Propylthiouracil
Thyroid Crisis, Goiter
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Drug Status
Government Approvals
US(FDA), UK(BNF)
WHO Essential Medicine
YES
Known Teratogen
NO
Pharmaceutical Class
Thyroid Hormone Synthesis Inhibitor
Controlled Drug Substance
NO
Propylthiouracil
Summary
Propylthiouracil is used to treat hyperthyroidism, particularly in conditions like Graves disease and toxic multinodular goiter. It is also used as a preparatory treatment for thyroid surgery or radioactive iodine therapy.
Propylthiouracil works by inhibiting the enzyme thyroid peroxidase, which is essential for the production of thyroid hormones. This reduces the levels of thyroxine (T4) and triiodothyronine (T3) in the body, helping manage hyperthyroidism.
For adults, the initial dose is typically 300 mg daily, divided into three doses. In severe cases, the dose may be increased. The maintenance dose is usually 100-150 mg daily. Propylthiouracil is usually taken orally.
Common side effects include nausea, vomiting, headache, dizziness, and joint pain. Serious adverse effects can include liver damage and a drop in white blood cells.
Propylthiouracil carries a risk of severe liver damage. It should be used cautiously in pregnant women and in pediatric patients. It is contraindicated in patients with hypersensitivity to the drug.
Indications and Purpose
How does Propylthiouracil work?
Propylthiouracil works by inhibiting the enzyme thyroid peroxidase, which is essential for the production of thyroid hormones. This action reduces the levels of thyroxine (T4) and triiodothyronine (T3) in the body, helping to manage hyperthyroidism. It also inhibits the conversion of T4 to T3 in peripheral tissues, further aiding in the control of thyroid hormone levels.
Is Propylthiouracil effective?
Propylthiouracil is an antithyroid medication that effectively treats hyperthyroidism by inhibiting the production of thyroid hormones. It is particularly used in patients with Graves' disease or toxic multinodular goiter who cannot tolerate other treatments. The medication is well-documented to reduce symptoms of hyperthyroidism and is used as a preparatory treatment for thyroid surgery or radioactive iodine therapy.
What is Propylthiouracil?
Propylthiouracil is used to treat hyperthyroidism, particularly in Graves' disease and toxic multinodular goiter. It works by inhibiting the production of thyroid hormones, helping to balance the body's metabolism. The medication is often used when other treatments are unsuitable and can also prepare patients for thyroid surgery or radioactive iodine therapy.
Directions for Use
For how long do I take Propylthiouracil?
The duration of Propylthiouracil treatment varies depending on the individual's condition and response to the medication. It is typically used until the patient becomes euthyroid, meaning their thyroid hormone levels are balanced. This can take several weeks to months. Long-term use may be necessary in some cases, but the exact duration should be determined by a healthcare provider.
How do I dispose of Propylthiouracil?
If you can, bring unused medicines to a drug take-back program or collection site at a pharmacy or hospital. They will dispose of this medicine properly so they don't harm people or the environment. If you can't find a take-back program, you can throw most medicines in the trash at home. But first, take them out of their original containers, mix them with something undesirable like used coffee grounds, seal the mixture in a plastic bag and throw it away.
How do I take Propylthiouracil?
Propylthiouracil is usually taken three times a day, every 8 hours. It can be taken with or without food, but taking it with food may help reduce stomach upset. There are no specific food restrictions while taking this medication, but patients should follow their doctor's advice regarding diet and any other medications they are taking.
How long does it take for Propylthiouracil to start working?
Propylthiouracil begins to work within days to weeks, but it may take several weeks to months for full effects to be seen. The time it takes to achieve a euthyroid state varies depending on the individual's condition and response to the medication. Regular monitoring by a healthcare provider is essential to assess the effectiveness of the treatment.
How should I store Propylthiouracil?
Propylthiouracil should be stored at room temperature, between 68°F to 77°F (20°C to 25°C). Keep the medication in its original container, tightly closed, and out of reach of children. It should be stored away from excess heat and moisture, so avoid keeping it in the bathroom. Proper storage ensures the medication remains effective and safe to use.
What is the usual dose of Propylthiouracil?
For adults, the initial dose of Propylthiouracil is typically 300 mg daily, divided into three doses. In severe cases, the dose may be increased to 400 mg or even 600-900 mg daily. The maintenance dose is usually 100-150 mg daily. For children, Propylthiouracil is generally not recommended unless other treatments are unsuitable. If used, the starting dose for children aged 6 years or older is 50 mg daily, with careful adjustment based on response.
Warnings and Precautions
Can I take Propylthiouracil with other prescription drugs?
Propylthiouracil may interact with blood thinners like warfarin, increasing the risk of bleeding. It can also affect the clearance of beta-blockers, digitalis glycosides, and theophylline, potentially requiring dose adjustments of these medications. Patients should inform their doctor of all medications they are taking to avoid adverse interactions and ensure safe use of Propylthiouracil.
Can Propylthiouracil be taken safely while breastfeeding?
Propylthiouracil is present in breast milk in small amounts, which are generally considered clinically insignificant for the nursing infant. However, close monitoring of the infant's development is recommended. Mothers should discuss the risks and benefits with their healthcare provider to ensure the safe use of Propylthiouracil while breastfeeding.
Can Propylthiouracil be taken safely while pregnant?
Propylthiouracil is used during the first trimester of pregnancy when necessary, as it poses less risk of birth defects compared to methimazole. However, it can cause liver damage in pregnant women and may harm the fetus. After the first trimester, switching to methimazole is often recommended. Pregnant women should be closely monitored, and the lowest effective dose should be used to minimize risks.
Does Propylthiouracil have adverse effects?
Adverse effects are unwanted or harmful effects that can occur with medication use. For Propylthiouracil, some concerning adverse effects include rash, joint pain, and nausea. Rare but serious effects include liver damage and a decrease in white blood cells, which can lead to infections. If you experience symptoms like yellowing of the skin or eyes, severe fatigue, or fever, seek medical attention immediately. Always report new symptoms to your healthcare provider and consult them before stopping the medication.
Does Propylthiouracil have any safety warnings?
Propylthiouracil has safety warnings, including the risk of liver damage and a decrease in white blood cells, which can lead to infections. Symptoms of liver damage include yellowing of the skin or eyes and severe fatigue. Signs of low white blood cells include fever and sore throat. It's important to monitor for these symptoms and seek medical attention if they occur. Regular blood tests may be needed to check liver function and blood cell counts. Always follow your doctor's advice and report any new symptoms.
Is it safe to drink alcohol while taking Propylthiouracil?
Most people tolerate Propylthiouracil well, and occasional alcoholic drinks should not affect the way this medicine works. There are no well-established interactions between this medicine and alcohol that would interfere with its effectiveness or cause harm. However, it's always wise to consume alcohol in moderation and discuss any concerns with your healthcare provider.
Is it safe to exercise while taking Propylthiouracil?
Propylthiouracil can cause dizziness, tiredness, and muscle pain, which may affect your ability to exercise. If you experience these symptoms, it's important to discuss them with your doctor. They can provide guidance on whether you should adjust your exercise routine or take any precautions while being active.
Is it safe to stop Propylthiouracil?
Propylthiouracil is used for managing hyperthyroidism, a chronic condition that requires long-term treatment. Stopping it suddenly can lead to a return of symptoms, such as increased heart rate, anxiety, and weight loss. In some cases, abrupt discontinuation can cause a thyroid storm, which is a life-threatening condition. Therefore, it's crucial to consult your doctor before stopping this medication. They can guide you on how to safely discontinue or adjust your treatment.
Is Propylthiouracil addictive?
Propylthiouracil is not addictive and has no known potential for dependence. There are no behaviors or warning signs of physical or psychological dependence associated with this medicine. You can take it as prescribed without worrying about addiction. Always follow your healthcare provider's instructions and discuss any concerns you may have about your medication.
Is Propylthiouracil safe for the elderly?
For elderly patients, caution is advised when using Propylthiouracil due to the increased likelihood of decreased liver, kidney, or heart function, and the presence of other medical conditions or medications. Dose selection should be cautious, and regular monitoring of thyroid function and liver health is recommended. Always consult a healthcare provider for personalized advice.
What are the most common side effects of Propylthiouracil?
A side effect is an unwanted effect of a medicine. Common side effects of Propylthiouracil include rash, joint pain, nausea, headache, and dizziness. These effects are not experienced by everyone and may be temporary. It's important to remember that new symptoms can occur when starting any new medicine and may not be related to the medicine itself. Always talk to your healthcare provider before stopping any medication, as they can help determine the cause of new symptoms and provide guidance.
Who should avoid taking Propylthiouracil?
Propylthiouracil carries a risk of severe liver damage, which can lead to liver failure or death. It is contraindicated in patients with hypersensitivity to the drug. It should be used cautiously in pregnant women due to potential harm to the fetus and in pediatric patients only when other treatments are unsuitable. Patients should report symptoms of liver dysfunction or infection immediately, and regular monitoring of liver function and blood counts is advised.