GENERIC NAME Propylthiouracil Rx

BRAND NAME PTU

IMAGE

CLASSIFICATION Propylthiouracil belongs to the class of thiouracils. Used in

the management of thyroid diseases.
ORDERED DOSE AND
FREQUENCY
SUGGESTED DOSE  Thyrotoxic crisis
(BY MANUFACTURER) - Adult/child: PO 200-400 mg q4hr for 1st 24 hr.
 Preparation for thyroidectomy
- Adult: PO 600-1200 mg/day
- Child: PO 10 mg/kg/day in divided doses
  Hyperthyroidism
- Adult: PO 100 mg tid increasing to 300 mg q8hr
if condition is severe; continue to euthyroid state,
then 100 mg daily tid.
- Child >6 yr: PO 50 mg/day divided q8hr, titrate
based on TSH/free T4 levels.
- Neonate (unlabeled): PO 5-10 mg/kg/day in
divided doses q8hr
Available forms: Tabs 50 mg

Administer:
• With meals to decrease GI upset
• At same time each day to maintain product level
• At lowest dose that relieves symptoms
MODE OF ACTION Blocks synthesis peripherally of T3, T4 (triiodothyronine,
thyroxine), inhibits organification of iodine.
INDICATION Preparation for thyroidectomy, thyrotoxic crisis,
hyperthyroidism, thyroid storm.
CONTRAINDICATIONS Pregnancy, breastfeeding, hypersensitivity,
agranulocytosis, hepatitis, jaundice.
SIDE EFFECTS  CNS: Drowsiness, headache, vertigo, fever,
paresthesia, neuritis
 GI: Nausea, diarrhea, vomiting, loss of taste,
 INTEG: Rash, urticaria, pruritus, alopecia,
hyperpigmentation, lupus-like syndrome
 MS: Myalgia, arthralgia, nocturnal muscle cramps,
osteoporosis
ADVERSE REACTION  Significant: Bleeding, hypoprothrombinemia, bone
marrow suppression (e.g., aplastic anemia,
thrombocytopenia, leucopenia), exfoliative
dermatitis, fever, hypothyroidism, lupus-like
 syndrome (e.g., splenomegaly), nephritis,
glomerulonephritis, interstitial pneumonitis.
 Blood and lymphatic system
disorders: Granulocytopenia, lymphadenopathy.
 Ear and labyrinth disorders: Hearing impairment.
 Potentially Fatal: Severe liver injury, acute liver
failure, agranulocytosis, vasculitis (e.g.,
leucocytoclastic). Rarely, serious skin reactions
(e.g., Stevens-Johnson syndrome, toxic epidermal
necrolysis).
DRUG INTERACTION May potentiate the effect of oral anticoagulants (e.g.,
warfarin). Concomitant β-blockers, digoxin and theophylline
may require dosage adjustments according to changes in
patient’s thyroid status.
NURSING  Assess the pulse, B/P, temperature.
RESPONSIBILITIES  Assess the I&O ratio; check for edema: puffy hands,
feet, periorbits; indicates hypothyroidism.
 Assess the blood dyscrasias: CBC with differential;
leukopenia, thrombocytopenia, agranulocytosis;
monitor periodically; agranulocytosis may develop in
first 2 months of treatment; discontinue treatment
 Assess hypersensitivity: rash, enlarged cervical
lymph nodes; product may have to be discontinued.
 Evaluate therapeutic response: weight gain,
decreased pulse, decreased T4, decreased B/P.
 Teach patient or the family members to take the
pulse daily.
 Tell the patient to report any signs of redness,
swelling, sore throat mouth lesions, which indicate
blood dyscrasias; and to report symptoms of hepatic
dysfunction (yellow skin or eyes, clay-colored stools,
 dark urine.)
 Advise patient and the family members to avoid OTC
products that contain iodine.
 Advise patient to take medication as prescribed; not
to skip or double dose; that missed doses should be
taken when remembered up to 1 hr. before next
dose.
 Teach the patient about the symptoms/signs of
overdose: periorbital edema, cold intolerance,
mental depression.

REFERENCES:
MIMS. Retrieved November 22, 2021, from
https://www.mims.com/philippines/drug/info/propylthiouracil?mtype=generic
Skidmore L. (2019). Mosby's 2019 Nursing Drug Reference. Elsevier.
Propylthiouracil: Indication, Dosage, Side Effect, Precaution | MIMS Philippines. (n.d.).