Methimazole

 
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More about Methimazole

What is/are Methimazole?

Methimazole (also known as Tapazole or Thiamazole or MMI) is an antithyroid drug, and part of the thioamide group. Like its counterpart propylthiouracil, a major side effect of treatment is agranulocytosis.

Adverse effects

It is important to monitor any symptoms of fever or sore throat while taking methimazole; this could indicate the development of agranulocytosis, an uncommon but severe side effect resulting from a drop in the white blood cell count (to be specific, neutropenia, a deficiency of neutrophils). A complete blood count (CBC) with differential is performed to confirm the suspicion, in which case the drug is discontinued. Administration of recombinant human granulocyte colony-stimulating factor (rhG-CSF) may increase recovery.

Other known side effects include:

  •     Skin rash
  •     Itching
  •     Abnormal hair loss
  •     Upset stomach
  •     Vomiting
  •     Loss of taste
  •     Abnormal sensations (tingling, prickling, burning, tightness, and pulling)
  •     Swelling
  •     Joint and muscle pain
  •     Drowsiness
  •     Dizziness
  •     Decreased white blood cells
  •     Decreased platelet
  •     Aplasia cutis congenita (prenatal exposure)

Drug interactions

Adverse effects may occur for individuals who:

  •    Take anticoagulants ('blood thinners') such as warfarin (Coumadin), diabetes medications, digoxin (Lanoxin), theophylline (Theobid, Theo-Dur), and vitamins
  •    Have ever had any blood disease, such as decreased white blood cells (leukopenia), decreased platelets (thrombocytopenia) or aplastic anemia, or liver disease (hepatitis, jaundice)
  •    Are pregnant, or going to become pregnant, or are breast-feeding.. 

Mechanism of action

Methimazole inhibits the enzyme thyroperoxidase, which normally acts in thyroid hormone synthesis by oxidizing the anion iodide (I-) to iodine (I0), facilitating iodine's addition to tyrosine residues on the hormone precursor thyroglobulin, a necessary step in the synthesis of triiodothyronine (T3) and thyroxine (T4). It does not inhibit the action of the sodium-dependent iodide transporter located on follicular cells' basolateral membranes. Inhibition of this step requires competitive inhibitors such as perchlorate and thiocyanate. It acts at CXCL10.

This article uses material from the Wikipedia article Methimazole, which is released under the Creative Commons Attribution-Share-Alike License 3.0.

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