title: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Medicine, University of California, Los Angeles, Los Angeles, California.
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Tyer
authors.affiliation: Department of Medicine, University of California, Los Angeles, Los Angeles, California.
authors.forename: Tiffany Y
authors.initials: TY
authors.lastname: Kim
authors.affiliation: Department of Medicine, University of California, Los Angeles, Los Angeles, California.
authors.forename: Dorothy S
authors.initials: DS
authors.lastname: Martinez
mesh_terms: D000328:Adult; D000638:Amiodarone; D000889:Anti-Arrhythmia Agents; D005260:Female; D006044:Goiter, Nodular; D006801:Humans; D006980:Hyperthyroidism / Q000188:drug therapy; D009364:Neoplasm Recurrence, Local; D011247:Pregnancy; D013968:Thyroiditis, Subacute; D013971:Thyrotoxicosis
chemical_list: D000889:Anti-Arrhythmia Agents; D000638:Amiodarone