Pronunciation:

proe-pil-thye-oh-URE-a-sil

Dosage Forms:

• Tablet

Warnings:

Severe liver injury and acute liver failure, including fatalities, have been reported with propylthiouracil. Liver transplantation was required in some cases. Reserve propylthiouracil for patients who can not tolerate methimazole when radioactive iodine therapy or surgery are not appropriate treatment options. Propylthiouracil may be the preferred treatment when an antithyroid drug is indicated during or just prior to the first trimester of pregnancy, because of the risk of fetal abnormalities associated with methimazole .

Classifications:

Therapeutic—

Antithyroid Agent

Chemical—

Thionamide

Uses of This Medicine:

Propylthiouracil is used to treat Graves' disease and hyperthyroidism, a condition where the thyroid gland produces too much thyroid hormone. It is also used before thyroid surgery or radioactive iodine treatment in patients who have already been treated with other medicines (e.g., methimazole) that did not work well.

Propylthiouracil is an antithyroid medicine. It works by making it harder for the body to use iodine to make thyroid hormone. It does not block the effects of thyroid hormone that was made by the body before its use was begun.

This medicine is available only with your doctor’s prescription.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Because of reports of severe liver problems, propylthiouracil is not recommended in pediatric patients except in instances where other medicines (e.g., methimazole), surgery, or radioactive iodine therapy have not worked well

Older adults—

No information is available on the relationship of age to the effects of propylthiouracil in geriatric patients.

Breast-feeding—

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Levoketoconazole
• Macimorelin
• Methotrexate
• Pexidartinib

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Acenocoumarol
• Anisindione
• Dicumarol
• Phenindione
• Phenprocoumon
• Warfarin

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Blood or bone marrow problems (e.g., agranulocytosis, aplastic anemia, thrombocytopenia) or
• Liver disease—Use with caution. May make these conditions worse.

Proper Use of This Medicine:

Take this medicine only as directed by your doctor to benefit your condition as much as possible. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

This medicine works best when there is a constant amount in the blood. To help keep the amount constant, do not miss any doses. Also, if you are taking more than one dose a day, it is best to take the doses at evenly spaced times day and night. For example, if you are to take 3 doses a day, the doses should be spaced about 8 hours apart. If this interferes with your sleep or other daily activities, or if you need help in planning the best times to take your medicine, check with your doctor.

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage form (tablets):
  • For treatment of hyperthyroidism (overactive thyroid):
    • Adults—At first, 300 to 900 milligrams (mg) daily, divided into 3 equal doses and given every 8 hours. The maintenance dose is usually 100 to 150 mg daily.
    • Children 6 years of age and older—At first, 50 mg daily, divided into 3 equal doses and given every 8 hours. Your doctor may adjust your dose as needed.
    • Children up to 6 years of age—Use and dose must be determined by your doctor.

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using This Medicine:

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood tests may be needed to check for unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. You should not become pregnant while you are taking this medicine. If you think you have become pregnant while using the medicine, tell your doctor right away.

Propylthiouracil can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:

• If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.
• Check with your doctor immediately if you notice any unusual bleeding or bruising; black, tarry stools; blood in the urine or stools; or pinpoint red spots on your skin.
• Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
• Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
• Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
• Avoid contact sports or other situations where bruising or injury could occur.

While you are being treated with propylthiouracil, and after you stop treatment with it, do not have any immunizations (vaccines) without your doctor’s approval. Propylthiouracil may lower your body’s resistance and there is a chance you might get the infection the immunization is meant to prevent. In addition, other persons living in your household should not take or have recently taken oral polio vaccine since there is a chance they could pass the polio virus on to you. Also, avoid other persons who have taken oral polio vaccine. Do not get close to them, and do not stay in the same room with them for very long. If you cannot take these precautions, you should consider wearing a protective face mask that covers the nose and mouth.

Liver problems may occur while you are using this medicine. Stop using this medicine and check with your doctor right away if you are having more than one of these symptoms: right upper abdominal or stomach pain or tenderness; clay-colored stools; dark urine; decreased appetite; fever; headache; itching; loss of appetite; nausea and vomiting; skin rash; swelling of the feet or lower legs; unusual tiredness or weakness; or yellow eyes or skin.

Before having any kind of surgery, tell the medical doctor in charge that you are using this medicine. Taking propylthiouracil together with medicines used during surgery may increase the risk of side effects.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Black, tarry stools

chest pain

chills

cough

fever

painful or difficult urination

shortness of breath

sore throat

sores, ulcers, or white spots on the lips or in the mouth

swollen glands

unusual bleeding or bruising

unusual tiredness or weakness

Less common

Dark-colored urine

general feeling of discomfort, illness, or weakness

headache

light-colored stools

nausea or vomiting

stomach pain, continuing

upper right abdominal or stomach pain

yellow eyes and skin

Incidence not known

Abdominal or stomach pain

agitation

bleeding gums

bleeding under the skin

blood in the urine or stools

bloody or cloudy urine

burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings

coma

confusion

cough or hoarseness

cracks in the skin

decreased urine output

depression

difficulty with breathing

difficulty with moving

dizziness

drowsiness

feeling of fullness

fever with or without chills

general feeling of discomfort, illness, or weakness

high blood pressure

hostility

irritability

joint pain

lethargy

loss of appetite and weight

loss of heat from the body

lower back or side pain

muscle aching or cramping

muscle pain or stiffness

muscle twitching

numbness or tingling of the hands, feet, or face

pain in the ankles or knees

painful, red lumps under the skin, mostly on the legs

pinpoint red spots on the skin

rapid weight gain

red, swollen skin

redness, soreness, or itching skin

scaly skin

seizures

soreness of the muscles

sores on the skin

sores, ulcers, or white spots on the lips or in the mouth

sores, welting, or blisters

stupor

swelling of the face, ankles, hands, feet, or lower legs

swollen joints

swollen salivary glands

swollen, painful, or tender lymph glands in the neck, armpit, or groin

tightness in the chest

unusual weight gain

wheezing

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

Bloody, black, or tarry stools

high fever

itching skin

pale skin

swelling

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known

Abnormal loss of hair

change in taste or bad unusual or unpleasant (after) taste

dizziness or lightheadedness

feeling of constant movement of self or surroundings

heartburn

hives or welts

loss of taste

pain or discomfort in the chest, upper stomach, or throat

sensation of spinning

skin rash

sleepiness

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.