From the FDA Drug Label
Propylthiouracil inhibits the synthesis of thyroid hormones and thus is effective in the treatment of hyperthyroidism. Propylthiouracil is a prescription medicine used to treat people who have Graves' disease with hyperthyroidism or toxic multinodular goiter.
The treatment options for hyperthyroidism include propylthiouracil, which is used to:
- Decrease symptoms of hyperthyroidism in preparation for a thyroidectomy (removal of the thyroid gland) or radioactive iodine therapy
- Treat people who have Graves' disease with hyperthyroidism or toxic multinodular goiter when certain other antithyroid medicines do not work well 1 1 Key points to consider:
- Propylthiouracil may be used when an antithyroid drug is needed during or just before the first trimester of pregnancy
- Propylthiouracil is not recommended for use in children 1
From the Research
Treatment of hyperthyroidism should prioritize methimazole (MMI) as the first-line medication due to its efficacy and safety profile, as supported by the most recent and highest quality study 2. The treatment options for hyperthyroidism include medications, radioactive iodine therapy, and surgery.
- Anti-thyroid medications like methimazole (10-30 mg daily) or propylthiouracil (100-300 mg daily in divided doses) block thyroid hormone production and are typically used for 12-18 months.
- Beta-blockers such as propranolol (20-40 mg 3-4 times daily) help control symptoms like rapid heart rate and tremors but don't affect hormone production.
- Radioactive iodine (I-131) is taken orally as a one-time treatment that gradually destroys overactive thyroid cells over 6-18 weeks.
- Surgical removal of part or all of the thyroid (thyroidectomy) provides a permanent solution when other treatments aren't appropriate. The choice of treatment depends on the cause of hyperthyroidism, patient age, pregnancy status, and other medical conditions, with MMI being the preferred choice for most cases due to its higher efficacy and lower risk of adverse effects compared to propylthiouracil (PTU) 3, 2. Regular blood tests are necessary to monitor thyroid function during and after treatment, and many patients eventually need thyroid hormone replacement if their treatment results in hypothyroidism, particularly after radioactive iodine or surgery 4, 5. It is also important to note that patients should be monitored for potential side effects, such as hepatotoxicity, especially when using PTU, and that baseline liver function should be assessed before starting treatment with antithyroid drugs 6.