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Propylthiouracil (Propylthiouracil) - Summary



WARNING: Severe liver injury and acute liver failure, in some cases fatal, have been reported in patients treated with propylthiouracil. These reports of hepatic reactions include cases requiring liver transplantation in adult and pediatric patients.

Propylthiouracil should be reserved for patients who can not tolerate methimazole and in whom radioactive iodine therapy or surgery are not appropriate treatments for the management of hyperthyroidism.

Because of the risk of fetal abnormalities associated with methimazole, proplythiouracil may be the treatment of choice when an antithyroid drug is indicated during or just prior to the first trimester of pregnancy (see Warnings and Precautions).



Propylthiouracil (6-propyl-2-thiouracil) is one of the thiocarbamide compounds. It is a white, crystalline substance that has a bitter taste and is very slightly soluble in water. Propylthiouracil is an antithyroid drug administered orally.

Propylthiouracil is indicated:

  • in patients with Graves' disease with hyperthyroidism or toxic multinodular goiter who are intolerant of methimazole and for whom surgery or radioactive iodine therapy is not an appropriate treatment option.
  • to ameliorate symptoms of hyperthyroidism in preparation for thyroidectomy or radioactive iodine therapy in patients who are intolerant of methimazole.

See all Propylthiouracil indications & dosage >>


Published Studies Related to Propylthiouracil

Greater energy intake from a buffet meal in lean, young women is associated with the 6-n-propylthiouracil (PROP) non-taster phenotype. [2011.02]
Taste blindness to 6-n-propylthiouracil (PROP) is a common phenotype that has been associated with increased adiposity in women, and might be linked to increased selection of dietary fats. Since exposure to a variety of high-fat/energy-dense foods is known to promote excess energy intake, we investigated if PROP non-taster women would consume more fat and/or energy in a buffet setting than super-taster women.

Effects of short-term propylthiouracil treatment on p wave duration and p wave dispersion in patients with overt hypertyroidism. [2007.06]
CONCLUSION: P wave duration and PWD are found prolonged in hyperthyroid patients and propylthiouracil treatment decreased them effectively. This mechanism may establish how the anti-thyroid treatment may prevent the development of atrial fibrillation in hyperthyroid patients.

Comparison of methimazole and propylthiouracil in patients with hyperthyroidism caused by Graves' disease. [2007.06]
CONTEXT: Although methimazole (MMI) and propylthiouracil (PTU) have long been used to treat hyperthyroidism caused by Graves' disease (GD), there is still no clear conclusion about the choice of drug or appropriate initial doses. OBJECTIVE: The aim of the study was to compare the MMI 30 mg/d treatment with the PTU 300 mg/d and MMI 15 mg/d treatment in terms of efficacy and adverse reactions... CONCLUSIONS: MMI 15 mg/d is suitable for mild and moderate GD, whereas MMI 30 mg/d is advisable for severe cases. PTU is not recommended for initial use.

The effect of combination therapy with propylthiouracil and cholestyramine in the treatment of Graves' hyperthyroidism. [2005.05]
OBJECTIVE: The study aims to evaluate the efficacy of combination therapy with propylthiouracil (PTU) and cholestyramine in the treatment of Graves' hyperthyroidism. BACKGROUND: Thyroxine (T4) is metabolized mainly in the liver by conjugation to glucuronides and sulphates that enter the enterohepatic circulation. Thyrotoxic patients have an abnormal increase in thyroid hormone in their enterohepatic circulation. Previous studies on combination therapy with methimazole and cholestyramine for Graves' hyperthyroidism have shown it to be an effective adjunctive treatment. In this study, we examined the efficacy of combination therapy with PTU and cholestyramine in the treatment of Graves' hyperthyroidism... CONCLUSION: Cholestyramine contributed to a more rapid and complete decline in thyroid hormone levels in patients with Graves' hyperthyroidism. It was thus proved to be an effective and well-tolerated adjunctive therapy.

Propylthiouracil before 131I therapy of hyperthyroid diseases: effect on cure rate evaluated by a randomized clinical trial. [2004.09]
A randomized clinical trial was performed to clarify whether pretreatment with propylthiouracil (PTU) before radioiodine ((131)I) therapy influences the final outcome of this therapy, as has been indicated by retrospective studies. Untreated consecutive hyperthyroid patients with Graves' disease (n = 23) or a toxic nodular goiter (n = 57) were randomized to either PTU (+PTU; n = 39) or no pretreatment (-PTU; n = 41) before compensated (131)I therapy...

more studies >>

Clinical Trials Related to Propylthiouracil

Antithyroid Drug Treatment of Thyrotoxicosis in Young People [Active, not recruiting]
The investigators aim to establish whether biochemical control during anti-thyroid drug therapy in young people with thyrotoxicosis varies depending upon whether a 'block and replace' or 'dose titration' regimen is used. The investigators will also assess remission rates and the frequency of side-effects in the two treatment groups.

Gustin Gene Polymorphism and 6-n-propylthiouracil (PROP) Taste [Completed]
The investigators investigate the possible association of PROP taste with gustin gene polymorphism rs2274333 (A/G), salivary zinc ion concentration and BMI.

The Effect of Early Total Thyroidectomy in the Course of Graves' Orbitopathy [Recruiting]
The relationship between the method of the treatment of hyperthyroidism due to Graves' disease and the course of Graves' ophthalmopathy is debated. The investigators aimed to compare the results of total thyroidectomy done in 6 months following the appearance of the symptoms of ophthalmopathy and the antithyroid drug therapy in patients with moderate to severe Graves' ophthalmopathy. The inclusion criteria: 1)Hyperthyroidism and moderate to severe Graves' ophthalmopathy within 6 months, 2)Thyroid volumes greater than or equal to 15 mL in thyroid ultrasonography, 3)Patients taking no treatment except local medications for Graves' ophthalmopathy, 4)Clinical activity score of 3/7 or more, proptosis greater than or equal to 21 mm in one eye or 2 mm difference between two eyes, presence of diplopia, the opening of the eye lid greater than or equal to 9 mm. All patients will be treated with antithyroid drug until TSH levels of the patients are between 0. 4-1. During this period all the patients will take pulse methyl prednisolone treatment of a total dose of 4. 5 gr. After pulse steroid treatment the patients will be randomised to two groups: one group will be sent to surgery for total thyroidectomy, and their TSH levels will be kept between 0. 4-1 with levothyroxine treatment; the other group will be followed under antithyroid drug treatment and their TSH levels will be kept between 0. 4-1 also. The smoking habits will be asked. Serum TSH, fT4 levels, Hertelmeter and eye lid opening measurements, clinical activity scores, diplopia will be evaluated monthly; TSH receptor antibody, anti-thyroid peroxidase and anti-thyroglobulin levels will be measured in 3 months intervals for a period of 12 months.

Sorting of Oral Sensations [Completed]
Recent research indicates that fatty acids in food may have a taste. There is no lexicon to describe the sensation of the fatty acids, but participants frequently describe the sensation as bitter or sour. The proposed study will ask participants who have been screened for their ability to detect fatty acids to sort a variety of taste stimuli, including sweet, sour, salty, bitter, umami, and fatty acid tastes. Observing how the participants sort the stimuli will allow us to determine if the fatty acid taste is unique from other taste sensations.

Effects of Thyroid Hormone Enzyme Blocking on Hypothyroidism [Withdrawn]

- Hypothyroidism is a condition caused by the loss of function of the thyroid gland. The

thyroid gland produces two hormones, T4 and T3. These hormones control the metabolism and function of many organs. Lack of energy, depression, and constipation are common symptoms of hypothyroidism. T4 is converted into T3, the active form of thyroid hormone, by two enzymes called deiodinases. People with hypothyroidism are treated with a synthetic T4 hormone, which the enzymes convert to T3. This treatment is usually effective, but some people continue to have symptoms even after treatment. Some researchers think that this may be caused by a problem with the enzymes that convert T4 into T3. They want to look at how the enzymes regulate the levels of T4 and T3 in the blood. They will do so by using a drug that blocks the action of one of the two enzymes. Objectives:

- To look at how thyroid hormone enzyme blocking affects hypothyroidism treatment

medication. Eligibility:

- Individuals at least 18 years of age who have hypothyroidism and are on thyroid hormone

replacement therapy. Design:

- The study consists of one screening visit, 9 days of inpatient hospital admission, and

a follow-up visit 2 weeks after discharge.

- Participants will be screened with a physical exam and medical history. They will

provide blood samples.

- Participants will receive balanced-diet meals to take home for the 2 days before they

enter the hospital. They will continue this diet while in the hospital.

- During the inpatient stay, participants will be monitored with regular blood tests.

They will have the following procedures:

- Continued thyroid hormone replacement for all 9 days.

- Drug to block thyroid enzyme for 7 days.

- Metabolism test, with room temperature changes, on days 1, 2, 5, 8, and 9.

- Measurements of body fat on days 2, 5, and 8.

- Blood glucose tests on days 1 and 9.

- Muscle contraction tests on days 1, 2, 4, 5, 8, and 9.

- Heart imaging studies on days 2, 5, and 8.

- Optional skeletal muscle and fat tissue biopsies on days 1 and 9.

- There will be a follow-up visit 2 weeks after leaving the hospital. Participants will

have a final physical exam and provide blood samples.

more trials >>

Reports of Suspected Propylthiouracil Side Effects

Hyperthyroidism (7)Thrombocytopenia (4)Weight Decreased (2)Nasopharyngitis (2)Head Circumference Abnormal (2)Foetal Exposure During Pregnancy (2)Tachycardia (2)Pyrexia (2)Cerebral Haemorrhage (2)Foetal Distress Syndrome (2)more >>


Based on a total of 1 ratings/reviews, Propylthiouracil has an overall score of 7. The effectiveness score is 6 and the side effect score is 6. The scores are on ten point scale: 10 - best, 1 - worst.

Propylthiouracil review by 43 year old female patient

Overall rating:  
Effectiveness:   Moderately Effective
Side effects:   Moderate Side Effects
Treatment Info
Condition / reason:   Hyperthyroid - Graves Disease
Dosage & duration:   150 - 450 mcg (dosage frequency: 3 times per day) for the period of 2 years
Other conditions:   None
Other drugs taken:   None
Reported Results
Benefits:   Reduced the level of thyroid hormone, thereby minimizing many of the hyperthyroid symptoms.
Side effects:   Muscle cramps.
Comments:   PTU was administered in varying doses while thyroid hormone levels were monitored. The dose was adjusted accordingly, but often the response was a few weeks behind the dosage change, hence it was difficult to titer and keep hormone levels within normal ranges.

See all Propylthiouracil reviews / ratings >>

Page last updated: 2011-12-09

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