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Single Daily Dose of Methimazole Compared to Every 8 Hours Propylthiouracil in the Treatment of Hyperthyroidism
Abstract
This study to compare single-dose and multiple-dose antithyroid therapy was prompted by a perceived lack of compliance in our University Medical Clinics by those patients using multidose regimens. Twenty-two hyperthyroid patients were randomly assigned to two therapy groups. Twelve received methimazole (Tapazole) 30 mg once daily in the morning; 10 received propylthiouracil 100 mg every 8 hours. Patients were seen every 4 weeks for 3 months and assessed clinically, as well as having the appropriate thyroid tests done. Univariate analysis revealed no difference in the two groups at baseline. Posttreatment assessment revealed the once-a-day methimazole therapy to be just as effective as propylthiouracil in improving thyroid indices and clinical markers. Compliance with methimazole was 83.3% compared to 53.3% with propylthiouracil. In conclusion, once-a-day methimazole was just as effective as propylthiouracil every 8 hours in this population. Compliance was also improved with the once-a-day therapy.
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“A dosage ratio of MMI to PTU of 1:20 is recommended when changing from one drug to another (115,319,480), although only two studies have examined this dosage ratio directly (115,319).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [319]
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Stagnaro-Green, A., Abalovich, M., Alexander, E., Azizi, F., Mestman, J., Negro, R., Nixon, A., Pearce, E. N., Soldin, O. P., Sullivan, S., et al. (2011) · Thyroid · doi:10.1089/thy.2011.0087 · Cited by 2,942
Ross, D. S., Burch, H. B., Cooper, D. S., Greenlee, M. C., Laurberg, P., Maia, A. L., Rivkees, S. A., Samuels, M., Sosa, J. A., Stan, M. N., et al. (2016) · Thyroid® · doi:10.1089/thy.2016.0229 · Cited by 2,938
“For example, 15 mg of MMI would be roughly equivalent to 300 mg of PTU, but because the half-life of PTU is considerably shorter than that of MMI, the dose of PTU should be split over the day (481,482); for example, MMI 15 mg once daily may be substituted with PTU 100 mg three times a day (319).”
BackgroundAlexander, E. K., Pearce, E. N., Brent, G. A., Brown, R. S., Chen, H., Dosiou, C., Grobman, W. A., Laurberg, P., Lazarus, J. H., Mandel, S. J., et al. (2017) · Thyroid® · doi:10.1089/thy.2016.0457 · Cited by 2,731
Bahn, R. S., Burch, H. B., Cooper, D. S., Garber, J. R., Greenlee, M. C., Klein, I., Laurberg, P., McDougall, I. R., Montori, V. M., Rivkees, S. A., et al. (2011) · Endocrine Practice · doi:10.4158/ep.17.3.456 · Cited by 1,098
Cooper, D. S. (2005) · New England Journal of Medicine · doi:10.1056/nejmra042972 · Cited by 1,008
Metadata
- Authors
- NICHOLAS, W. C., FISCHER, R. G., STEVENSON, R. A., & BASS, J. D.
- Affiliations
- University of Mississippi Medical Center (US)
- Venue
- Southern Medical Journal
- Publisher
- Southern Medical Association
- Published
- 1995-09
- Volume
- 88
- Issue
- 9
- Pages
- 973-976
- ISSN
- 0038-4348 (ISSN-L)
- OpenAlex
- W1535496843
- Cited by
- 64
- References
- 0
- Citations by year
- 2026: 1 · 2024: 2 · 2023: 1 · 2022: 2 · 2021: 3 · 2020: 3 · 2019: 2 · 2018: 2 · 2017: 5 · 2016: 3 · 2015: 2 · 2014: 2
- FWCI
- 0.26
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Southern Medical Journal (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Health Sciences › Medicine › Ophthalmology › Ophthalmology and Eye Disorders
- Keywords
- hyperthyroidism, methimazole, propylthiouracil, once-daily dosing, medication adherence, treatment efficacy, thyroid function tests
- MeSH terms
- Drug Administration Schedule, Female, Humans, Hyperthyroidism, Male, Methimazole, Patient Compliance, Propylthiouracil, Thyrotropin, Thyroxine, Triiodothyronine
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