propylthiouracil / Generic mfg. - LARVOL DELTA

Fulminant Thyrotoxicosis-induced Cholestatic Liver Failure: Navigating Thyroid Management Amid Hepatotoxic Risk (ACG 2026) - "The patient was treated with methimazole, propranolol, corticosteroids, lactulose, rifaximin, antimicrobials, and hemodialysis...Management includes hemodynamic stabilization, beta-blockade, corticosteroids, and careful antithyroid selection, with methimazole preferred over propylthiouracil in significant liver dysfunction...Figure: Figure 2. Long-axis ultrasound of the right hepatic lobe showing gallbladder wall thickening and sludge without biliary ductal dilation, consistent with cholestatic changes."

Acute Kidney Injury • Atrial Fibrillation • Autoimmune Hepatitis • Cardiovascular • CNS Disorders • Endocrine Disorders • Hematological Disorders • Hepatology • Immunology • Infectious Disease • Inflammation • Liver Failure • Nephrology • Renal Disease • Respiratory Diseases • Thrombocytopenia

Acute Pancreatitis Following Methimazole Dose Escalation in Gravesâ Disease: A Rare Adverse Drug Reaction (ACG 2026) - "She was transitioned to propylthiouracil for management of hyperthyroidism with rapid clinical improvement. Application of the Naranjo Adverse Drug Reaction Probability Scale yielded a score of 6, consistent with a probable medicationârelated reaction. Clinicians should recognize methimazole as a rare cause of acute pancreatitis, particularly following recent initiation or dose escalation."

Adverse drug reaction • Dyslipidemia • Endocrine Disorders • Gastroenterology • Grave’s Disease • Hypertriglyceridemia • Infectious Disease • Inflammation • Mood Disorders • Pancreatitis • Severe Hypertriglyceridemia

Severe Hyperbilirubinemia in Gravesâ Thyrotoxicosis: A Therapeutic Dilemma in Cholestatic Liver Injury (ACG 2026) - "Severe hyperbilirubinemia creates a dilemma because antithyroid drugs, especially propylthiouracil (PTU), can cause hepatotoxicity...Despite hyperbilirubinemia, PTU was started with prednisone, cholestyramine, and close monitoring due to concern that thyrotoxicosis was perpetuating cholestatic liver injury...Figure: Figure 1. Liver Chemistry Improvement After PTU-Based Therapy"

Autoimmune Hepatitis • Cardiovascular • Cholestasis • Endocrine Disorders • Grave’s Disease • Hematological Malignancies • Hepatitis C • Hepatology • Immunology • Infectious Disease • Inflammation • Liver Failure • Multiple Myeloma • Portal Hypertension • Respiratory Diseases • Smoldering Multiple Myeloma

Propylthiouracil-Induced Liver Injury Treated With N-Acetyl Cysteine: A Case Report and Brief Literature Review (ACG 2026) - "Clinicians must maintain high suspicion for PTU-DILI in hyperthyroid patients with GI symptoms and educate them on warning signs. Further trials are needed to confirm NAC's benefit."

Case report • Clinical • Review • Endocrine Disorders • Hematological Disorders • Hepatology • Liver Failure

Refractory Graves' Disease With Propylthiouracil-Induced Hemophagocytic Lymphohistiocytosis and Multiple Drug Allergies Treated With Total Thyroidectomy: A Case Report. (PubMed, Cureus) - "Methimazole (MMI) and propylthiouracil (PTU) are commonly used, sometimes with adjunctive agents such as potassium iodide (KI), β-blockers, or corticosteroids...Due to multiple drug allergies, a drug-induced lymphocyte stimulation test was performed preoperatively and was positive for levothyroxine (LT4), although patch and oral provocation tests were negative, confirming LT4 safety...The course was uneventful, without allergic manifestations, and she was discharged in good condition. This case highlights the risk of severe hematologic complications from PTU and demonstrates that, with careful preoperative evaluation and individualized perioperative management, safe surgical treatment of refractory Graves' disease is possible."

Journal • Allergy • Endocrine Disorders • Fatigue • Grave’s Disease • Hematological Disorders • Hemophagocytic lymphohistiocytosis • Immunology • Rare Diseases

Correlation Between the TAS2R38 Genetic Polymorphism, PROP Perception and Eating Habits: A Cross-Sectional Molecular Epidemiological Study. (PubMed, Epidemiologia (Basel)) - "Background/Objectives: Genetic variation in bitter taste receptors, particularly TAS2R38, influences sensitivity to bitter compounds such as 6-n-propylthiouracil (PROP)... TAS2R38 polymorphism influenced bitter taste perception but showed limited relevance for food preferences and dietary habits. Lifestyle factors appeared more influential in shaping dietary behaviour."

Journal

Drug-associated central nervous system vasculitis and reversible cerebral vasoconstriction syndrome: A global disproportionality analysis of the WHO pharmacovigilance database (VigiBase). (PubMed, Br J Clin Pharmacol) - "Drug-associated CNSV and RCVS exhibit distinct pharmacological and temporal profiles, which may help inform drug withdrawal decisions and optimal management of these neurovascular emergencies."

Adverse events • Journal • Oncology • Ophthalmology • Thyroid Eye Disease • Vasculitis

Propylthiouracil-induced ANCA-associated vasculitis presenting as large tense bulla and extensive cutaneous necrosis: a case report (EADV 2026) - No abstract available

Case report • Clinical • ANCA Vasculitis • Vasculitis

Comparative transcriptomics reveals a core molecular signature of hypothyroid testis development across three TPO inhibitors. (PubMed, Ecotoxicol Environ Saf) - "Here, we build on previous work to define a molecular signature in testes from hypothyroid rats induced by three thyroperoxidase (TPO)-inhibiting chemicals: the pharmaceuticals propylthiouracil (PTU), and methimazole (MMI), and the pesticide amitrole (AMI). The shared transcriptional changes were associated with biological processes related to cell cycle regulation, developmental growth, and pathways involved in Sertoli cell proliferation, germ cell development, and testis morphogenesis. Collectively, these findings support the existence of a TH-mediated molecular signature that aligns with the classical morphologic phenotype of hypothyroid testis and underscores its potential value for the development of alternative, mechanism-based test methods for regulatory purposes."

Journal • Endocrine Disorders

Thyroid Storm Presenting With Refractory Atrial Arrhythmia and Tachycardia-Induced Dilated Cardiomyopathy: A Case Report. (PubMed, Cureus) - "Multiple rhythm-control and rate-control strategies were required, including direct-current cardioversion, adenosine, magnesium, digoxin, beta-blockers and escalating infusions. Amiodarone was discontinued following multidisciplinary review due to concerns regarding iodine-induced exacerbation of thyrotoxicosis. Thyroid storm was treated with propylthiouracil, Lugol's iodine, hydrocortisone, propranolol and cholestyramine. Serial echocardiography demonstrated interval improvement in left ventricular systolic function, supporting a reversible tachycardia-mediated mechanism. This case highlights the diagnostic and therapeutic complexity of thyroid storm with refractory arrhythmia and underscores the importance of early recognition, multidisciplinary management and careful selection of antiarrhythmic therapy."

Journal • Cardiomyopathy • Cardiovascular • Cognitive Disorders • Congestive Heart Failure • Endocrine Disorders • Grave’s Disease • Heart Failure • Hypertension • Metabolic Disorders • Pulmonary Arterial Hypertension • Pulmonary Disease • Respiratory Diseases

Maternal Kisspeptin-10 Treatment Partially Rescues Fetal and Postnatal Cardiac Programming Disrupted by Maternal Hypothyroidism. (PubMed, Cardiovasc Toxicol) - "MH was induced in Wistar rats using propylthiouracil (PTU), and Kp10 administration began on gestational day 8...However, it increased redox (8-OHdG) and endoplasmic reticulum (ER) stress (Grp78, Chop) mediators in fetal hearts, while reduced postnatal Chop expression in both sexes. Collectively, these findings demonstrate that maternal hypothyroidism disrupts cardiac development and postnatal cardiac programming, whereas maternal Kp10 administration partially mitigates these effects, highlighting novel mechanisms through which kisspeptin may positively regulate cardiac development."

IO biomarker • Journal • Cardiovascular • Endocrine Disorders • BAX • BCL2 • HSPA5

Context-dependent effects of triiodothyronine on progesterone secretion and cAMP responses in rat ovarian tissues. (PubMed, Endocr Connect) - "In vivo experiments confirmed that hyperthyroid conditions elevated ovarian cAMP content, whereas hypothyroidism induced by propylthiouracil (PTU) sensitized gonadotropin responsiveness. These results suggest that thyroid hormone status may influence ovarian function through cAMP-mediated mechanisms and highlight a potential link between thyroid dysfunction and altered reproductive endocrine regulation. Further studies are warranted to elucidate the underlying molecular pathways."

Journal • Preclinical • Endocrine Disorders

Propylthiouracil-induced MPO-ANCA positivity: a diagnostic challenge in thyroid disease (ETA 2026) - "Her medical history was notable for severe asthma, chronic sinonasal disease, and treatment with mepolizumab. This case highlights the diagnostic challenge of interpreting MPO-ANCA positivity in patients receiving PTU, particularly in the presence of respiratory comorbidities that may mimic vasculitic involvement. The absence of unequivocal systemic manifestations, together with serological negativization after PTU discontinuation, strongly supports PTU-induced MPO-ANCA positivity. Early recognition of this association and multidisciplinary evaluation are crucial to avoid misdiagnosis, unnecessary immunosuppression, and delays in appropriate thyroid treatment."

ANCA Vasculitis • Asthma • Endocrine Disorders • Glomerulonephritis • Hematological Disorders • Immunology • Inflammation • Lupus Nephritis • Nephrology • Otorhinolaryngology • Pneumonia • Respiratory Diseases • Vasculitis • MPO

Methimazole-Induced Agranulocytosis: A Case Report (ETA 2026) - "Treatment was initiated with piperacillin/tazobactam, filgrastim, and propylthiouracil (PTU) 200 mg every 8h, and methimazole was discontinued...PTU was discontinued, and propranolol 10 mg every 8h, hydrocortisone 100 mg every 8h, and cholestyramine 4 g every 8h were initiated... Routine monitoring of leukocyte counts is not recommended, as agranulocytosis occurs abruptly. Given its potential severity, it is essential to inform patients about warning signs and symptoms at the initiation of treatment with thionamides."

Case report • Clinical • Agranulocytosis • Dysphonia • Endocrine Disorders • Febrile Neutropenia • Gastrointestinal Disorder • Granulocytopenia • Grave’s Disease • Hematological Disorders • Infectious Disease • Leukopenia • Mood Disorders • Neutropenia • Otorhinolaryngology

Carbimazole resistant Graves' disease: A case report. (ETA 2026) - "Adjunctive therapy including beta-blockers, dexamethasone, and cholestyramine provided minimal biochemical improvement...The patient was subsequently switched to propylthiouracil (200 mg twice daily), with only partial biochemical response. Given persistent thyrotoxicosis and the risk of long-term drug toxicity, definitive surgical management with total thyroidectomy was undertaken, following which the patient achieved biochemical remission and was maintained on levothyroxine replacement... This case highlights the importance of recognizing true ATD resistance after excluding non-adherence and malabsorption. Early consideration of definitive therapy, particularly thyroidectomy, can provide rapid and effective control of hyperthyroidism when medical therapy fails."

Case report • Clinical • Cardiovascular • Celiac Disease • Endocrine Disorders • Grave’s Disease • Immunology • Movement Disorders • Ophthalmology

Skin Rash Following Initiation of Methimazole Therapy: A Diagnostic and Management Challenge in Graves’ Disease (ETA 2026) - "Treatment with methimazole, propranolol and insulin were initiated, and the patient was subsequently followed in the endocrinology clinic with progressive adjustment of insulin and methimazole dosages...Suspecting a hypersensitivity reaction to methimazole, treatment was switched to propylthiouracil until October 2025. During this period, she reported persistent pruritus without maculopapular lesions, leading to the switch back to methimazole with concomitant therapy with bilastine... Chronic spontaneous urticaria is commonly linked to underlying autoimmune conditions, particularly autoimmune thyroid disease, and may resemble antithyroid drug hypersensitivity, complicating the management of Graves disease. Therefore, the onset of urticaria after starting antithyroid drug therapy should not be automatically interpreted as drug hypersensitivity, and alternative diagnoses should be considered. This case emphasizes the importance of a multidisciplinary approach to ensure..."

Chronic Spontaneous Urticaria • Dermatology • Diabetes • Endocrine Disorders • Grave’s Disease • Immunology • Metabolic Disorders • Pruritus • Urticaria

Thyroid Dysfunction in One Twin Born to a Mother with Hyperthyroidism (ETA 2026) - "She was treated with propylthiouracil, and thyroid function was monitored... Discordant thyroid dysfunction may occur in twin pregnancies, underscoring the need for careful clinical and biochemical evaluation of all neonates exposed to maternal TRAb."

Cardiovascular • Endocrine Disorders

Optimization of the thyroid peroxidase inhibition assay in protein extracts derived from ex vivo (ETA 2026) - "A comparative analysis was conducted on the protein extracts, utilising the AUR assay, in basal condition and following treatment with specific TPO inhibitors, MMI (methimazole) and PTU (propylthiouracil). More importantly, it facilitates the storage of tissue samples collected at different time points, thereby eliminating the necessity for immediate processing. Consequently, experiments can be planned and organized more efficiently."

Preclinical

Thyroid Hormone Acts Independently of The Thyroid Hormone Receptor Beta in Hepatocytes to Improve Systemic Insulin Sensitivity (ETA 2026) - "In both genotypes we assessed euthyroid chow fed mice, hypothyroid mice on a propylthiouracil/low iodine diet with and without T3 treatment, and finally in euthyroid mice fed a high fat diet (HFD)... T3 signaling impacts systemic glucose homeostasis independently of its actions through the THR1 in hepatocytes."

Diabetes • Endocrine Disorders • Fibrosis • Hepatology • Immunology • Liver Cirrhosis • Metabolic Disorders • Metabolic Dysfunction-Associated Steatotic Liver Disease • Type 2 Diabetes Mellitus

Comparison of the Efficacy and safety of treatment protocol for Graves’ disease: a high-dose PTU monotherapy vs. a combination therapy of a low-dose PTU with potassium iodide (ETA 2026) - "Background: Propylthiouracil (PTU) has been one of the medications for Graves disease (GD) for more than 70 years. Although its use has declined due to drug-induced liver injury, there is still a need for PTU for patients who cannot be treated with Thiamazole... The Combination protocol of low-dose PTU and KI demonstrated quicker efficacy in decreasing FT4 level, but a certain percentage of patients may require an increase in the dose. Our results also showed that the low-dose PTU protocol could prevent severe adverse effects related to PTU."

Clinical • Combination therapy • Monotherapy • Agranulocytosis • Endocrine Disorders • Granulocytopenia • Grave’s Disease • Hepatology • Liver Failure

Severe symptomatic hypocalcemia with probable transient parathyroid dysfunction following radioiodine therapy for Graves' disease: a case report. (PubMed, Oxf Med Case Reports) - "A 66-year-old woman with a 30-year history of Graves' disease underwent RAIT (555 MBq 131I) after long-term treatment with thiamazole and briefly with propylthiouracil without achieving remission. She later developed post-RAIT hypothyroidism. This case highlights the importance of considering transient parathyroid dysfunction in patients with symptomatic hypocalcemia after RAIT and supports long-term biochemical monitoring and supplementation."

Journal • Endocrine Disorders • Grave’s Disease • Hypoparathyroidism

Impact of propylthiouracil-induced thyroid hormone deficiency on reproduction and larval development in Japanese medaka (Oryzias latipes). (PubMed, Comp Biochem Physiol C Toxicol Pharmacol) - "These findings indicate that TH-responsive molecular and organ-/tissue-level endpoints are not necessarily directly relevant to population-level adverse outcomes and should be interpreted carefully. Overall, this study supports the utility of medaka as a model for evaluating thyroid active substances and highlights the importance of a weight-of-evidence approach integrating diverse endpoints for the assessment of endocrine-disrupting chemicals in aquatic environments."

Journal

Management of hyperthyroidism in pregnancy. (PubMed, Endocr Pract) - "Propylthiouracil is preferred during the first trimester to reduce teratogenic risk. Methimazole is considered safe during lactation at low doses, with no adverse effects on infant growth or neurodevelopment, while radioactive iodine therapy remains contraindicated. Collectively, contemporary evidence emphasizes early diagnosis, individualized therapy, and multidisciplinary care as central to optimizing maternal and fetal outcomes in hyperthyroidism during the reproductive years."

Journal • Review • Endocrine Disorders • Grave’s Disease • Gynecology • Immunology

Discovery and Preclinical Characterization of NE-2-6 as a Potent Thyroid Peroxidase Inhibitor with Antithyroid Activity. (PubMed, Antioxidants (Basel)) - "However, current TPO-targeting drugs, such as propylthiouracil, have limited selectivity and can cause serious adverse effects...In the Ad-TSHR289-induced thyroid hyperfunction model, NE-2-6 reduced serum T4 levels, supporting antithyroid pharmacodynamic activity. Because autoimmune endpoints and dose-matched PK-PD relationships were not fully assessed, the findings should be interpreted as preliminary preclinical evidence supporting further evaluation of NE-2-6 as a TPO-targeting antithyroid candidate."

Journal • Preclinical • Endocrine Disorders • Grave’s Disease • Immunology • MPO

Identification of Epigenetic Regulator-Associated Genes in Keloid Disease Through Integrated Bulk and Single-Cell Transcriptomics With RT-qPCR Validation. (PubMed, FASEB J) - "Computational screening identified 10 potential compounds for HR (including propylthiouracil, estradiol, and triiodothyronine) and 8 compounds for SMYD4 (including acetaminophen, bisphenol A, and pirinixic acid)...Clinical validation confirmed these expression patterns. In the present investigation, two key genes associated with epigenetic factor were obtained, which might serve as potential exploratory biomarkers and warrant further epigenetic mechanistic investigation."

Journal • Fibrosis