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At a glance

Methimazole is an anti-thyroid drug used for the treatment of hyperthyroidism. It works by inhibiting the synthesis of thyroid hormones.

Indications
  • Graves' disease or toxic multinodular goiter - when surgery or radioactive iodine therapy is not appropriate
  • To ameliorate symptoms of hyperthyroidism in preparation for thyroidectomy or radioactive iodine therapy
Pharmacology

Methimazole inhibits thyroid peroxidase enzyme to prevent the synthesis of thyroid hormones (T3 and T4).

Dosage

Adult Dose (Oral):

  • Mild hyperthyroidism: 15 mg/day (in 3 divided doses, 8-hour intervals)
  • Moderate-severe: 30-40 mg/day
  • Severe: 60 mg/day
  • Maintenance: 5-15 mg/day

Pediatric Dose: 0.4 mg/kg/day (in 3 divided doses); Maintenance: approximately half of initial dose

Side effects

Common Side Effects:

  • Skin rash, urticaria
  • Nausea, vomiting, epigastric distress
  • Arthralgia, paresthesia
  • Loss of taste, hair loss
  • Myalgia, headache
  • Pruritus, drowsiness, neuritis
  • Edema, vertigo, skin pigmentation
  • Jaundice, sialadenopathy, lymphadenopathy
Use in pregnancy

Use in Pregnancy: Methimazole is unsafe during pregnancy (Category D); risk of congenital malformations, especially in the first trimester. Use only if needed and at the lowest effective dose.

Pregnancy Category: D — always consult a doctor before taking during pregnancy.

Precautions & warnings
  • Report immediately if symptoms of agranulocytosis (fever, sore throat) occur
  • Discontinue if liver toxicity (transaminases >3x ULN) occurs
  • Monitor TSH and free T4 regularly for hypothyroidism
  • Avoid use in first trimester of pregnancy (risk of fetal harm)
  • Caution during lactation
Overdose effects

Overdose may cause nausea, vomiting, epigastric distress, headache, fever, joint pain, pruritus, edema; agranulocytosis or aplastic anemia may occur; symptomatic treatment.

Storage conditions

Store below 30°C in a cool and dry place, away from light; keep out of reach of children.

Methimazole — see the full informationPharmacology, precautions, pregnancy, overdose and the rest on the generic page
⚠️ This information is for educational purposes only — not a substitute for medical advice. Consult a registered physician before taking any medicine.