Archives of Head and Neck Surgery
Archives of Head and Neck Surgery
Original Article Thyroid diseases and tumors

Adverse events involving levothyroxine in patients treated at the toxicological assistance center of São Paulo

Marina Romera Cavallari, Anthony Wong, Leandro Luongo Matos

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Introduction: Thyroxine is prescribed for patients with thyroid hormone deficiency in the event of hypothyroidism or thyroidectomy. Objective: The Toxicological Assistance Center of Sao Paulo (CEATOX-SP) aims to provide specific information to the general public and health professionals in the event of poisoning, exposure to toxic substances, accidents with venomous animals, and adverse drug reactions, assisting with diagnosis and treatment. This study assesses the epidemiology of adverse events involving levothyroxine reported at the CEATOX-SP. Materials and Methods: This is a crosssectional, retrospective study involving cases of therapeutic error, adverse reaction, individual accident with medication, and substance abuse involving levothyroxine, between 2013 and 2015. Results: During the study period, a total of 39,501 patients were treated at the CEATOX-SP, with 1% (396) of the cases involved the use of levothyroxine, and most occurrences (77.8%) were reported in the state of Sao Paulo. All occurrences were domestic; however, the CEATOX-SP was most contacted by physicians, after assistance at health services. Mean age of the patients was 24.4 ± 26.2 years, and 68.9% of them were female. The most common circumstance was “individual accident” (47.5%), the most prevalent type of exposure was “acute only” (56.3%), and the most predominant type of occurrence was “exposure” (73.5%). The main reason for seeking the service were accidents involving children, who found tablets in the house and ingested them. Conclusion: Accident prevention campaigns targeting children and medicines, and awareness of health professionals about the importance of medical prescription can reduce the number of adverse events involving levothyroxine.


thyroxine; drug effects; prescription drug misuse; pharmacovigilance


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