test announcement
During either carbimazole or propylthiouracil treatment, advise patients to report signs and symptoms of infection, especially sore throat, which may indicate bone marrow suppression, and to discontinue medication pending further investigation. The drug should only be recommenced once neutropenia has been excluded following a blood count. Routine monitoring of white blood cell count is unnecessary. If sensitivity (eg rash) occurs with carbimazole then propylthiouracil is an alternative. Propylthiouracil is the drug of choice in pregnant women. For information on the treatment of thyrotoxic crisis, refer to BNF.
MHRA alert: Carbimazole: risk of acute pancreatitis (February 2019) (www.gov.uk).
MHRA alert: Carbimazole: increased risk of congenital malformations; strengthened advice on contraception (February 2019 (www.gov.uk).
Risk minimisation materials
Tablets 5mg, 20mg (specialist use only)
Initially 20 to 40mg once daily. Repeat TFTs after 4 to 6 weeks and adjust the dose following specialist advice.
Tablets 50mg (s)
Initially 200mg daily in divided doses. Repeat TFTs after 4 to 6 weeks and adjust the dose following specialist advice.
MHRA advice: Drug-name confusion: reminder to be vigilant for potential errors (January 2018) (www.gov.uk).
Modified release capsules 80mg, 160mg
By mouth, for the relief of thyrotoxic symptoms modified release capsules 80 to 160mg daily.
Solution total iodine (Lugol’s Solution) 130mg/mL (s) unlicensed
TAM (Treatments and Medicines) NHS Highland