Propylthiouracil: clinical overview of its efficacy and its side effects more than 50 years after the introduction of its use in thyrostatic treatment

Abstract

This minireview gives a clinical overview of the efficacy and of the side effects of the thyrostatic drug propylthiouracil, which is in use for the treatment of Graves' disease for more than 5 decades. It is the aim of this minireview to give convincing evidence of the value of propythiouracil in the treatment of thyrotoxic patients with Graves' disease: The modalities of treatment are given. The advantages in comparison to methimazole are mentioned: Especially for thyrotoxic nursing mothers it represents the only thyrostatic drug approved by the American Academy of Pediatrics. Patients who experience side effects with methimazole usually can be switched successfully to propylthiouracil and vice versa. Its use for the treatment of thyrotoxicosis in pregnant women is recommended by many centres because of the comparatively little placental transfer of the drug, although the effect for the newborn does not seem to differ from that of methimazole. The minireview should remind the medical community of the value of propylthiouracil as a very valuable thyrostatic drug representing a good alternative to methimazole. It should attract interest in the drug, in spite of the fact that after 5 decades in the market there is probably only little financial profit left in selling it.