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Cited by 21Thyroid Disorders and TreatmentsThyroid Cancer Diagnosis and TreatmentThyroid and Parathyroid Surgery

DURATION OF ANTITHYROID ACTION OF METHIMAZOLE ESTIMATED WITH AN INTRAVENOUS PERCHLORATE DISCHARGE TEST

McCRUDEN, D. C., HILDITCH, T. E., CONNELL, J. M. C., McLELLAN, A. R., ROBERTSON, J., ALEXANDER, W. D.·1987·Clinical Endocrinology
DOI 10.1111/j.1365-2265.1987.tb03636.x
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Abstract

SUMMARY: We have used a method based on a perchlorate discharge test to estimate the duration of antithyroid effect of two doses of methimazole (MMI). Six patients with diffuse toxic goitre took 5 mg MMI twice daily and six took 20 mg twice daily over the study period of 12 weeks. Biochemical control of hyperthyroidism was achieved in all patients and thyroid hormone supplementation was required by all of the patients in the higher dose group to avoid hypothyroidism. Discharge of radioiodine from the thyroid by perchlorate diminished in both groups with time after MMI. After 5 mg MMI, perchlorate discharge as a percentage of the 30‐min uptake (mean ± SD), was 81.7 ± 3.3% at 2.2 h, 69.3 ± 18.9% at 5.9 h, 22.6–23.4% at 13.4 h and 2.7–6.7% at 25.1 h. After 20 mg MMI, the discharge was 92.5 ± 1.9% at 2.2 h, 84.3 ± 8.8% at 6.3 h, 64.8 ± 24.1 % at 13.3 h and 26.9–29.4% at 25.1 h. Only four patients (one in the lower dose group) showed a detectable discharge at 25 h and one of the patients treated with the lower dose showed no discharge at 13 h. These estimates of the effect of MMI on thyroidal iodide organification are not in keeping with published thyroidal MMI concentrations which do not show a fall between 3–6 h and 17–20 h after carbimazole. The explanation for this disparity is not clear but may be based on a redistribution of thioureylenes within the thyroid with time after dosage. The present data suggest that once daily is not the optimum dosage interval for MMI with respect to its effect on the organification of iodide.

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Crossref · 10.1111/j.1365-2265.1987.tb03636.x

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  • When more rapid biochemical control is needed in severe thyrotoxicosis, an initial split dose of MMI may be more effective than a single daily dose because the duration of action of MMI may be less than 24 hours.

    “When more rapid biochemical control is needed in patients with severe thyrotoxicosis, an initial split dose of MMI (e.g., 15 or 20 mg twice a day) may be more effective than a single daily dose because the duration of action of MMI may be less than 24 hours (118).”

    From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [118]

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Authors
McCRUDEN, D. C., HILDITCH, T. E., CONNELL, J. M. C., McLELLAN, A. R., ROBERTSON, J., & ALEXANDER, W. D.
Affiliations
Western Infirmary (GB)
Corresponding author
McCRUDEN, D. C.
Venue
Clinical Endocrinology
Publisher
Wiley
Published
1987-01
Volume
26
Issue
1
Pages
33-39
ISSN
  • 0300-0664 (ISSN-L)
  • 1365-2265
DOI
10.1111/j.1365-2265.1987.tb03636.x
OpenAlex
W2051390341
Cited by
21
References
19
Citations by year
2025: 1 · 2020: 1 · 2019: 1 · 2017: 2 · 2016: 1 · 2015: 3 · 2012: 1
FWCI
0.60
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 7746 d)
Locations
  • Clinical Endocrinology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
  • Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
Keywords
methimazole, carbimazole, perchlorate discharge test, hyperthyroidism, hypothyroidism, thyroid hormone replacement, drug dose comparison
MeSH terms
Adult, Humans, Hyperthyroidism, Iodides, Iodine Radioisotopes, Methimazole, Middle Aged, Thyroid Gland, Time Factors

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