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Methimazole-induced urticaria in hyperthyroid patients: A safe re-administration protocol.
Ferdaous Chahed1, Nadia Ben Fredj1, Haifa Ben Romdhane1
1Department of Clinical Pharmacology, University Hospital/Faculty of Medicine of Monastir, University of Monastir, 5000 Monastir, Tunisia.
Therapie
|February 25, 2024
Summary
Methimazole (MMI) is crucial for hyperthyroidism. Even with urticaria, MMI can be safely reintroduced using a gradual protocol with antihistamines, ensuring continued treatment success.
Area of Science:
- Endocrinology
- Pharmacology
- Dermatology
Background:
- Methimazole (MMI) is a preferred treatment for hyperthyroidism.
- Urticaria is a potential side effect of MMI.
- Safe re-administration protocols are essential for MMI-treated patients.
Purpose of the Study:
- To report a case series of methimazole-induced urticaria.
- To provide a stepwise protocol for the safe re-administration of MMI in patients with hyperthyroidism.
Main Methods:
- Retrospective case series of 11 patients with MMI-induced urticaria.
- Pharmacovigilance data from March 2013 to January 2022.
- Gradual MMI reintroduction protocol with antihistamines.
Main Results:
- Eleven patients (SR: 0.22) developed urticaria after MMI initiation (median 14.5 days, median dose 40mg).
- Urticaria resolved upon MMI withdrawal and antihistamine use.
- Successful MMI reintroduction in 10/11 patients using a stepwise dose escalation over 10 days with concurrent cetirizine.
Conclusions:
- MMI should not be withdrawn solely due to urticaria in hyperthyroid patients.
- A gradual reintroduction of MMI with antihistamine support is effective and safe.
- This approach allows for continued MMI therapy and successful hyperthyroidism management.
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