Lomazole 5mg US Pharma treatments for basedow, thyroid poisoning, hyperthyroidism during pregnancy (10 blisters x 10 tablets)

Dosage form Box of 10 blisters x 10 tablets
Specifications Carbimazol

Ingredient

Composition information	Content
Carbimazol	5mg

Uses

Indications

Lomazole is indicated in the case: hyperthyroidism, preparation for thyroid removal due to hyperthyroidism, pre -treatment and post -radiation therapy iodine.

Pharmacokology

Classification: anti -thyroid drugs, thioimidazol.

Mechanism of action:

Carbimazol is an anti -thyroid, thioimidazole (imidazol with sulfur). In the body, carbimazol is rapidly transformed and completely into thiamazol; Therefore, the mechanism of action of carbimazol is also a mechanism of thiamazol. The synthetic inhibitor of thyroid hormone by preventing iodine attaching to the tyrosyl root of thyroglobulin, and also inhibits the combination of two iodotyrosyl roots to iodotothyronin. The drug does not inhibit the effect of thyroid hormone formed in the thyroid gland or in the circulation, does not inhibit the release of thyroid hormones, nor does it affect the effectiveness of the hormone from the outside. Therefore, carbimazol does not work in poisoning due to overdose of thyroid hormones.

If the thyroid has a relatively high iodine concentration (due to the use of iodine before or due to radioactive iodine for diagnostic purposes), the body will respond slowly to the drug.

Carbimazol does not cure the cause of hyperthyroidism and is often not used for prolonged treatment of hyperthyroidism.

If the carbimazol is too high and the time is too long, it is easy to reduce the ability to reduce armor. The decrease in the concentration of thyroid hormone causes the pituitary to increase the secretion of TSH (thyreo-stimulating hormone). TSH stimulates the development of the thyroid gland, which can cause goiter. To avoid this phenomenon, when the armor function has returned to normal, must use a moderate low doses, to only inhibit the production of thyroid hormones to a certain extent, or combine the use of synthetic thyroid hormones such as levothyroxin, so that the pituitary gland does not increase secretion țsh.

Unlike the anti -thyroid drugs of the thyouracil derivatives (benzylthiouracil, propylthiouracil, methylthiouracil), carbimazol does not inhibit the iodine reduction of thyroxin in the periphery of triiodyronin (the effect of triiodothyronin is much stronger than Thyroxin). Therefore, in the poisoning of propylthiouracil armor is often used more.

pharmacokinetics

Carbimazol absorb fast (15 - 30 minutes) through the gastrointestinal tract after drinking. In the body, carbimazol is metabolized quickly and completely into thiamazol. In the blood, usually only identified Thiamazol, carbimazol cannot be determined. Therefore, the pharmacokinetics of carbimazol are only different from Thiamazol in the transition from carbimazol to thiamazol. The peak concentration of plasma is achieved within 1-2 hours after drinking.

The drug is focused on the thyroid. The distribution volume is 40 liters. The drug is associated with protein in plasma. Thiamazol (carbimazol metabolites) through the placenta and secretion of breast milk with concentrations equal to the mother's plasma concentrations.

Selling time is about 5 - 6 hours. Selling time may increase when liver failure or kidney failure.

The drug is eliminated in urine about 80% of the dose in the form of metabolites, about 7% in thiamazol form; Carbimazol format.

Before taking Lomazole 5mg US Pharma treatments for basedow, thyroid poisoning, hyperthyroidism during pregnancy (10 blisters x 10 tablets)

How to use

Take oral use.

Dosage

Carbimazol works to prevent thyroid hormone synthesis, reducing the amount of thyroid hormone in the circulation, thus reducing thyroid poisoning. Carbimazol cannot treat the cause of hyperthyroidism, so, if after taking the drug for 12 to 18 months (usually less than 24 months) and the contaminated contamination of the armor is still removed, it is necessary to remove the armor or use radioactive iodine.

The starting dose for adults is 15 - 40 mg, can be used up to 60 mg daily, depending on light, moderate or heavy hyperthyroidism. Usually divided into 3 drinks, 8 hours apart at meals. But can also be used 1-2 times a day.

Carbimazol often improves symptoms after 1-3 weeks, and the thyroid function will return to normal after 1-2 months. When the patient's thyroid activity returns to normal, reduce the dose gradually, until the lowest dose while retaining the normal thyroid function. Usually, maintenance dose is 5 - 15 mg per day depending on the patient.

When adjusted for maintenance dose, attention should be noted: If the maintenance dose is too low, hyperthyroidism appears or progresses heavily; If the dose is too high, it will reduce the ability of the armor, increase TSH, increase the volume of goiter.

The treatment time is usually 12 - 18 months.

Children with the starting dose of 0.25 mg/kg at a time, 3 times a day; Then adjust the dose depending on the clinical response.

After a period of treatment, when clinical manifestations decrease, determine the content of thyroid hormones, if it is normal, it may stop the drug. If after stopping the drug, the disease recurs, the medication must be used again, or treat it with other methods.

What do

do when using overdose? But the most serious is the pulp, loss of leukocytes; Especially can lead to increased TSH, reduce thyroid function, increase goiter volume.

Need to take care of medical measures, symptomatic treatment, may need antibiotics or corticosteroids, blood transfusion if the marrow and leukopenia.

What to do when you forget 1 dose?

Side Effects

The general ratio of unwanted effects is 2 - 14%, weighing less than 1%. The accident occurs depending on the dose and usually occurs in the first 6-8 weeks.

Common, ADR> 1/100:

Skin: allergies, skin rash, itching (2 - 4%).

Digestive: Nausea, vomiting, digestive disorders.

Blood: Lose leukemia is usually mild and medium. But about 10% of non -treated hyperthyroidism patients, leukocytes often decreased to less than 4000/mm3.

Systemic: headache, medium and transient fever.

Uncommon, 1/1000

Blood: Cockets, granulocytes (0.03%, document 0.7%) manifested as severe fever, chills, throat infections, cough, mouth pain, hoarseness. More often happens if an elderly patient or high doses. Reducing blood prothrombin, causing blood anemia.

musculoskeletal: joint pain, arthritis, muscle pain.

Skin: Hair loss, erythema syndrome.

Rare, ADR

liver: jaundice, hepatitis.

Kidney: glomerulonephritis.

Systemic: headache, mild fever, loss of taste, tinnitus, hearing loss.

Selection: High doses and prolonged doses can cause thyroid reduction, increased goiter volume.

Instructions on how to handle ADR:

When the sore throat, bacterial infection, skin rash, fever, chills, the patient must go to the physician to check blood. If the grain leukemia is found, the marrow, it is necessary to stop treatment, care, symptomatic treatment and may have to be blood transfusion.

jaundice of cholestasis, rare hepatitis; But if it happens, it must be stopped immediately, because there is a death.

Multiple muscle pain, must be tested for creatin phosphokinase; If increased much, do not reduce the dose or stop the drug.

When toxic to ears, carbimazol stops and replacement with benzylthiouracil or propylthiouracil.

Roll itching, allergies, can be overcome by taking antihistamines without stopping the drug. Carbimazol can be replaced with anti -thyroid drugs.

Notice the doctor with unwanted effects when using the drug.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

contraindicated

Hypersensitivity to carbimazol or any ingredients of the drug.

Be cautious when using

must have a specialized physician that appoints and monitored during treatment.

Need to monitor the number of leukemia and white blood cells before starting treatment, and weekly in the first 6 months of treatment, it may occur with severe white blood cells, especially elderly patients or dose of 40 mg per day or more.

Monitor Prothrombin before and during treatment if hemorrhage, especially before surgery.

Must be very careful when using carbimazol for people who are taking known drugs to cause granulocytes.

The effect of the drug on the ability to drive and operate machinery

Patients may have visual disorders, dizziness, dizziness, chicken sleep or nervous system disorders during the time of using carbimazol, so it is necessary to be cautious when driving or operating machinery.

Use drugs for women during pregnancy and lactation

Pregnant women:

Thiamazol, the metabolic form is still active of carbimazol, through the placenta, so it can be harmful to the fetus (goiter, reduce armor, some birth defects), but the risk is often low, especially when using low doses.

It is necessary to consider the benefits/harms between treatment and no treatment. In case of treatment, propylthiouracil is often chosen to be used, as the drug through the placenta is less than thiamazol. When using carbimazol, the lowest dose is effective to maintain the mother's armor function at a high level within the normal limit of normal pregnancy, especially in the last 3 months of pregnancy.

Reduce armor and goiter in the fetus often occurs when taking anti -thyroid drugs near the birth date, because the thyroid thyroid has not produced thyroid hormone until the 11th week or 12 of pregnancy.

Armor hyperplasia may decrease in the mother when the fetus progresses, so in some people can reduce the dose of carbimazol, sometimes stop treatment for 2-3 months before giving birth.

Hormonal hormone through the placenta is very small, so it is less likely to protect the fetus. Thyroid hormones should not be used during pregnancy, as the drug can cover the signs of regression of hyperthyroidism and avoid increasing carbimazol dose in vain, causing more harm to the mother and the fetus.

breastfeeding women:

Thiamazol is a metabolic substance of carbimazol excreted into breast milk, which can cause disasters for children, because the level of thiamazol in serum and breast milk is nearly equal. If the mother needs to use the drug, the lowest dose must be used and must be used for 4 hours after taking the drug to breastfeed.

A daily dosage study of 15 mg of carbimazol or 10 mg thiamazol or 150 mg propylthiouracil and breastfeeding after 4 -hour medication, no harm to the baby. More certainly, if the mother uses the medication, do not breastfeed.

Drug interaction

with aminophyllin, oxtriphyline, Theophyllin, glycosides of cardiac support, beta blockers: When hyperthyroidism, the metabolism of these drugs increases. Use carbimazol, if the thyroid gland returns to normal, it is necessary to reduce the dose of these drugs.

With Amiodaron, Iodoglycerol, Iod or Ki: drugs with iodine reduces the body's response to carbimazol, so it is necessary to increase the dose of carbimazol (amiodaron with 37% iodine).

With anticoagulant drugs Coumarin or indandion: Carbimazol can reduce blood prothrombin, so it increases the effects of oral anticoagulants. Therefore, it is necessary to adjust the anticoagulant dose based on prothrombin.

Radioactive iodine 131i: Anti -thyroid medications can cause thyroids to reduce absorption 131i; 131i absorbing may rise again after a sudden stopping of anti -thyroid drugs for 5 days.

Storage

Store the drug in a dry place, temperatures below 30 ° C, avoiding light.

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