Levothyroxine liquid solution versus tablet form for replacement treatment in pregnant women. (2nd April 2016)

• Record Type: Journal Article
• Authors: Cappelli, Carlo; Negro, Roberto; Pirola, Ilenia; Gandossi, Elena; Agosti, Barbara; Castellano, Maurizio
• Is Part Of: Gynecological endocrinology. Volume 32:Number 4(2016:Apr.)
• Page Start: 290
• Page End: 292
• Publication Date: 2016-04-02
• Subjects: Hypothyroidism -- levothyroxine -- liquid solution -- pregnant women; Endocrine gynecology -- Periodicals; Generative organs, Female -- Diseases -- Periodicals; 618.1
• DOI: 10.3109/09513590.2015.1113518
• Languages: English
• ISSNs: 0951-3590

Abstract

Abstract: Objective: To evaluate the need and the magnitude of levothyroxine (LT4) increase in hypothyroid pregnant women on liquid compared to tablet formulations. Methods : Patients were recruited by searching our "thyroid patients" database. The selection criteria were as follows: a) pregnant women on treatment for hypothyroidism (both liquid and tablet LT4) who gave birth at our hospital between February 2012 and January 2014; b) thyroid stimulating hormone (TSH) and free thyroxine (FT4) levels obtained at least 3 months before missed menstrual cycle, with a TSH value less than 2.5 mIU/L and c) TSH and FT4 obtained within 12 weeks of pregnancy, and each month subsequently. Results : During pregnancy, 8/31 (25.5%) of the women had to increase the dosage of LT4. Of these, 7/17 (41.2%) were on LT4 replacement therapy with tablets, and 1/14 (7.1%) with liquid formulation ( p = 0.038). Daily LT4 was significantly increased in the liquid group only (52.9 ± 19.5 versus 67.5 ± 19.2 mcg/day ( p = 0.013). A logistic regression analysis showed that the treatment with LT4 tablets was the only predictor of LT4 increase (OR: 0.44; 95% CI: 0.04–0.83; p = 0.031). Conclusion: Pregnant women on optimal replacement therapy before pregnancy require an increase of LT4 dosage more often when on a tablet than liquid formulation.