The lowest dose possible should be used, and this can often be discontinued three to four weeks before term, in order to reduce the risk of neonatal complications. Due to risk of fetal abnormalities with first trimester exposure to methimazole (carbimazole, thiamazole), this drug is suggested for use prior to conception and in the first trimester. But the lowest possible dose should be given. There are, however, some medicines that can harm a baby’s normal development. Re-exposure to carbimazole may result in life-threatening acute pancreatitis. Carbimazole embryopathy: an emerging phenotype. Please encourage all women to complete an online reporting form. You will receive an email when new content is published. If you are trying to conceive you should speak to your doctor who may suggest that you change to a different medicine. 2. Before using Carbimazole, inform your doctor about your current list of medications, over the counter products (e.g. Women who have been treated with carbimazole or methimazole during the first trimester may be offered the option of having earlier and more detailed anomaly scans to look for birth defects in addition to the main scan for birth defects which is generally offered at around 20 weeks. The most common causes of hyperthyroidism during pregnancy are Graves’ diseaseand hCG-mediated hyperthyroidism such as gestational transient hyperthyroidism, hyperemesis gravidarum (intractable … A series of Clinical Practice Guidelines aimed at optimising fetal and maternal outcomes in women with Graves' disease have been published in recent years. When deciding whether or not to use a medicine in pregnancy you need to weigh up how the medicine might improve your and/or your unborn baby’s health against any possible problems that the drug may cause. I have just received an email alert regarding Carbimazole. Pre-conception patients may be offered definitive therapy - eg, ablation with radiotherapy (ideally, the patient should not conceive until six months later, once the levothyroxine dose has been optimised). To have your say on how we can improve our website and the information we provide please visit here. If you would like to report a pregnancy to UKTIS please click here to download our pregnancy reporting form. Background: Hyperthyroidism is one of the most common endocrine disorders in pregnant women, and it can severely complicate the course and outcome of pregnancy. ; Long-term management of hyperthyroidism may include drugs that suppress thyroid function such as propylthiouracil, carbimazole and methimazole . The lowest dose possible should be used, and this can often be discontinued three or four weeks before term, in order to reduce the risk of neonatal complications. This accounts for the dramatic improvement in both subjective and objective symptoms of hyperthyroidism, … Carbimazole crosses the placenta but, provided the mother's dose is within the standard range and her thyroid status is monitored; there is no evidence of neonatal thyroid abnormalities. Following absorption, carbimazole is rapidly and completely metabolised to methimazole, which inhibits the synthesis of the thyroid hormones thyroxine (T4) and triiodothyronine (T3). The MHRA said an EU review of evidence from epidemiological studies and case reports showed that carbimazole is associated with an increased risk of congenital malformations when used during pregnancy, especially during the first trimester and at high dosages (≥15mg daily). Fetal hyperthyroidism can be life-threatening, and needs to be recognised as soon as possible so that treatment of the fetus with antithyroid drugs via … UKTIS is a not-for-profit organisation funded by Public Health England on behalf of UK Health Departments. General pregnancy and pre-conception advice to all women - eg, folic acid. We strongly advise that printouts should NOT be kept for any length of time, or for “future reference” as they can rapidly become out of date. If carbimazole is used during pregnancy, close maternal, foetal and neonatal monitoring is recommended (see section 4.4). They can access more detailed medical and scientific information from www.uktis.org. Treatment with carbimazole, methimazole or other antithyroid medicines after week 10 of pregnancy can affect the development of the unborn baby’s thyroid gland. 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