gradual dose titration regime in thyrotoxicosis
Starting dose depends on the severity of the hyperthyroidism and the size of the thyroid gland
- in mild hyperthyroidism and small glands - 10–15 mg daily
- severe hyperthyroidism and large thyroids need 20–40 mg daily
- equivalent dose is 140% of that of thiamazole.
- 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)
- (1) De Leo S, Lee SY, Braverman LE. Hyperthyroidism. Lancet (London, England). 2016;388(10047):906-918.
- (2) Vaidya B, Pearce SH. Diagnosis and management of thyrotoxicosis. BMJ. 2014;349:g5128
Last edited 04/2018