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- What is propylthiouracil, and how does it work (mechanism of action)?
- What brand names are available for propylthiouracil?
- Is propylthiouracil available as a generic drug?
- Do I need a prescription for propylthiouracil?
- What are the side effects of propylthiouracil?
- What is the dosage for propylthiouracil?
- Which drugs or supplements interact with propylthiouracil?
- Is propylthiouracil safe to take if I'm pregnant or breastfeeding?
- What else should I know about propylthiouracil?
What is propylthiouracil, and how does it work (mechanism of action)?
Propylthiouracil (PTU) is an oral medication that is used to manage hyperthyroidism which is due to an overactive thyroid gland. It is an anti-thyroid drug that has a mechanism of action that is similar to methimazole (Tapazole). Graves' disease is the most common cause of hyperthyroidism. It is an autoimmune disease where an individual makes antibodies to thyroid stimulating hormone receptors on cells of the thyroid gland and then trigger overproduction of thyroid hormone by the cells. The two thyroid hormones manufactured by the thyroid gland, thyroxine (T4 ) and triiodothyronine (T3), are formed by combining iodine and a protein called thyroglobulin with the assistance of an enzyme called peroxidase. PTU inhibits iodine and peroxidase from their normal interactions with thyroglobulin to form T4 and T3. This action decreases production of thyroid hormone. PTU 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. The FDA approved PTU in July 1947.
What are the side effects of propylthiouracil?
The most common side effects are related to the skin, such as:
Other important side effects include:
- loss of taste,
- joint or muscle aches,
- numbness, and
Less common but serious side effects have occurred with PTU therapy. A decrease of white blood cells in the blood (agranulocytosis) may occur. Symptoms and signs of agranulocytosis include infectious lesions of the throat, the gastrointestinal tract, and skin with an overall feeling of illness and fever.
A decrease in blood platelets (thrombocytopenia) also may occur. Since platelets are important for the clotting of blood, thrombocytopenia may lead to excessive bleeding. Severe liver injury and acute liver failure, in some cases fatal, have been associated with PTU. Some adults and pediatric patients required liver transplantation.
What is the dosage for propylthiouracil?
The initial adult dose of PTU is 300 mg/day divided into 3 divided doses. PTU is usually administered every eight hours. Patients with large goiters may require initial doses up to 900 mg daily. The usual long-term adult dose after initial treatment is 100-150 mg/day.
Which drugs or supplements interact with propylthiouracil?
Hyperthyroidism may cause increased elimination of beta blockers (for example, propranolol [Inderal, Inderal LA, Innopran XL)). Once hyperthyroidism is reversed the excretion of beta-blockers may return to normal and less beta-blocker will be needed to provide the same effect.
Digoxin (Lanoxin) blood levels may be increased when hyperthyroidism is reversed in patients on a stable digoxin dose. A smaller dose of digoxin may be needed in order to avoid toxicity of digoxin. Similarly, theophylline elimination may decrease when hyperthyroidism is reversed in patients on a stable theophylline dose. A reduced dose of theophylline may be needed in order to avoid toxicity of theophylline.
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Is propylthiouracil safe to take if I'm pregnant or breastfeeding?
PTU crosses the placenta and may cause harm to the fetus. If it is necessary to use PTU during pregnancy the lowest effective dose should be used. Since methimazole is associated with fetal abnormalities, PTU is used during the first trimester if an antithyroid drug is needed.
PTU is excreted in breast milk in small amounts.
What else should I know about propylthiouracil?
What preparations of propylthiouracil are available?
Tablet: 50 mg.
How should I keep propylthiouracil stored?
PTU should be stored at room temperature, 15 C - 30 C (59 F - 86 F).
Propylthiouracil (PTU) is a medication prescribed to manage hyperthyroidism and Graves' disease. Side effects, drug interactions, warnings and precautions, and pregnancy safety information should be reviewed prior to taking this medication.
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Hyperthyroidism Symptoms and Treatment
What is hyperthyroidism? Hyperthyroidism occurs when an overactive thyroid gland produces an excessive amount of thyroid...
Picture of Graves Disease
Generalized diffuse overactivity ("toxicity") of the entire thyroid gland which becomes enlarged into a goiter. See a picture of...
Related Disease Conditions
Hyperthyroidism is an excess of thyroid hormone due to an overactive thyroid gland. Symptoms can include increased heart rate, weight loss, heart palpitations, frequent bowel movements, depression, fatigue, fine or brittle hair, sleep problems, thinning skin, and irregular vaginal bleeding. Graves' disease is the most common cause of hyperthyroidism. Many other health problems or taking excess thyroid hormone medication can cause an overactive thyroid gland. Treatment for the condition is with medication, radioactive iodine, thyroid surgery (rarely), or reducing the dose of thyroid hormone. No diet has been shown to treat hyperthyroidism or its symptoms and signs.
There are several types of thyroid disorders including hypothyroidism, hyperthyroidism, goiters, thyroid nodules, and thyroid cancer. Symptoms vary by condition. Diagnosis is made with blood tests, scans, ultrasound, or biopsy. Treatments depend on the disorder and can include medication or surgery.
Hypothyroidism is any state in which thyroid hormone production is below normal. Normally, the rate of thyroid hormone production is controlled by the brain by the pituitary gland. Hypothyroidism is a very common condition and the symptoms of hypothyroidism are often subtle, but may include, constipation, memory loss, hair loss, and depression. There are a variety of causes of hypothyroidism, and treatment depends on the cause.
Graves' disease is an autoimmune disease that affects the thyroid. Some of the symptoms of Graves' disease include hand tremors, rapid heartbeat, trouble sleeping, enlarged thyroid, thinning of the skin or fine brittle hair. Causes of Graves' disease are thought to be multifactorial such as genes, gender, stress, and infection. Treatment for Graves' disease is generally medication.
Thyroiditis is the inflammation of the thyroid gland. The inflamed thyroid gland can release an excess of thyroid hormones into the blood stream, resulting in a temporary hyperthyroid state. Some forms of thyroiditis can be diagnosed based on tenderness and enlargement of the thyroid gland. A thyroid scan sometimes is used in making the diagnosis. Thyroiditis can also be diagnosed with a biopsy of the thyroid gland.
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