Last update: Feb. 23, 2017

Propylthiouracil

Very Low Risk for breastfeeding


Safe. Compatible.
Not risky for breastfeeding or infant.

Small amount of Propylthiouracil can reach the breast milk but it doesn't cause harm to the thyroid function (Low 1979, Kampmann 1980, Cooper 1987).

The American Thyroid Association among others (Mandel 2001, Stagnaro 2011, Alexander 2017) stated that a daily dose as high as 450 mg is safe while breastfeeding. However, some studies have shown no harmful effect at a daily dose as high as 750 mg (Kampmann 1980, McDougall 1986, Cooper 1987, Momotani 1989 y 2000, Bartalena 2005, Azizi 2006, Marx 2008, Inoue 2009, Glatstein 2009).

Methimazole or Carbimazole is preferred since liver toxicity has been found among patients who were treated with Propylthiouracil (Karras 2009, 2010 y 2012, Azizi 2011, Serrano 2014, Hudzik 2016).

The American Academy of Pediatrics has rated it (2001) as compatible with breastfeeding.

Eleventh WHO Model List of Essential Drugs 2002: Compatible with breastfeeding.

Alternatives

We do not have alternatives for Propylthiouracil since it is relatively safe.

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Propylthiouracil is also known as


Propylthiouracil in other languages or writings:

Group

Propylthiouracil belongs to this group or family:

Tradenames

Main tradenames from several countries containing Propylthiouracil in its composition:

Pharmacokinetics

Variable Value Unit
Bioavailability 95 %
Molecular weight 170 daltons
Protein Binding 80 %
VD 0,87 l/Kg
Tmax 1 - 2 hours
T1/2 1 - 2 hours
M/P ratio 0,8 -
Theoretical Dose 0,1 mg/Kg/d
Relative Dose 2,1 %
Relat.Ped.Dose 1 - 2 %

References

  1. Alexander EK, Pearce EN, Brent GA, Brown RS, Chen H, Dosiou C, Grobman WA, Laurberg P, Lazarus JH, Mandel SJ, Peeters RP, Sullivan S. 2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum. Thyroid. 2017 Abstract Full text (link to original source) Full text (in our servers)
  2. Hudzik B, Zubelewicz-Szkodzinska B. Antithyroid drugs during breastfeeding. Clin Endocrinol (Oxf). 2016 Abstract
  3. Serrano Aguayo P, García de Quirós Muñoz JM, Bretón Lesmes I, Cózar León MV. Tratamiento de enfermedades endocrinológicas durante la lactancia. [Endocrinologic diseases management during breastfeeding.] Med Clin (Barc). 2015 Abstract
  4. Karras S, Krassas GE. Breastfeeding and antithyroid drugs: a view from within. Eur Thyroid J. 2012 Abstract Full text (link to original source) Full text (in our servers)
  5. Lazarus JH. Pre-conception counselling in graves' disease. Eur Thyroid J. 2012 Abstract Full text (link to original source) Full text (in our servers)
  6. Azizi F, Amouzegar A. Management of hyperthyroidism during pregnancy and lactation. Eur J Endocrinol. 2011 Abstract Full text (link to original source) Full text (in our servers)
  7. Stagnaro-Green A, Abalovich M, Alexander E, Azizi F, Mestman J, Negro R, Nixon A, Pearce EN, Soldin OP, Sullivan S, Wiersinga W; American Thyroid Association Taskforce on Thyroid Disease During Pregnancy and Postpartum.. Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum. Thyroid. 2011 Abstract Full text (link to original source) Full text (in our servers)
  8. Karras S, Tzotzas T, Kaltsas T, Krassas GE. Pharmacological treatment of hyperthyroidism during lactation: review of the literature and novel data. Pediatr Endocrinol Rev. 2010 Abstract
  9. Inoue M, Arata N, Koren G, Ito S. Hyperthyroidism during pregnancy. Can Fam Physician. 2009 Abstract Full text (link to original source) Full text (in our servers)
  10. Glatstein MM, Garcia-Bournissen F, Giglio N, Finkelstein Y, Koren G. Pharmacologic treatment of hyperthyroidism during lactation. Can Fam Physician. 2009 Abstract Full text (link to original source) Full text (in our servers)
  11. Karras S, Tzotzas T, Krassas GE. Antithyroid drugs used in the treatment of hyperthyroidism during breast feeding. An update and new perspectives. Hormones (Athens). 2009 Abstract Full text (link to original source) Full text (in our servers)
  12. Fumarola A, Calvanese A, Di Fiore A, Dainelli M, D'Armiento M. [Antithyroid drugs therapy]. Clin Ter. 2009 Abstract
  13. Azizi F. Treatment of post-partum thyrotoxicosis. J Endocrinol Invest. 2006 Abstract
  14. Clark SM, Saade GR, Snodgrass WR, Hankins GD. Pharmacokinetics and pharmacotherapy of thionamides in pregnancy. Ther Drug Monit. 2006 Abstract
  15. Azizi F. The safety and efficacy of antithyroid drugs. Expert Opin Drug Saf. 2006 Abstract
  16. Koren G, Soldin O. Therapeutic drug monitoring of antithyroid drugs in pregnancy: the knowledge gaps. Ther Drug Monit. 2006 Abstract Full text (link to original source) Full text (in our servers)
  17. Bartalena L, Tanda ML, Bogazzi F, Piantanida E, Lai A, Martino E. An update on the pharmacological management of hyperthyroidism due to Graves' disease. Expert Opin Pharmacother. 2005 Abstract Full text (link to original source) Full text (in our servers)
  18. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  19. Mandel SJ, Cooper DS. The use of antithyroid drugs in pregnancy and lactation. J Clin Endocrinol Metab. 2001 Abstract Full text (link to original source) Full text (in our servers)
  20. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001 Sep;108(3):776-89. Abstract Full text (link to original source) Full text (in our servers)
  21. Azizi F, Khoshniat M, Bahrainian M, Hedayati M. Thyroid function and intellectual development of infants nursed by mothers taking methimazole. J Clin Endocrinol Metab. 2000 Abstract Full text (link to original source) Full text (in our servers)
  22. Lee A, Moretti ME, Collantes A, Chong D, Mazzotta P, Koren G, Merchant SS, Ito S. Choice of breastfeeding and physicians' advice: a cohort study of women receiving propylthiouracil. Pediatrics. 2000 Abstract Full text (link to original source) Full text (in our servers)
  23. Momotani N, Yamashita R, Makino F, Noh JY, Ishikawa N, Ito K. Thyroid function in wholly breast-feeding infants whose mothers take high doses of propylthiouracil. Clin Endocrinol (Oxf). 2000 Abstract
  24. Momotani N, Yamashita R, Yoshimoto M, Noh J, Ishikawa N, Ito K. Recovery from foetal hypothyroidism: evidence for the safety of breast-feeding while taking propylthiouracil. Clin Endocrinol (Oxf). 1989 Abstract
  25. Cooper DS. Antithyroid drugs: to breast-feed or not to breast-feed. Am J Obstet Gynecol. 1987 Abstract
  26. Goldman JM. Propylthiouracil and breast-feeding. CMAJ. 1987 Abstract
  27. McDougall IR, Bayer MF. Should a woman taking propylthiouracil breast-feed? Clin Nucl Med. 1986 Abstract
  28. Lamberg BA, Ikonen E, Osterlund K, Teramo K, Pekonen F, Peltola J, Välimäki M. Antithyroid treatment of maternal hyperthyroidism during lactation. Clin Endocrinol (Oxf). 1984 Abstract
  29. Kampmann JP, Hansen JM. Clinical pharmacokinetics of antithyroid drugs. Clin Pharmacokinet. 1981 Abstract
  30. Tegler L, Lindström B. Antithyroid drugs in milk. Lancet. 1980 Abstract
  31. Kampmann JP, Johansen K, Hansen JM, Helweg J. Propylthiouracil in human milk. Revision of a dogma. Lancet. 1980 Abstract
  32. Low LC, Lang J, Alexander WD. Excretion of carbimazole and propylthiouracil in breast milk. Lancet. 1979 Abstract

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