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Gradual dose titration regime in thyrotoxicosis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Starting dose depends on the severity of the hyperthyroidism and the size of the thyroid gland

  • thiamazole
    • in mild hyperthyroidism and small glands - 10–15 mg daily
    • severe hyperthyroidism and large thyroids need 20–40 mg daily
  • carbimazole
    • equivalent dose is 140% of that of thiamazole.
  • propylthiouracil
    • usually 50–150 mg administered three times daily.

Thyroid function is measured every 4-6 weeks after initiation of therapy and dose is progressively lowered at regular intervals to allow endogenous synthesis of thyroid hormone to continue in a regulated fashion (1,2).

Once euthyroidism is achieved:

  • a maintenance dose of thiamazole of 5–10 mg daily, or 50 mg propylthiouracil two or three times daily, or lower
  • thyroid function is measured every 2-3 months
  • treatment shouldbe continued for 12-18 months (some suggest an even longer duration of therapy) (1)

Reference:

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