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a thyroid inhibitor used to treat hyperthyroidism; administered orally.

propylthiouracil (PTU)

Propyl-Thyracil (CA)

Pharmacologic class: Thioamide derivative

Therapeutic class: Antithyroid agent

Pregnancy risk category D

FDA Box Warning

• Drug has caused severe liver injury and acute liver failure, in some cases fatal. These reports of hepatic reactions include cases requiring liver transplant.

• Reserve drug for patients intolerant of methimazole and in whom radioactive iodine therapy or surgery isn't appropriate for management of hyper-thyroidism.

• Because of risk of fetal abnormalities associated with methimazole, propylthiouracil may be treatment of choice when an antithyroid drug is indicated during or just before first trimester.


Directly interferes with thyroid synthesis by preventing iodine from combining with thyroglobulin, leading to decreased thyroid hormone levels


Tablets: 50 mg

Indications and dosages


Adults: Initially, 300 to 450 mg P.O. daily in equally divided doses q 8 hours; for maintenance, 100 to 150 mg P.O. daily.

Thyrotoxic crisis

Adults: 200 mg P.O. q 4 to 6 hours during first 24 hours, then a maintenance dosage of 100 to 150 mg P.O. daily


• Hypersensitivity to drug


Use cautiously in:

• decreased bone marrow reserve

• pregnancy and breastfeeding patients

• children.


• Give with meals to reduce GI upset.

• Be aware that drug shouldn't be used in children unless patient is allergic to or intolerant of methimazole, and there are no other treatment options available.

Adverse reactions

CNS: drowsiness, headache, vertigo, neuritis, paresthesia

GI: nausea, vomiting, diarrhea, epigastric distress

Hematologic: agranulocytosis, leukopenia, thrombocytopenia

Hepatic: jaundice, hepatic necrosis, liver failure

Metabolic: hypothyroidism

Musculoskeletal: joint pain, myalgia

Skin: rash, urticaria, pruritus, skin discoloration, alopecia, cutaneous vasculitis

Other: taste loss, fever, lymphadenopathy, parotitis, edema


Drug-drug. Anticoagulants: potentiation of anticoagulant effect

Drug-diagnostic tests. Alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase, bilirubin, lactate dehydrogenase: increased levels

Granulocytes, platelets: decreased levels Prothrombin time: prolonged

Patient monitoring

• Monitor CBC and liver and thyroid function tests.

• Assess for signs and symptoms of hypothyroidism (cold intolerance, nonpitting edema, fatigue, weight gain, and depression).

Monitor for severe rash, fever, jaundice, or enlarged cervical lymph nodes. If present, stop therapy and notify prescriber.

Patient teaching

• Instruct patient to take with meals to reduce GI upset.

• Teach patient to recognize and report signs and symptoms of hypothyroidism and jaundice.

• Advise patient to discuss iodine intake (as in iodized salt and shellfish) with prescriber.

• Tell patient to avoid over-the-counter cold remedies that contain iodine.

• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.

• Advise female patient of childbearing age to discuss pregnancy or breastfeeding with prescriber before taking.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

pro·pyl·thi·o·u·ra·cil (PTU),

An antithyroid agent that inhibits the synthesis of thyroid hormones; used in the treatment of hyperthyroidism; a goitrogen.


/pro·pyl·thio·ura·cil/ (pro″pil-thi″o-u´rah-sil) a thyroid inhibitor used in the treatment of hyperthyroidism.


Abbr. PTU A drug, C7H10N2OS, that inhibits the synthesis of thyroid hormones and is used to treat hyperthyroidism.


an inhibitor of thyroid hormone biosynthesis.
indications It is prescribed in treatment of hyperthyroidism and thyrotoxic crisis and in preparation for thyroidectomy.
contraindications Mental depression, cold intolerance, or known hypersensitivity to this drug prohibits its use. Caution is recommended in pregnancy, in patients older than 40 years of age (can cause hypoprothrombinemia and bleeding), and in use in combination with other drugs that can cause agranulocytosis.
adverse effects Among the more serious adverse effects are GI distress, pruritus, and rashes. Rarely blood dyscrasia occurs.


(PT) (prō'pil-thī'ō-yūr'ă-sil)
An antithyroid agent that inhibits synthesis of thyroid hormones; used to treat hyperthyroidism.


A drug used to treat overactivity of the thyroid gland (hyperthyroidism). The drug is on the WHO official list.


An agent used to treat hyperthyroidism; a goitrogen.


a thyroid inhibitor used in the treatment of hyperthyroidism, but because of severe hematologic toxicity in cats other drugs are preferred.
References in periodicals archive ?
Substitution of Propylthiouracil for Carbimazole was the only choice we had.
Recommendation 71: We suggest that patients taking methimazole who decide to become pregnant obtain pregnancy testing at the earliest suggestion of pregnancy and be switched to propylthiouracil as soon as possible in the first trimester and changed back to methimazole at the beginning of the second trimester.
Thyroid Ca2+/NADPH-dependent H2O2 generation is partially inhibited by propylthiouracil and methimazole.
Animals were induced to hypothyroidism by daily administration of propylthiouracil (PTU; Sigma Aldrich, St.
Propylthiouracil (PTU), an antithyroid drug, was used as a reference compound.
Long-term treatment of alcoholic liver disease with propylthiouracil.
In general, management of the hyperthyroid state can be accomplished by (1) reducing thyroid hormone production with propylthiouracil or methimazole, (2) inhibiting thyroid hormone release with iodine or lithium, and (3) reducing peripheral conversion of [T.
Propylthiourea is closely related to propylthiouracil, which is one of the main drugs used to treat hyperthyroidism.
Since then, I've been treated with medications including propylthiouracil pills and Inderal.
TORONTO, ONTARIO - Propylthiouracil, a drug used by patients with overactive thyroids, appears to protect alcoholics from the worst ravages of liver disease, according to a recent study by researchers from Toronto's Addiction Research Foundation and the University of Toronto.
Patients should be switched to propylthiouracil as soon as pregnancy is diagnosed.