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Effect of amiodarone on serum T4 and T3 levels in hyperthyroid patients treated with methimazole

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Summary

We investigated the course of thyroid hormones levels in the serum of hyperthyroid patients acutely treated with amiodarone. Ten patients were treated either with amiodarone, 3 × 400 mg daily for 3 days in addition to methimazole, 3 × 20 mg daily for 10 days (Group I;n=5) or with a placebo plus methimazole at the same doses (Group II;n=5). Basal T3, T4 and rT3 serum concentrations were: 297 ng/dl, 16.6 µg/dl and 507 pg/dl, respectively in Group I and 377 ng/dl, 17.6 µg/dl and 362 pg/dl in Group II (NS). Compared with basal values, the drop in serum T3 concentration became significant on Day 1 in Group I, but not until day 5 in Group II. The decrease in serum T3 concentration was significantly higher in Group I than in Group II from Day 1 to Day 7. In Group I, T4 concentration was significantly lower on Days 2, 4 and 6; the percentage drop in T4 calculated from the areas under the curves was higher and the T3/T4 ratio lower on Days 3–5, 7 and 9; rT3 was higher on Days 4 and 5 and its rise was significant on Days 1, 3 and 4. During the follow-up period a transient rise in T4 and T3 concentrations was observed in two patients in Group I when the methimazole dosage was tapered or stopped because of agranulocytosis. In conclusion, in our hyperthyroid patients, amiodarone in conjunction with methimazole induced a greater fall in T3 and T4 than did methimazole alone.

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Authors and Affiliations

  1. Department of Medicine and Institute of Interdisciplinary Research, Erasme Hospital, School of Medicine, Free University of Brussels, Brussels, Belgium

    O. Van Reeth, C. Decoster & J. Unger

  2. Laboratoire d'Anatomie Pathologique et de Microscopie Electronique Campus Erasme, Bât. C, Niveau 3, Route de Lennik 808, B-1070, Brussels, Belgium

    O. Van Reeth

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  1. O. Van Reeth
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  2. C. Decoster
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  3. J. Unger
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Van Reeth, O., Decoster, C. & Unger, J. Effect of amiodarone on serum T4 and T3 levels in hyperthyroid patients treated with methimazole. Eur J Clin Pharmacol 32, 223–227 (1987). https://doi.org/10.1007/BF00607567

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  • DOI: https://doi.org/10.1007/BF00607567

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