Effect of Rifampin on Thyroid Function Test in Patients on Levothyroxine MedicationReportar como inadecuado




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Background

Levothyroxine LT4 and rifampin RIF are sometimes used together; however, no clinical studies have assessed the effects of these drugs on thyroid function or the need to adjust LT4 dose.

Methods

We retrospectively reviewed the records of 71 Korean patients who started RIF during LT4 treatment. Clinically relevant cases that required dose adjustment according to the American Thyroid Association ATA-American Association of Clinical Endocrinologists AACE guidelines were identified, and risk factors of increased LT4 dose were analyzed.

Results

After administering RIF, median serum thyroid-stimulating hormone TSH level 2.58 mIU-L, interquartile range IQR 0.21–7.44 was significantly higher than that before RIF 0.25 mIU-L, IQR, 0.03–2.62; P < 0.001. An increased LT4 dose was required for 50% of patients in the TSH suppression group for thyroid cancer and 26% of patients in the replacement group for hypothyroidism. Risk factor analysis showed that remaining thyroid gland odds ratio OR 9.207, P = 0.002, the time interval between starting RIF and TSH measurement OR 1.043, P = 0.019, and baseline LT4 dose per kg body weight OR 0.364, P = 0.011 were clinically relevant variables.

Conclusions

In patients receiving LT4, serum thyroid function test should be performed after starting RIF treatment. For patients with no remnant thyroid gland and those receiving a lower LT4 dose, close observation is needed when starting RIF and TB medication.



Autor: Hye In Kim, Tae Hyuk Kim, Hosu Kim, Young Nam Kim, Hye Won Jang, Jae Hoon Chung, Seong Mi Moon, Byung Woo Jhun, Hyun Lee, Won-Jun

Fuente: http://plos.srce.hr/



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