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Effect of Rifampin on Thyroid Function Test in Patients on Levothyroxine Medication

Title
Effect of Rifampin on Thyroid Function Test in Patients on Levothyroxine Medication
Author
이현
Issue Date
2017-01
Publisher
PUBLIC LIBRARY SCIENCE
Citation
PLOS ONE, v. 12, no. 1, Article no. e0169775
Abstract
BackgroundLevothyroxine (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.MethodsWe 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.ResultsAfter 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.ConclusionsIn 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.
URI
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0169775http://repository.hanyang.ac.kr/handle/20.500.11754/106120
ISSN
1932-6203
DOI
10.1371/journal.pone.0169775
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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