How is amiodarone-associated thyroid dysfunction prevented?

Updated: Aug 28, 2020
  • Author: Mini Gopalan, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

Test baseline thyroid function in all patients starting amiodarone therapy to exclude underlying gland dysfunction that may predispose them to thyroid abnormalities after therapy begins. The serum levels of TSH, free T4, and free T3 may be reassessed after 3 months of amiodarone therapy. In patients with euthyroidism, thyroid function results may be used as reference for future comparisons. Periodically monitor serum TSH levels and other thyroid indices if TSH levels are abnormal or clinical suspicion of thyroid dysfunction exists. The threshold for performing thyroid function tests should be low in patients who are taking amiodarone or who have in the past, as type 2 AIT has an abrupt onset. Continue to measure thyroid function for at least a year after amiodarone therapy is discontinued.

Research indicates that another benzofuran-derived drug, dronedarone (Multaq), may be a useful alternative treatment for arrhythmia. Although apparently not as effective an antiarrhythmic as amiodarone, dronedarone seems to be less toxic to the thyroid. [15]  Dronedarone was approved by the FDA on July 2, 2009.


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