Talk:Propylthiouracil

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How long does it take after begining treatment, for the bodies store of T3/4 to run out? This drug only stops its synthesis, not stored TH release.

-- (Response to above unsigned comment) Per my class notes, both Propylthiouracil and Methimazole take "several weeks" to be effective. --Spiffulent (talk) 17:06, 2 June 2010 (UTC)

Use in pregnancy

While propylthiouracil is rated class D in pregnancy, as the cited epocrates page says, "propylthiouracil may be tx of choice during or just prior to first trimester pregnancy due to fetal abnormality risk w/ methimazole." This is consistent with my class notes, which indicate that propyl is preferred due to meth's teratogenesis risk. I added this info to the article. Do we have any further clarification on it?

Also, with regard to the below, it doesn't seem that this article should be part of the Food and drink project. --Spiffulent (talk) 17:06, 2 June 2010 (UTC)

WikiProject Food and drink Tagging

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Dose frequency

The second reference (drugs.com) notes the manufacturer's recommendation that PTU be dosed at least every 8 hours (or more frequently). We frequently see that recommendation ignored by doctors on patient support forums, whose doctors dose daily; usually when the patient notes PTU doesn't appear to be working very well.

There is a reference in pharmokinetics to 8 hour dosing, but the language isn't very clear for lay readers. I would prefer this to be in the introduction, but I don't want to end up accused of original research, and obviously my support forum work isn't easily referenced (although I bet there are papers and case studies that mention similar).

Dosed appropriately PTU is arguably the most effective antithyroid drug, which is why it is used for thyroid storm. It just isn't preferred for reasons of flavour, frequency of dosing, and risk to liver, but we see it failing because of the once daily dosing, or we see much higher total doses given than needed due to once daily dosing, which is not what you want with drugs that can adversely affect the liver.

Don't change your dose without talking to your doctor, do say "doctor drugs.com says 8 hourly dosing with PTU is recommended by the manufacturer, am I supposed to be doing that?" Lot of doctors don't prescribe it much now we have Methimazole and Carbimazole, they may need to Google the answer.

Article once daily PTU vs MMI 19% euthyroid on 150mg vs 77% on 15mg. Lousy study but it is a reference.

https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1365-2265.2001.01239.x

8 hourly dosing works in rats,once daily was more erratic

https://academic.oup.com/endo/article-abstract/96/5/1324/2619309

Divided dosing of PTU discussed in this paper on compliance dosing. We know from more recent papers patients on once daily dosing are more compliant that thrice daily (73% vs 52%), but various studies show divided dosing works better for hyperthyroidism even if patients miss slightly more doses.

https://scholar.google.com/scholar?start=50&q=ptu+dose+daily+thrice&hl=en&as_sdt=0,5#d=gs_qabs&t=1770164926003&u=%23p%3D3IOChvw5fG8J

~2026-61565-4 (talk) 00:10, 4 February 2026 (UTC)