Propyl Thiouracil

Indications
 Oral
Hyperthyroidism
Adult: 150-450 mg daily in divided doses. For severe cases, initial doses of 600-1200 mg daily have been used. Maintenance dose for euthyroid patients: 50-150 mg daily. Treatment is usually continued for 1-2 yr.
Child: Neonates: 2.5-5 mg/kg bid; 1 mth-1 yr: 2.5 mg/kg tid; 1-5 yr: 25 mg tid; 5-12 yr: 50 mg tid; 12-18 yr: 100 mg tid.
CrCl (ml/min)Dosage Recommendation
<10Reduce dose by 50%.
10-50Reduce dose by 25%.
Hepatic impairment: Dose reduction is recommended.

Special Populations: Reduce dose by 25% in mild to moderate renal impairment and by 50% in severe renal impairment. May also need to reduce dose in hepatic impairment.
Contraindications
 Hypersensitivity, pregnancy, lactation.
Warnings / Precautions
 Reserve use for patients unable to tolerate any other treatments e.g. methimazole, radioactive iodine or surgery. Inform patient of liver failure risk and to report any signs of liver dysfunction (e.g. loss of appetite, nausea, vomiting, pruritus, dark coloured urine, light coloured stools, jaundice, right upper-quadrant pain) or agranulocytosis (e.g. fever, sore throat) immediately. Stop treatment upon signs of agranulocytosis, aplastic anaemia, fever, liver injury, elevated LFT above 3 times the upper limit of normal, or exfoliative dermatitis. Regular monitoring of thyroid function and CBC is advisable. Monitor prothrombin time regularly during treatment, especially before surgical procedures.
Adverse Reactions
 Mild leukopenia, lupus-like syndrome, cutaneous vasculitis, thrombocytopenia. Skin rash, urticaria, arthralgia and fever. GI discomfort, vomiting, headache.
Potentially Fatal: Agranulocytosis, aplastic anaemia, liver injury and liver failure.
Overdose Reactions
 Symptoms include nausea, vomiting, epigastric distress, headache, fever, arthralgia, pruritus, oedema and pancytopenia. Agranulocytosis is the most serious effect. Rarely, exfoliative dermatitis, hepatitis, neuropathies or CNS stimulation or depression may occur.
Drug Interactions
 May potentiate activity of anticoagulants. Doses of β-blockers, digitalis glycosides and theophylline may need to be reduced when patient becomes euthyroid.
See Below for More propylthiouracil Drug Interactions
Mechanism of Actions
 Propylthiouracil inhibits the production of thyroid hormones by preventing iodine from being oxidised in the thyroid gland. It also blocks the peripheral deiodination of thyroxine to tri-iodothyronine.
Absorption: Rapidly absorbed. Bioavailability: about 50-75%.
Distribution: 80% bound to plasma proteins. Crosses the placenta and distributes into the breast milk.
Excretion: Elimination half-life: about 1-2 hr. Excreted in the urine as glucuronide conjugates.
Administration
 Should be taken with food.
Storage Conditions
 Oral: Store at 15-30°C.
ATC Classification
 H03BA02 - propylthiouracil ; Belongs to the class of thiouracils. Used in the management of thyroid diseases.
Storage
 Oral: Store at 15-30°C.
Available As
  • Propyl Thiouracil 50 mg

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