Tirozol - instructions for use, analogs, reviews and release forms (5 mg and 10 mg tablets) of the drug for the treatment of thyrotoxicosis in adults, children and pregnancy. Composition, alcohol and weight gain

In this article, you can read the instructions for using the drug Tyrosol. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Tyrozol in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Tyrozole in the presence of existing structural analogues. Use for treatment of thyrotoxicosis in adults, children, as well as during pregnancy and lactation.Composition, interaction with alcohol and a possible increase in weight on the background of taking the drug.

Tyrosol antithyroid preparation. It breaks the synthesis of thyroid hormones, blocking the enzyme peroxidase, involved in iodination of thyronin in the thyroid gland with the formation of triiodo- and tetraiodothyronine.

The drug is effective in symptomatic therapy of thyrotoxicosis (except for cases of development of the disease due to the release of hormones after destruction of thyroid cells during treatment with radioactive Iodine or thyroiditis).

Tyrozole does not affect the release of synthesized thyronins from thyroid follicles. This explains the latent period of different duration, which may precede the normalization of T3 and T4 levels in blood plasma and improve the clinical picture.

The drug reduces the basal metabolism, accelerates the excretion of the thyroid gland of iodides, increases the reciprocal activation of synthesis and secretion of the thyroid-stimulating hormone by the pituitary gland, which may be accompanied by some hyperplasia of the thyroid gland.

The duration of the drug after a single dose is about 24 hours.

Composition

Thiamazole + auxiliary substances.

Pharmacokinetics

After taking the drug inside, Tyrozol quickly and almost completely absorbed. Virtually does not bind to plasma proteins. Cumulates in the thyroid gland. Small amounts of thiamazole are found in breast milk. Slowly metabolized in the thyroid gland, as well as in the kidneys and liver. Thiamazole is excreted in urine (within 24 hours 70% of the drug, with 7-12% unchanged) and bile. Pharmacokinetic parameters of the drug do not depend on the functional state of the thyroid gland.

Indications

• thyrotoxicosis;
• preparation for surgical treatment of thyrotoxicosis;
• preparation for treatment of thyrotoxicosis with radioactive iodine;
• therapy in the latent period of action of radioactive iodine - is carried out before the onset of action of radioactive iodine (within 4-6 months);
• in exceptional cases, prolonged maintenance therapy of thyrotoxicosis, when in connection with the general condition or for individual reasons it is impossible to perform radical treatment;
• prophylaxis of thyrotoxicosis when prescribing iodine preparations (including cases of using iodine-containing radiocontrast agents) in the presence of latent thyrotoxicosis, autonomic adenomas or thyrotoxicosis in anamnesis.

Forms of release

Tablets coated with 5 mg and 10 mg.

Instructions for use and dosing regimen

The drug is taken orally after a meal. Tablets should be taken without chewing, squeezed with enough liquid.

The daily dose is prescribed in a single dose or divided into 2-3 single doses. At the beginning of treatment, single doses are taken during the day at a strictly defined time. The maintenance dose should be taken in one session after breakfast.

In thyrotoxicosis, depending on the severity of the disease, the drug is prescribed in a dose of 20-40 mg per day for 3-6 weeks. After the normalization of thyroid function (usually after 3-8 weeks), they switch to a maintenance dose of 5-20 mg per day. Since this time, an additional method of levothyroxine is recommended.

When preparing for surgical treatment, thyrotoxicosis is prescribed 20-40 mg per day until the euthyroid state is reached. Since this time, an additional method of levothyroxine is recommended. In order to reduce the time needed to prepare for the operation, additionally prescribe beta-blockers and iodine preparations.

When preparing for treatment with radioactive iodine, 20-40 mg per day is prescribed until the euthyroid state is reached.

When therapy in the latent period of action of radioactive iodine, depending on the severity of the disease, 5-20 mg per day is prescribed before the onset of action of radioactive iodine (4-6 months).

With prolonged thyreostatic maintenance therapy, Tyrozol is prescribed in doses of 1.25-2.5-10 mg per day with an additional dose of levothyroxine in small doses. In the treatment of thyrotoxicosis, the duration of therapy is from 1.5 to 2 years.

With the goal of preventing thyrotoxicosis when prescribing iodine preparations (including cases of using iodine-containing radiocontrast agents) in the presence of latent thyrotoxicosis, autonomic adenomas or thyrotoxicosis in the history, Tyrozol is prescribed in a dose of 10-20 mg per day and potassium perchlorate 1 g per day for 8-10 days before taking iodine-containing products.

To children aged 3 to 17 years, tyrosol is prescribed in an initial dose of 0.3-0.5 mg / kg of body weight in 2-3 equal divided doses daily. The maximum recommended dose for children weighing more than 80 kg is 40 mg per day. The maintenance dose is 0.2-0.3 mg / kg per day. If necessary, additionally prescribed levothyroxine.

It is not recommended to use in children aged 0 to 3 years.

In pregnancy, the drug is prescribed in minimal doses: single dose - 2.5 mg, daily - 10 mg.

In case of liver failure, the drug is prescribed in the minimum effective dose under careful medical supervision.

When preparing for the operation of patients with thyrotoxicosis, the drug is administered until the euthyroid state is reached within 3-4 weeks before the planned operation day (in some cases, longer) and ends the day before it.

Side effect

• agranulocytosis (symptoms may appear even after weeks and months after the start of treatment and lead to the need to cancel the drug);
• generalized lymphadenopathy, thrombocytopenia, pancytopenia;
• insulin autoimmune syndrome with hypoglycemia;
• reversible change in taste sensations;
• dizziness;
• neuritis;
• polyneuropathy;
• increased salivary glands;
• vomiting;
• cholestatic jaundice;
• toxic hepatitis;
• generalized rashes on the skin;
• alopecia;
• lupus-like syndrome;
• skin manifestations (itching, redness, rashes) as manifestations of allergy;
• slow progressing arthralgia without clinical signs of arthritis;
• temperature increase;
• weakness;
• an increase in body weight (caused by the normalization of the hormonal background, namely, a decrease in the concentration of thyroid hormones in the blood during treatment).

Contraindications

• agranulocytosis during previous therapy with carbimazole or thiamazole;
• granulocytopenia (including in the anamnesis);
• cholestasis before treatment;
• therapy with thiamazole in combination with levothyroxine during pregnancy;
• hypersensitivity to the components of the drug;
• hypersensitivity to thiourea derivatives.

Application in pregnancy and lactation

Absence of treatment of thyroid hyperfunction during pregnancy can lead to serious complications: premature birth, malformations of the fetus. However, hypothyroidism, caused by treatment with inadequate doses, can lead to miscarriage.

Tyrosol penetrates through the placental barrier and in the blood of the fetus reaches the same concentration as the mother. Therefore, during pregnancy, the drug should be prescribed only if the intended benefit for the mother exceeds the potential risk for the fetus, at the lowest effective dose (up to 10 mg per day) and without additional use of levothyroxine.

Thiamazole in doses much higher than recommended, can cause the formation of goiter, hypothyroidism in the fetus, and the newborn may have a reduced body weight at birth.

During the lactation period, thyrotoxicosis treatment with Tyrosol can be continued if necessary. Since thiamazole is excreted in breast milk and can reach a concentration corresponding to the level of thiamazole in the mother's blood, a newborn can develop hypothyroidism. It is necessary to regularly monitor the function of the thyroid gland in newborns.

Use in children

It is not recommended to use in children aged 0 to 3 years.

special instructions

Patients with a significant increase in the thyroid gland narrowing the lumen of the trachea, Tyrozol is prescribed for a short time in combination with levothyroxine, tk. with prolonged use may increase the goiter and even more compression of the trachea. It is necessary to carry out careful monitoring of the patient (control of the level of TSH and tracheal lumen).

During the period of treatment with the drug, regular monitoring of the peripheral blood pattern is necessary.

Thiamazole and thiourea derivatives can reduce the sensitivity of thyroid tissue to radiation therapy.

If during the treatment with the drug suddenly there are pains in the throat, difficulty swallowing, fever, signs of stomatitis or furunculosis (possible symptoms of agranulocytosis), stop taking the medication and consult a doctor immediately.

With the appearance of subcutaneous hemorrhages or bleeding of unclear genesis, generalized skin rash and itching, persistent nausea or vomiting, jaundice, severe epigastric pain and severe weakness during treatment, it is necessary to cancel the drug.

In the event of an early cessation of treatment, a relapse of the disease is possible.

The appearance or deterioration of the course of endocrine ophthalmopathy is not a side effect of adequate treatment with the drug Tyrozole, carried out properly.

There was no negative effect of tyrosol and alcohol during joint admission.

In rare cases, after the end of treatment, late hypothyroidism may occur, which is not a side effect of the drug, but is associated with inflammatory and destructive processes in the thyroid tissue that occur within the underlying disease.

Impact on the ability to drive vehicles and manage mechanisms

Tirozol does not affect the ability to drive vehicles and mechanisms.

Drug Interactions

When administering the drug after the application of iodine-containing contrast media at a high dose might weaken the effect of the drug tyrosol.

The lack of iodine increases the effect of the preparation Tyrozol.

Patients taking tirozol about hyperthyroidism after achieving euthyroid state (normalization of thyroid hormones in the blood serum) may be necessary to reduce the received doses of cardiac glycosides (digoxin and digitoxin), aminophylline, and increase the received doses of Warfarin and other anticoagulants - derivatives Coumarin and indanedione (pharmacodynamic interaction).

Formulations lithium, beta-blockers, reserpine, Amiodarone increase methimazole effect (it requires correction dose).

While the use of sulfonamides, metamizole sodium and myelotoxic drugs increases the risk of leukopenia.

Leukogen and folic acid with simultaneous use with thiamazole reduce the risk of developing leukopenia.

Gentamicin increases the antithyroid effect of Tyrozole.

Data on the effect of other drugs on the pharmacokinetics and pharmacodynamics of the drug are absent. However, it should be borne in mind that when thyrotoxicosis is accelerated metabolism and elimination of substances. Therefore, in a number of cases it is necessary to adjust the dose of other drugs.

Analogues of the drug Tyrosol

Structural analogs for the active substance:

• Mercazolyl;
• Metizol;
• Thiamazole.

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