Nebenwirkungen der antithyreoidalen Therapie der Hyperthyreose: Eine Untersuchung an 1256 fortlaufend betreuten Patienten

Abstract

Side effects of antithyroid treatment were retrospectively analysed in 1256 patients with hyperthyroidism. Overall rate of side effects was 14.3%. Skin reactions were the most frequent ones (5.6%), followed by arthropathies (1.6%). The incidence of agranulocytosis was 0.14%. Median duration of all side effects was 1.5 months. In half the cases the side effects were controllable so that treatment was continued, although at a changed dosage. The rate of cross-reaction between carbimazole and thiamazole, on the one hand, and propylthiouracil, on the other, was 13.8% and 15.2%, respectively. The side effects became apparent after a mean of one month's treatment, almost always (in 97.1%) within the first year of treatment. There was a significant dose dependence for an initial thiamazole dose of over 20 mg (relative side effect risk of 2.3), and for an initial dose of over 30 mg for carbimazole (relative side effect risk of 1.6). Although most side effects were not dangerous, in normal instances the lowest possible dosage should be administered to control hyperthyroid metabolism. Long-term treatment with low doses seem to be without problems.

Adverse Effects Related to Antithyroid Drugs and their Dose Regimen

“…The 2 groups of patients were observed in both high and low doses regimen. Recently, Meyer-Gebner et al (1989) found high toxicity rate in patients taking over 20 mg of thiamazol or over 30 mg daily of carbimazole. It is very difficult to find a satisfactory explanation for the discrepancy between our findings and the data of Meyer-Gebner et al (1989).…”

“…Recently, Meyer-Gebner et al (1989) found high toxicity rate in patients taking over 20 mg of thiamazol or over 30 mg daily of carbimazole. It is very difficult to find a satisfactory explanation for the discrepancy between our findings and the data of Meyer-Gebner et al (1989). They studied a population of hyperthyroid patients that included toxic multinodular goiter that are often older than Basedow's disease patients.…”

Asymptomatic Propylthiouracil Induced Agranulocytosis in a Patient with Toxic Nodular Goiter: A Rare Case Report

“…Other major adverse effects include acute liver failure (for which PTU has a black box warning), hypothyroidism, ANCA associated vasculitis, hypersensitivity reaction (Steven Johnson syndrome, toxic epidermal necrolysis, and urticaria). 4 , 5 Mild and more prevalent side effects are fever, arthralgias, and lymphadenopathy. Cholestatic jaundice, lupus-like syndrome, hypergammaglobulinemia, taste and smell abnormalities, sialadenitis, myopathy, and hair loss are less frequent side effects.…”

Evaluation of potential thiamazole exposure of owners of orally treated hyperthyroid cats

“…Antithyroid drugs are associated with side effects in both cats and humans. 2–8 Furthermore, antithyroid medication could be potentially teratogenic and, although owners should handle antithyroid medication with care, this recommendation does not always seem to be followed. 8–11 Currently, no studies have qualified and quantified the urinary excretion of thiamazole in cats in combination with a risk assessment of direct or indirect exposure for the owners.…”