discussionmentioning

confidence: 99%

“…Most of these descriptions pertained to case reports which, while being important for highlighting possible adverse effects, suffer from the weakness of being anecdotal evidence [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]. Later on, eight epidemiological studies were conducted to verify the existence of a methimazole embryopathy [2,[28][29][30][31][32][33], but, as assessed by a recent review of the literature [34], most of them do not take into account crucial factors such as maternal thyroid function, ATD dose and exposure time during pregnancy or do not include controls, so that a definitive answer is still lacking.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pregnancy outcome in women treated with methimazole or propylthiouracil during pregnancy

Gianetti

Russo

Orlandi

et al. 2015

J Endocrinol Invest

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pregnancy outcome in women treated with methimazole or propylthiouracil during pregnancy

Gianetti

Russo

Orlandi

et al. 2015

J Endocrinol Invest

View full text Add to dashboard Cite

show abstract

“…After this, various other types of birth defects were reported, including special facial features. This leads to the description of a MMI/CMZ embryopathy (52,53), considered to be very rare (54).…”

Section: Therapy Of Graves' Disease and The Risk Of Birth Defectsmentioning

confidence: 99%

ENDOCRINOLOGY IN PREGNANCY: Pregnancy and the incidence, diagnosing and therapy of Graves’ disease

Laurberg

Andersen

2016

European Journal of Endocrinology

View full text Add to dashboard Cite

Thyroid hormones are essential developmental factors, and Graves' disease (GD) may severely complicate a pregnancy. This review describes how pregnancy changes the risk of developing GD, how early pregnancy by several mechanisms leads to considerable changes in the results of the thyroid function tests used to diagnose hyperthyroidism, and how these changes may complicate the diagnosing of GD. Standard therapy of GD in pregnancy is anti-thyroid drugs. However, new studies have shown considerable risk of birth defects if these drugs are used in specific weeks of early pregnancy, and this should be taken into consideration when planning therapy and control of women who may in the future become pregnant. Early pregnancy is a period of major focus in GD, where pregnancy should be diagnosed as soon as possible, and where important and instant change in therapy may be warranted. Such change may be an immediate stop of anti-thyroid drug therapy in patients with a low risk of rapid relapse of hyperthyroidism, or it may be an immediate shift from methimazole/carbimazole (with risk of severe birth defects) to propylthiouracil (with less risk), or maybe to other types of therapy where no risk of birth defects have been observed. In the second half of pregnancy, an important concern is that not only the mother with GD but also her foetus should have normal thyroid function.Thyroid hormones are essential developmental factors as first shown by Gudernatsch when he, in 1912, fed tadpoles thyroid tissue and observed metamorphosis (1). In mammals, thyroid hormones are especially of importance for brain development (2, 3), and even a few months with lack of thyroid hormones in infant life may lead to irreversible brain damage. This is the background for the universal screening for congenital hypothyroidism performed in many countries. However, thyroid hormones are also important for normal pregnancy, and maternal thyroid disease may severely increase the risk of pregnancy complications, including Invited author's profile Peter Laurberg was Clinical Professor of Internal Medicine and Endocrinology, Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark. His research mainly focused on thyroid disease prevention, epidemiology, diagnosing and therapy, including studies on iodine and thyroid, and pregnancy and thyroid. He had special research interest on the risk from and optimal management of autoimmune hypo-and hyperthyroidism in pregnancy and post-partum, management of Graves' disease in general, and how the burden of thyroid disease can be minimized by adjusting the population's iodine intake. He has coauthored several international guidelines on thyroid disease management, including management of thyrotoxicosis, and thyroid disease in pregnancy. Peter Laurberg died June 20, 2016.

show abstract

“…Additionally, similar to a study in Canada, there were more prescriptions of propylthiouracil in the first trimester than before pregnancy, and the use of propylthiouracil was sustained through the pregnancy . On the basis of research, hyperthyroidism can produce severe risks for both the fetus and mother . Hence, evaluating risks and benefits of drug exposure for the mother and fetus and controlling a mother's abnormal thyroid function are extremely important issues.…”

Section: Commentsmentioning

confidence: 89%

Prescriptions for category D and X drugs during pregnancy in Taiwan: a population-based study

Chen

Lin

Chung

2014

Pharmacoepidemiol Drug Saf

View full text Add to dashboard Cite

show abstract

The Safety of Methimazole and Propylthiouracil in Pregnancy

Cited by 15 publications

References 0 publications

Pregnancy outcome in women treated with methimazole or propylthiouracil during pregnancy

Pregnancy outcome in women treated with methimazole or propylthiouracil during pregnancy

ENDOCRINOLOGY IN PREGNANCY: Pregnancy and the incidence, diagnosing and therapy of Graves’ disease

Prescriptions for category D and X drugs during pregnancy in Taiwan: a population-based study

Contact Info

Product

Resources

About