Hyperthyroidism. Thyroid gland. Preparation for thyroidectomy. Supporting treatment with radioactive iodine.
Composition:
1 tabl contains 5 mg of thiamazole. The preparation contains lactose.
Action:
The active carbimazole metabolite. Thiamazole in a dose-dependent manner inhibits the incorporation of Iodine into tyrosine and thus inhibits the synthesis of thyroid hormones. It does not significantly affect iodine uptake by thyroid or peripheral conversion of thyroxine to triiodothyronine. After oral administration, the drug is absorbed quickly and completely, reaching a maximum concentration in the blood within about 0.5-1 hours. Thiamazole accumulates in the thyroid gland. T0,5 in the elimination phase is 5-6 h and it is prolonged in liver failure. It is metabolized in the liver and excreted in the urine and bile. The drug passes the placental barrier and is excreted into breast milk.
Contraindications:
Hypersensitivity to thiamazole or other components of the preparation.
Precautions:
Premature discontinuation of thiamazole may result in increased thyroid hyperfunction. In the case of symptoms that may indicate agranulocytosis, a control blood count should be performed. Caution should be exercised in patients with hepatic insufficiency, as the elimination of the drug from the body in this group of patients may be prolonged. Due to the lactose content, the preparation should not be used in patients with galactose intolerance, Lapp lactase deficiency or malabsorption of glucose-galactose. The use of thiamazole in children aged 2 years or less is not recommended.
Pregnancy and lactation:
The preparation should be used during pregnancy in the lowest effective doses only when it is absolutely necessary, and the use of an alternative method of treatment is impossible and not recommended. Thiamazole is excreted in breast milk, therefore breastfeeding women should use the lowest effective doses not exceeding 10 mg per day. If high doses of thiamazole are needed, the patient should stop breast-feeding.
Side effects:
Very often: leukopenia. Common: fever; skin rashes or itching of the skin. Uncommon: agranulocytosis. Very rare: severe skin hypersensitivity reactions, including Stevens-Johnson syndrome. Not known: aplastic anemia, thrombocytopenia, lymphadenopathy; peripheral neuropathy, dizziness; vasculitis; arthralgia and inflammation, lupus-like syndrome; nausea, vomiting, abdominal pain, changes in the salivary glands; jaundice and hepatic necrosis; nephritis and renal arteritis; weakness of appetite.
Dosage:
Orally, the dosage is set individually, depending on the severity of the hyperthyroidism and the size of the goiter.Adults. The initial dose is usually 40-60 mg per day and is given in 3-4 divided doses. This dosage is maintained until thyroid function is stopped (usually 2-3 weeks, though sometimes even for 8 weeks or longer). The dose should then be gradually reduced to a maintenance dose of typically 5-20 mg per day in a single dose or two divided doses. Treatment of hyperthyroidism usually lasts for 0.5-2 years. Thyroid gland: the initial dose is 100 mg, then 30 mg every 8 hours. In preparation for thyroidectomy surgery, the preparation is usually used 3-4 weeks before the procedure. There is no need to change the dosage in patients with impaired renal function and the elderly. The smallest doses used in patients with impaired liver function.Children and adolescents (aged from 3 to 17 years). The starting dose should be adjusted to the patient's body weight. Usually at the beginning of treatment, 0.5 mg / kg is used in 2-3 equal doses. The dose used in maintenance therapy may be lower, depending on the patient's response to treatment. Additional administration of levothyroxine may be necessary to avoid hypothyroidism. Do not exceed the total daily dose of 40 mg of thiamazole.
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