Thyrozol 10mg Merck medicine for treatment of hyperthyroidism (10 blisters x 10 tablets)

Dosage form Box of 10 blisters x 10 tablets
Specifications Thiamazol

Ingredient

Composition information	Content
Thiamazol	10mg

Uses

indications

Thyrozol 10mg drug is indicated for treatment cases, including:

Treatment of hyperthyroidism, especially in the case of small or no tumor. Hidden, automatic thyroid tumor or History of hyperthyroidism when exposed to iodine (such as X -rays with contrast containing iodine).

ATC code: H03BB02

Thiamazole inhibits the dose of iodine combination into tyrosin and thus inhibits the renewal of thyroid hormones. Currently, it is not yet determined whether Thiamazole has an additional effect on the natural process of immunotherapy (Graves disease), which means whether it inhibits the process of producing main immune disease or not.

The release of thyroid hormones has been synthesized before the thyroid imprisonment is not affected. This explains the reason why the potential time until normalization of thyroxine and triiodyroninine concentrations, and thus leads to clinical improvement, different in each case.

pharmacokinetics

absorption and distribution:

Thiamazole is absorbed quickly and completely. After drinking, the maximum serum concentration is reached within 0.4 -1.2 hours. The cohesion with protein is negligible. Thiamazole accumulates in the thyroid gland when it is slowly transformed.

Although serum concentrations change, the accumulation of thiamazole in the thyroid gland still leads to concentration stability. This leads to nearly 24 hours of impact on single dose.

Metabolism and elimination:

Selling time is about 3 to 6 hours and lasts for liver failure. Thiamazole is eliminated through the kidneys and bile; The excretion through small stool, the hypothesis is to follow the bowel circulation.

7o% is excreted through the kidney within 24 hours. Only a small amount of excretion in constant form. Currently, the pharmaceutical activity has not been found.

Before taking Thyrozol 10mg Merck medicine for treatment of hyperthyroidism (10 blisters x 10 tablets)

How to use

swallow the whole pill with sufficient amount of water.

During the treatment of hyperthyroidism with a high starting dose, daily dose should be broken down and drink regularly during the day.

Maintenance dose can be used in the morning, during or after breakfast.

Dosage

Thiamazole is a carbimazole metabolic form, but 1 mg of thiamazole is not equivalent to 1 mg of carbimazole. This should be noted when starting with thiamazole or in case of transferring from carbimazole to thiamazole. Should be used according to the recommended dose below:

Adults

Depending on the severity of the disease and the amount of iodine used, usually begins to treat daily dose from 10 mg to 40 mg. In many cases, the inhibition of thyroid hormone production can usually be achieved with the starting dose of 20 to 30 mg thiamazole.

In lighter cases, a full dose may not be necessary, so it is possible to consider a lower starting dose.

In case of heavy hyperthyroidism, the starting dose of 40mg Thiamazole.

The starting dose is adjusted depending on the patient's metabolic conditions, indicating by the progression of the thyroid hormone.

maintenance treatment, should be used according to one of the following recommendations:

Daily maintenance dose from 5 to 20 mg thiamazole combined with levothyroxine, to avoid hypothyroidism. Hypothyroidism due to iodine may need higher doses.

Children

Used in children and young people (3 to 17 years old)

The starting dose for children and young people (3 to 17 years old) should be adjusted according to the patient's weight. Typically, the treatment is started at a dose of 0.5mg/kg daily, divided evenly into 2 or 3 times. For maintenance treatment, daily dose may be reduced and used once a day, depending on the response of the patient with treatment. May need further treatment with levothyroxine to avoid hypothyroidism.

The maximum recommended dosage must not exceed 40 mg/day.

Used in young children (2 years old and under 2 years old)

The safety and effectiveness of Thiamazole in 2 -year -old children and under 2 years old has not been systematically assessed. Therefore, it is not recommended to use thiamazol in 2 years old and under 2 years old.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.

Hyperid conservation treatment

The purpose of the treatment is to achieve the metabolism of the armor and recover for a long time after a certain treatment. Depending on the choice of the patient treated, the recovery in one year is achieved in 50% of the highest cases. The recovery rate is very different without any obvious reason given.

Hyperthyroidism (immunity or immunity), treatment time, dosage as well as iodine used are firmly affected factors. In the treatment of hyperthyroidism conservation, the treatment time usually lasts from 6 months to 2 years (average is 1 year). According to statistics, the ability to recover increases over time of treatment.

In cases where the recovery cannot be achieved and the determined treatments are not applied or rejected, Thiamazole can be used as long -term anti -armored therapy at a low dose that can not be used or combined with low doses of Levothyroxine. Patients with large goiter and trachea should only be treated for short -term with Thiamazole because long -term use can lead to tumor growth. It may be necessary to specially monitor the entire treatment process (TSH concentration, trachea). It is best to treat in combination with using more levothyroxine.

treatment before surgery

Temporary treatment (for 3 to 4 weeks or longer, in individual cases) can achieve the conditions of fire transfer, thus reducing the risk of surgery.

Surgery should be conducted as soon as the patient reaches the level of armor. If not, levothyroxine should be used. The treatment may end the day before surgery.

The risk of increased crunching and hemorrhage of thymazole can be compensated by high doses of iodine 10 days before surgery (iodine therapy).

treatment before treatment with radioactive iodine

Achieving the metabolism of the armor before treatment with radioactive iodine is especially important in cases of severe hyperthyroidism, because the post -treatment poisoning has occurred in cases of individuals after radioactive iodine treatment without previous treatment.

Note: Thionamide derivatives may reduce the sensitivity to the radioactive of the thyroid tissue. In the treatment of automatic thyroid tumors with radioactive iodine according to the program, the activation of the thyroid tissue by the core by the previous treatment must be prevented.

Radioactive treatment after treatment

The time and treatment do the dose must be adjusted for each individual depending on the clinical condition and the prediction time until the radioactive iodine therapy starts to work (about 4 to 6 months).

Preventive treatment in patients is at risk of developing hyperthyroidism due to the use of iodine containing substances for diagnosis purposes

In general, daily dose is from 10 to 20 mg thiamazole and/or 1 g perchlorate for about 10 days (for example, for contrast substances excreted through the kidneys). Treatment time depends on the time of containing iodine stored in the body.

Special case

Patients with hepatic impairment: In patients with hepatic impairment, plasma clearance of thiamazole is reduced. Therefore, the dose should be kept at the lowest possible and patients should be carefully monitored.

Patients with renal impairment: Because there is no fullness of thiamazole pharmacokinetics in patients with renal impairment, it is recommended to adjust the dose carefully for each individual and should be monitored carefully. Dosage should be kept low as possible.

The elderly: Although there is no accumulation in the elderly, it is necessary to adjust the dose carefully for each individual and should be monitored carefully.

What to do when overdose? This can be avoided by reducing the dose as soon as the metabolism of the armor, and if necessary, Levothyroxine can be used.

What to do when you forget 1 dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double dose to compensate for missed dose.

Side Effects

When using thyrozol 10mg, you may experience unwanted effects (ADR).

Common, ADR> 1/100

Musculoskeletal and connective muscle disorders: joint pain progress gradually and occur even after months of treatment.

Uncommon, 1/1000

Blood disorders and lymphatic systems: The loss of granulocytes occurs at about 0.3 to 0.6% of cases. Most cases of self -recovery.

Instructions on how to handle ADR

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Warnings

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

contraindicated

Thyrozol drugs contraindicated in the following cases:

Hypersensitivity to Thiamazole, with other thionamide derivatives or any ingredients of the drug. History of acute pancreatitis after taking Thiamazole or the precursor of Thiamazole is Carbimazole.

Caution when using

History of mild hypersensitivity reactions (such as allergies, itching).

Should only use Thiamazole in a short time under careful monitoring in patients.

Large goiter with trachea due to the risk of tumor growth.

toxicity on the bone marrow

The grain leukemia is reported in 0.3 to 0.6% of cases. Patients should be noted for the symptoms of grain leukemia (stomatitis, sore throat, fever) before starting treatment. Loss of granulocytes often occurs during the first weeks of treatment, but may become clear a few months after the beginning of treatment or during use. It is recommended to carefully monitor the sample formula before and after the beginning of treatment, especially for cases of mild grain leukemia. In case of observation, the above symptoms, especially in the first weeks of treatment, patients must be consulted, so they should contact the doctor immediately for blood formula tests. If you identify the loss of granulocytes, stop using the drug is necessary.

Other harmful reactions caused by bone marrow disease are very rare for recommended doses. These reactions are especially reported regarding the very high doses Thiamazole (about 120 mg per day). These doses should only be used for special indications (serious illness, armor poisoning). Thiamazole must be discontinued when bone marrow poisoning occurs during treatment, and if necessary, switch to other anti -thyroid drugs.

Acute pancreatitis

There are reports after circulation of acute pancreatitis in patients using Thiamazole or carbimazole precursors. When suffering from acute pancreatitis, thiamazole should be stopped immediately. Do not use thiamazole in patients with a history of acute pancreatitis after using thiamazole or carbimazole. This reuse can cause recurrent acute pancreatitis, with a decrease in onset.

Pregnant women and women are likely to be pregnant

Women who are likely to get pregnant must use effective contraceptive measures during treatment.

Using Thiamazole in pregnant women must be based on the assessment of benefits/risks on each patient individual. If using thiamazole in pregnant women, the lowest effective dose should be used without using more thyroid hormones. Must ensure maternal, fetal and newborn supervision.

Hyperthyroidism control

Overdose can cause clinical or hidden hyperthyroidism and tumor growth due to increased TSH. Therefore, thiamazole should be reduced as soon as the level of armor and, if necessary, can be used more levothyroxine. It is not helpful to stop using thiamazole but only continue treatment with levothyroxine.

Tumor growth during treatment with Thiamazole despite the inhibition of TSH is the result of the main disease and cannot be prevented by further treatment with levothyroxine. Achieving normal TSH is the main thing to reduce the risk of/or decline in hormonal eye disease. However, this situation is usually not dependent on the progression of thyroid disease. This complication is not the reason for changing the treatment and is not considered a harmful reaction to the correct treatment.

With a low percentage, late hypothyroidism can occur after treatment of thyroid resistance without using other surgical methods. This may not be a harmful reaction of the drug, but is considered as the process of inflammation and destruction of the main thyroid parenchyma.

Reducing energy consumption of pathology due to hyperthyroidism can lead to (common desire) during weight gain during treatment with Thiamazole. It should be notified to the patient that the improvement of the clinical condition shows the normalization of the energy they consume.

excipients

thyrozol contains lactose, so it is not recommended for patients with genetic galactose tolerance, lapp lactase deficiency or absorbing glucose-galactose.

This drug contains less than 1 mmol sodium (23 mg) in 1 tablet, which is basically "no sodium".

Use drugs for women during pregnancy and lactation

Women are likely to be pregnant

Women who are likely to get pregnant must use effective contraceptive measures during treatment.

Pregnant women

Need to treat adequate hyperthyroidism in pregnant women to prevent serious complications for mothers and fetuses.

Thiamazole can pass through the placenta.

Based on human experience from epidemiological research and voluntary reports, Thiamazole is suspected of causing birth defects when used for pregnant women, especially when used in high doses in the first 3 months of pregnancy.

Distance is reported including babies born without skin, cranial deformities (anal stenosis; face defects), umbilical hernia, esophageal narrow, abnormal abnormal abnormal abnormality, and ventricular ventricular.

Only use Thiamazole in pregnant women after assessing the benefits/risks closely and only used with the lowest doses of effectiveness without using more thyroid hormones. If using thiamazole in pregnant women, closely monitor mothers, fetuses and babies.

breastfeeding women

Thiamazole enters milk and can achieve concentrations equivalent to the concentration of mother serum, so there is a risk of hypothyroidism in newborns.

Can breastfeed while being treated with thiamazole; However, low doses of up to 10 mg daily without using thyroid hormones. The thyroid function of the newborn must be carefully monitored.

The ability to drive and operate machinery

Thiamazole does not affect the ability to drive and operate machinery.

Drug interaction

Lack of iodine increases the response of the thyroid gland with Thiamazole, excess iodine reduces the response. Direct interactions are different from other drugs. However, it should be noted that the metabolism and elimination of other drugs can accelerate in hyperthyroidism. They standardize according to the level of armor. Must adjust the dose when necessary.

Moreover, there is evidence that the correction of hyperthyroidism can normalize the increased activity of anticoagulant drugs in hyperthyroidism patients. Interactive studies have not been conducted in pediatric patients.

Storage

Store at a temperature not exceeding 30 degrees C.

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