Review of Oral Cholecystographic Agents for the Management of Hyperthyroidism
Abstract
Objective Although the use of oral cholecystographic agents (OCAs) had declined due to limited availability, there is literature to suggest it is an effective medication for thyrotoxicosis in appropriate clinical situations.Methods The authors performed a PubMed search and systematically reviewed all the English written case reports, original studies and reviews from 1953 to 2012. Additional information was supplemented from available online pharmacologic databases.Results The off-label use of OCAs was reviewed for the management of neonatal and adult Graves' disease, subacute thyroiditis, amiodarone-induced thyroiditis (AIT), exogenous hyperthyroidism, toxic multinodular goiter (TMNG), thyrotropinoma, thyrotoxicosis during pregnancy, rapid pre-operative control of hyperthyroidism, and thyroid storm. Adverse effects were also reviewed.Conclusion OCAs generally are effective agents in treating thyrotoxicosis in the etiologies reviewed. OCAs are clinically relevant in patients who require rapid control, such as in the pre-operative state or patient who cannot tolerate a thyrotoxicosis state. OCA may also be beneficial in situations where other anti-thyroidal medication would be hazardous or ineffective, such as thionamide allergy or exogenous thyrotoxicosis. Given concern for long-term relapse, OCAs should be considered a short-term bridge to definitive therapy. OCAs are limited in TMNG and should be second line after glucocorticoids in AIT II. OCAs do not preclude the use of radioactive iodine, which can be performed one week after OCA therapy.
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Treatment with inorganic iodine (SSKI/Lugol's solution) or oral cholecystographic agents leads to rapid decreases in both T4 and T3 levels.
“Treatment with inorganic iodine (SSKI/Lugol's solution) or oral cholecystographic agents (235) leads to rapid decreases in both T 4 and T 3 levels.”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [235]
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“Technical remarks: Treatment with inorganic iodine (SSKI/Lugol’s solution) or oral cholecystographic agents (235) leads to rapid decreases in both T4 and T3 levels.”
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- Authors
- Tyer, N. M., Kim, T. Y., & Martinez, D. S.
- Affiliations
- University of California, Los Angeles (US)
- Corresponding author
- Martinez, Dorothy S.
- ORCID
- Kim, Tiffany Y.
- Venue
- Endocrine Practice
- Publisher
- Elsevier BV
- Published
- 2014-10
- Volume
- 20
- Issue
- 10
- Pages
- 1084-1092
- ISSN
- 1530-891X (ISSN-L)
- OpenAlex
- W2320178511
- Cited by
- 10
- References
- 76
- Citations by year
- 2022: 1 · 2021: 1 · 2020: 2 · 2019: 1 · 2017: 2 · 2016: 2 · 2015: 1
- FWCI
- 0.26
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Endocrine Practice (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Pathology and Forensic Medicine › Ophthalmology and Eye Disorders
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Keywords
- thyrotoxicosis, hyperthyroidism, Graves' disease, subacute thyroiditis, toxic multinodular goiter, thyroid storm, glucocorticoids, radioactive iodine, adverse effects
- MeSH terms
- Adult, Amiodarone, Anti-Arrhythmia Agents, Female, Goiter, Nodular, Humans, Hyperthyroidism, Neoplasm Recurrence, Local, Pregnancy, Thyroiditis, Subacute, Thyrotoxicosis
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