International Journal of Clinical Pharmacy

, Volume 36, Issue 2, pp 405–411 | Cite as

Amiodarone-induced thyroid dysfunction in Taiwan: a retrospective cohort study

  • Chun-Jui Huang
  • Po-Ju Chen
  • Jing-Wen Chang
  • De-Feng Huang
  • Shih-Lin Chang
  • Shih-Ann Chen
  • Tjin-Shing Jap
  • Liang-Yu LinEmail author
Research Article


Background The incidence and risk factors of amiodarone-induced thyroid dysfunction are variable in the literature. Objective The aim of this study was to investigate the clinical and biochemical features and risk factors of amiodarone-induced thyroid dysfunction in Taiwan. Setting This study was conducted at a tertiary referral center for arrhythmia. Method Retrospective analysis of patients treated with amiodarone during the years 2008–2009 was performed. Main outcome measure Incidence and risk factors of amiodarone-induced thyrotoxicosis (AIT) and amiodarone-induced hypothyroidism (AIH) were assessed. Results Of the 527 patients, 437 (82.9 %) remained euthyroid, 21 (4.0 %) developed AIT, and 69 (13.1 %) were affected with AIH. In univariate analysis, AIT was associated with younger age, and the risk factors for AIH included older age, higher baseline thyroid stimulating hormone (TSH) titer, lower baseline free T4 level, lower cumulative amiodarone dosage, and shorter amiodarone treatment duration. Cox regression analysis was performed to determine the different risk categories in the elderly population of age 65–74 (young-old), 75–84 (old-old), and ≥85 years old (oldest-old). Additionally increased risk of AIH was found in the groups of old-old (HR 2.09, 95 % CI 1.11–3.96) and oldest-old (HR 2.57, 95 % CI 1.21–4.75). In the multivariate analysis of risk factors for AIH, baseline TSH level (HR 1.38, 95 % CI 1.12–1.70) and cumulative amiodarone dosage (HR 0.95, 95 % CI 0.93–0.97) remained statistically significant. Conclusion AIH was much more common than AIT in Taiwan, an area with sufficient iodine intake. Higher baseline TSH level was the predominant independent risk factor for the development of AIH.


Amiodarone Hypothyroidism Thyrotoxicosis 



This study was partly supported by research Grants V100B-039, V101B-023, V102B-048 to L.Y.L. and V100A-013 to P.J.C from Taipei Veterans General Hospital, Taipei, Taiwan.

Conflicts of interest



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Copyright information

© Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie 2014

Authors and Affiliations

  • Chun-Jui Huang
    • 1
    • 2
  • Po-Ju Chen
    • 1
  • Jing-Wen Chang
    • 3
  • De-Feng Huang
    • 2
    • 4
  • Shih-Lin Chang
    • 2
    • 5
  • Shih-Ann Chen
    • 2
    • 5
  • Tjin-Shing Jap
    • 1
    • 2
  • Liang-Yu Lin
    • 1
    • 2
    • 6
    Email author
  1. 1.Division of Endocrinology and Metabolism, Department of MedicineTaipei Veterans General HospitalTaipei CityTaiwan
  2. 2.Faculty of MedicineNational Yang-Ming UniversityTaipei CityTaiwan
  3. 3.Department of MedicineKaohsiung Armed Forces General HospitalKaohsiung CityTaiwan
  4. 4.Division of Allergy, Immunology and Rheumatology, Department of MedicineTaipei Veterans General HospitalTaipei CityTaiwan
  5. 5.Division of Cardiology, Department of MedicineTaipei Veterans General HospitalTaipei CityTaiwan
  6. 6.Institute of PharmacologyNational Yang-Ming UniversityTaipei CityTaiwan

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