Nursing & Healthcare Directories on: The Nursefriendly
Prescription Drugs, Medications
Anti-Thyroid, Hyperthyroidism, Anti-Hyperthyroidism
Tapazole, Methimazole, Thimazole

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Methimazole special precautions to follow:medlineplus:"tell your doctor and pharmacist if you are allergic to methimazol, lactose, or any other drugs. tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially anticoagulants ('blood thinners') such as warfarin (Coumadin), beta blockers such as propranolol (Inderal), diabetes medications, digoxin (Lanoxin), theophylline (Theobid, Theo-Dur), and vitamins. tell your doctor if you have or have ever had any blood disease, such as decreased white blood cells (leukopenia), decreased platelets (thrombocytopenia), or aplastic anemia, or liver disease (hepatitis, jaundice). tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. Methimazole should not be used during pregnancy or breast-feeding. If you become pregnant while taking methimazole, call your doctor immediately. Methimazole may harm the fetus. if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking methimazole"
U.S. National Library of Medicine
8600 Rockville Pike, Bethesda, MD 20894
custserv@nlm.nih.gov
http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a682464.html

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Side effects of Methimazole:personalmd:"This medication may cause stomach upset, nausea, loss of taste sensation, headache, drowsiness or dizziness. If any of these effects persist or become bothersome, inform your doctor. Notify your doctor if you experience any of the following: fever, sore throat, easy or unusual bleeding or bruising, skin rash, yellowing of the eyes or skin, vomiting or general weakness. If you notice other effects not listed above, contact your doctor or pharmacist. PRECAUTIONS: Tell your doctor your medical history, especially of liver disease, blood disorders and of any allergies you may have. Before you have surgery, including dental surgery, tell the doctor that you take this medication. Methimazole is not recommended for use during pregnancy. Consult your doctor before taking this medication. This drug is excreted into breast milk and may have undesirable effects on a nursing infant. Do not breast-feed while using this drug. Consult your doctor"
http://www.personalmd.com/drgdb/8122.htm

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Methimazole range and frequency:wholehealthmd:"Range and Frequency Adults: 15 to 60 mg a day in 1 daily dose or in 2 divided daily doses. Usual maintenance dose is 5 to 15 mg a day. Children: 0.2 mg per 2.2 lbs (1 kg) of body weight a day in 1 daily dose or in 2 divided daily doses. To treat a thyroid crisis: 12 to 20 mg every 4 hours. Onset of Effect 5 days or more. Duration of Action Unknown. Dietary Advice Methimazole can be taken with or without food. It should be taken consistently in the same way, either with or between meals."
http://www.wholehealthmd.com/print/view/1%2C1560%2CDR_401%2C00.html

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Warnings while taking Methimazole:health.yahoo.com:"Warnings Talk to your doctor before taking this medicine if you are pregnant. If you become pregnant while taking this medicine, stop taking it and call your doctor right away. Tell your doctor or dentist before having any surgery that you are taking this medicine. You should not use more of the medicine than your doctor ordered, large amounts can be very harmful. Side effects Call your doctor right away if you have any of these side effects: Fever, chills, cough, sore throat, Unusual bruising or bleeding, Severe rash or itching, Severe nausea and vomiting, Yellowing of skin or eyes, Severe upper stomach pain, Extreme weakness"
http://health.yahoo.com/health/pdr_drugs/0423/1.html

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Methimazole dosage and administration:mythyroid.com:"The initial starting dose of methimazole ranges from 5-30 mg daily, with occasional patients with severe hyperthyroidism requiring higher doses. Methimazole is secreted into breast milk, and nursing mothers should discuss this issue with their physicians. Although Methimazole has been used successfully to treat pregnant women, there appears to be more case reports of isolated congenital defects with Methimazole, compared to PTU, hence PTU is preferred by many physicians as the drug of choice for treatment of pregnant women. The side effect profile of Methimazole is quite similar to that described for PTU. It is important to remember that while medications will be initially effective in reducing the levels of circulating thyroid hormones in all patients with hyperthyroidism irrespective of the cause, only patients with Grave's disease may experience a long-lasting or permanent remission of the disease once medications are discontinued. Patients with hyperthyroidism due to a hot nodule or toxic nodular goiter frequently need to receive subsequent definitive treatment for their hyperthyroidism, which may involve radioactive iodine or surgery"
http://www.mythyroid.com/medications_for_hyperthyroidism.htm

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Important note about Methimazole also available is the full prescribing information:King Pharmaceuticals, Inc:"Agranulocytosis is potentially a serious side effect associated with Tapazole®. Patients should be instructed to report any signs of agranulocytosis, including fever or sore throat, to their physicians. Leukopenia, thrombocytopenia, aplastic anemia and hepatitis may also occur. Tapazole® can cause fetal harm, including rare instances of congenital defects, when administered to a pregnant woman and is contraindicated in nursing mothers. The most common adverse events associated with the use of Tapazole® are skin rash, urticaria, nausea, vomiting, arthraglia, hair loss, loss of taste, lymphadenopathy and drug fever."
http://www.kingpharm.com/product_view.asp?KP_Product_ID=47

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Things to know before taking Methimazole:drugs.com:"In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For antithyroid agents, the following should be considered-Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to methimazole or propylthiouracil. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes. Pregnancy—Use of too large a dose during pregnancy may cause problems in the fetus. However, use of the proper dose, with careful monitoring by the doctor, is not likely to cause problems. Breast-feeding—These medicines pass into breast milk. (Methimazole passes into breast milk more freely and in higher amounts than propylthiouracil.) However, your doctor may allow you to continue to breast-feed, if your dose is low and the infant gets frequent check-ups. If you are taking a large dose, it may be necessary for you to stop breast-feeding during treatment. Children—This medicine has been used in children and, in effective doses, has not been shown to cause different side effects or problems in children than it does in adults"
http://www.drugs.com/xq/cfm/pageID_0/htm_202067/type_cons/bn_Tapazole/micr_medex/qx/index.htm#SXX08

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Methimazole drug class and mechanism:medicinenet:"Methimazole is used to manage hyperthyroidism (overactivity of the thyroid gland). It is considered an antithyroid agent, like propylthiouracil (PTU). Grave's disease is the most common cause of hyperthyroidism. It is an autoimmune disease in which an individual's own antibodies attach to thyroid stimulating hormone receptors within thyroid cells and thereby trigger overproduction of thyroid hormones. The two thyroid hormones manufactured by the thyroid gland, thyroxine (T4 ) and triiodothyronine (T3), are formed by combining iodine with a protein called thyroglobulin with the assistance of an enzyme called peroxidase. Methimazole inhibits iodine and peroxidase from their normal interactions with thyroglobulin to form T4 and T3. This action decreases thyroid hormone production. (methimazole also interferes with the conversion of T4 to T3, and, since T3 is more potent than T4, this also reduces the activity of thyroid hormones.)"
http://www.medicinenet.com/script/main/art.asp?li=MNI&ArticleKey=16379

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Methimazole indications for use:ahealthyme:"This medication prevents the thyroid gland from producing thyroid hormone. It is used to treat hyperthyroidism (overactive thyroid gland) and to prepare the thyroid for surgery. HOW TO USE Take this medication at regular intervals around the clock, usually 3 times daily, every eight hours. Or take as directed by your doctor. This medication may cause stomach upset, nausea, loss of taste sensation, headache, drowsiness or dizziness. If any of these effects persist or become bothersome, inform your doctor. Notify your doctor if you experience any of the following: fever, sore throat, easy or unusual bleeding or bruising, skin rash, yellowing of the eyes or skin, vomiting, general weakness. If you notice other effects not listed above, contact your doctor or pharmacist"
http://www.ahealthyme.com/viewmonograph?selectedDrugId=256830&selectedDrugDescription=Methimazole+Oral+Tablet+5+mg

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Methimazole action and kinetics:nursespdr:"Onset is more rapid but effect is less consistent than that of propylthiouracil. Bioavailability may be affected by food. t1/2: 4-14 hr. Onset: 10-20 days. Time to peak effect: 2-10 weeks. t1/2: 6-13 hr. Crosses the placenta; high levels appear in breast milk. Metabolized in the liver and excreted through the kidneys (7% unchanged)."
http://www.nursespdr.com/members/database/archives/methimazole.html

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