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Chemistry

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Also known as: 60-56-0, Thiamazole, Tapazole, 2-mercapto-1-methylimidazole, 1-methylimidazole-2-thiol, Mercazolyl
Molecular Formula
C4H6N2S
Molecular Weight
114.17  g/mol
InChI Key
PMRYVIKBURPHAH-UHFFFAOYSA-N
FDA UNII
554Z48XN5E

Methimazole
A thioureylene antithyroid agent that inhibits the formation of thyroid hormones by interfering with the incorporation of iodine into tyrosyl residues of thyroglobulin. This is done by interfering with the oxidation of iodide ion and iodotyrosyl groups through inhibition of the peroxidase enzyme.
Methimazole is a Thyroid Hormone Synthesis Inhibitor. The mechanism of action of methimazole is as a Thyroid Hormone Synthesis Inhibitor.
1 2D Structure

Methimazole

2 Identification
2.1 Computed Descriptors
2.1.1 IUPAC Name
3-methyl-1H-imidazole-2-thione
2.1.2 InChI
InChI=1S/C4H6N2S/c1-6-3-2-5-4(6)7/h2-3H,1H3,(H,5,7)
2.1.3 InChI Key
PMRYVIKBURPHAH-UHFFFAOYSA-N
2.1.4 Canonical SMILES
CN1C=CNC1=S
2.2 Other Identifiers
2.2.1 UNII
554Z48XN5E
2.3 Synonyms
2.3.1 MeSH Synonyms

1. 1 Methyl 2 Mercaptoimidazole

2. 1-methyl-2-mercaptoimidazole

3. Favistan

4. Henning, Thiamazol

5. Hexal, Thiamazol

6. Mercasolyl

7. Mercazol

8. Mercazole

9. Mercazolyl

10. Merkazolil

11. Methizol

12. Methylmercaptoimidazole

13. Methymazol

14. Metisol

15. Metizol

16. Strumazol

17. Tapazole

18. Thiamazol Henning

19. Thiamazol Hexal

20. Thiamazole

21. Thimazol

22. Thyrozol

23. Tiamazol

24. Tirodril

2.3.2 Depositor-Supplied Synonyms

1. 60-56-0

2. Thiamazole

3. Tapazole

4. 2-mercapto-1-methylimidazole

5. 1-methylimidazole-2-thiol

6. Mercazolyl

7. Methimazol

8. Favistan

9. Mercazole

10. Metazolo

11. Thymidazol

12. Thymidazole

13. 1-methyl-1h-imidazole-2-thiol

14. Mercaptazole

15. Merkazolil

16. Metothyrin

17. Metothyrine

18. Strumazol

19. Thiamazol

20. Thycapzol

21. Basolan

22. Danantizol

23. Frentirox

24. Merkastan

25. Metotirin

26. Thacapzol

27. Thycapsol

28. Metizol

29. Mercasolyl

30. Methylmercaptoimidazole

31. 1-methyl-2-mercaptoimidazole

32. Methiamazole

33. 2h-imidazole-2-thione, 1,3-dihydro-1-methyl-

34. 3-methyl-1h-imidazole-2-thione

35. Usaf El-30

36. N-methyl-2-mercaptoimidazole

37. Tapuzole

38. Thimazole

39. 1-methyl-1,3-dihydro-2h-imidazole-2-thione

40. 1-methyl-2-imidazolethiol

41. 1-methyl-1h-imidazole-2(3h)-thione

42. 2-mercaptomethylimidazole

43. 1,3-dihydro-1-methyl-2h-imidazole-2-thione

44. 1-methylimidazole-2(3h)-thione

45. Imidazole-2-thiol, 1-methyl-

46. 1-metylo 2 Merkaptoimidazolem

47. Mercaptizole

48. 1-methyl-1,3-dihydroimidazole-2-thione

49. 4-imidazoline-2-thione, 1-methyl-

50. Mfcd00179321

51. Thiamazole [inn]

52. Methimazole (usp)

53. Methimazole [usp]

54. Nsc-38608

55. Tiamazol

56. Chembl1515

57. Mercazolylum

58. Methimazolum

59. Metimazol

60. 1-methyl-2,3-dihydro-1h-imidazole-2-thione

61. Chebi:50673

62. Imidazole, 1-methyl-2-mercapto-

63. 554z48xn5e

64. Nsc38608

65. 223768-14-7

66. Cas-60-56-0

67. Tiamazolo [dcit]

68. Ncgc00016273-01

69. Methamazole

70. Thiamazolum

71. Strumazole

72. Tiamazolo

73. Dsstox_cid_820

74. Thiamazol [inn-french]

75. Tiamazol [inn-spanish]

76. Dsstox_rid_75808

77. Dsstox_gsid_20820

78. Thiamazolum [inn-latin]

79. 85916-84-3

80. Mmz

81. Felimazole

82. Tapazole (tn)

83. Smr000058376

84. 1-metylo 2 Merkaptoimidazolem [polish]

85. Hsdb 3361

86. Sr-05000001672

87. Einecs 200-482-4

88. Nsc 38608

89. 1-methyl-imidazole-2-thiol

90. Tiamazole

91. Unii-554z48xn5e

92. Ai3-60285

93. 1,3-dihydro-1-methyl-2h-imidazol-2-thione

94. Thiamazole,(s)

95. 2-mercapto-1-methyl-1h-imidazole

96. Prestwick_1010

97. Spectrum_000995

98. Methimazole [mi]

99. Thiamazole [jan]

100. Prestwick0_000786

101. Prestwick1_000786

102. Prestwick2_000786

103. Prestwick3_000786

104. Spectrum2_001273

105. Spectrum3_000495

106. Spectrum4_000048

107. Spectrum5_000954

108. M0868

109. Methimazole [hsdb]

110. Methimazole [iarc]

111. Thiamazole (jp17/inn)

112. 1-methylimidazole-2-thione

113. Methimazole [vandf]

114. Methimazole-d3(methyl-d3)

115. N-methyl Imidazole-2-thiol

116. Thiamazole [mart.]

117. 2-mecapto 1-methylimidazole

118. 2-mercapto-1-methylimidazol

119. Thiamazole [who-dd]

120. 2-mercapto-n-methylimidazole

121. Schembl41647

122. 2-mercapto-3-methylimidazole

123. Bspbio_000892

124. Bspbio_001989

125. Kbiogr_000515

126. Kbioss_001475

127. Methimazole [usp-rs]

128. Mls000028413

129. Mls002548853

130. Bidd:gt0163

131. Divk1c_000188

132. Spectrum1500396

133. Wln: T5n Cnj A Bsh

134. 1-methyl-2-mercapto-imidazole

135. 2-mercapto-1-methyl-imidazole

136. Spbio_001266

137. Spbio_002831

138. 1-methyl-2-mercapto Imidazole

139. Imidazole-2-thio, 1-methyl-

140. Bpbio1_000982

141. Gtpl6649

142. Methimazole, Analytical Standard

143. Dtxsid4020820

144. Methimazole (tapazole, Northyx)

145. 1-methyl-1h-immidazole-2-thiol

146. 1-methyl-3h-imidazole-2-thione

147. Hms500j10

148. Kbio1_000188

149. Kbio2_001475

150. Kbio2_004043

151. Kbio2_006611

152. Kbio3_001489

153. Methimazole [orange Book]

154. Thiamazole [ep Monograph]

155. 1-methyl-1-h-imidazole-2-thiol

156. Ninds_000188

157. Hms1570m14

158. Hms1920l17

159. Hms2090b17

160. Hms2091d12

161. Hms2094c05

162. Hms2097m14

163. Hms3259l09

164. Hms3651i13

165. Hms3714m14

166. Pharmakon1600-01500396

167. Methimazole [usp Monograph]

168. 1-methyl-1h-imidazole-2-thiol #

169. Amy11202

170. Bcp02147

171. Hy-b0208

172. Str03572

173. Zinc1187543

174. Tox21_110341

175. Tox21_201341

176. Tox21_300532

177. Ac-785

178. Bdbm50241361

179. Ccg-39656

180. Nsc757111

181. S1609

182. Stk300018

183. Stk802184

184. Akos000119427

185. Akos000269708

186. Tox21_110341_1

187. Bs-3743

188. Ccg-220786

189. Db00763

190. Nc00636

191. Nsc-757111

192. 2-mercapto-1-methylimidazole, >=99%

193. Idi1_000188

194. Ncgc00016273-02

195. Ncgc00016273-03

196. Ncgc00094721-01

197. Ncgc00094721-02

198. Ncgc00094721-03

199. Ncgc00094721-04

200. Ncgc00094721-05

201. Ncgc00094721-06

202. Ncgc00094721-07

203. Ncgc00178875-01

204. Ncgc00254307-01

205. Ncgc00258893-01

206. Methimazol 100 Microg/ml In Acetonitrile

207. Sbi-0206922.p001

208. Sbi-0206922.p004

209. Db-053649

210. 2h-imidazole-2-thione,3-dihydro-1-methyl-

211. Ft-0603253

212. Sw197088-3

213. C07190

214. D00401

215. H10722

216. Ab00443630-03

217. Ab00443630-04

218. Ab00443630_06

219. Ab00443630_07

220. Methimazole, Vetranal(tm), Analytical Standard

221. A832780

222. Q419663

223. Sr-01000695434

224. Q-201364

225. Sr-01000695434-2

226. Sr-05000001672-1

227. Sr-05000001672-2

228. Brd-k54416256-001-15-7

229. Z57901905

230. F0001-2396

231. F1679-0258

232. Thiamazole, European Pharmacopoeia (ep) Reference Standard

233. Methimazole, United States Pharmacopeia (usp) Reference Standard

2.4 Create Date
2005-03-25
3 Chemical and Physical Properties
Molecular Weight 114.17 g/mol
Molecular Formula C4H6N2S
XLogP3-0.3
Hydrogen Bond Donor Count1
Hydrogen Bond Acceptor Count1
Rotatable Bond Count0
Exact Mass114.02516937 g/mol
Monoisotopic Mass114.02516937 g/mol
Topological Polar Surface Area47.4 Ų
Heavy Atom Count7
Formal Charge0
Complexity119
Isotope Atom Count0
Defined Atom Stereocenter Count0
Undefined Atom Stereocenter Count0
Defined Bond Stereocenter Count0
Undefined Bond Stereocenter Count0
Covalently Bonded Unit Count1
4 Drug and Medication Information
4.1 Drug Information
1 of 4  
Drug NameMethimazole
PubMed HealthMethimazole (By mouth)
Drug ClassesAntithyroid Agent
Drug LabelMethimazole (1-methylimidazole-2-thiol) is a white, crystalline substance that is freely soluble in water. It differs chemically from the drugs of the thiouracil series primarily because it has a 5- instead of a 6-membered ring.Each tablet contains 5...
Active IngredientMethimazole
Dosage FormTablet
Routeoral; Oral
Strength5mg; 10mg; 20mg
Market StatusPrescription
CompanyVintage Pharms; Cedar Pharms; Sun Pharm Inds; Sandoz; Emcure Pharms Usa; Mylan

2 of 4  
Drug NameTapazole
PubMed HealthMethimazole (By mouth)
Drug ClassesAntithyroid Agent
Drug LabelTAPAZOLE (Methimazole Tablets, USP) (1-methylimidazole-2-thiol) is a white, crystalline substance that is freely soluble in water. It differs chemically from the drugs of the thiouracil series primarily because it has a 5- instead of a 6-membered r...
Active IngredientMethimazole
Dosage FormTablet
RouteOral
Strength5mg; 10mg
Market StatusPrescription
CompanyKing Pharms

3 of 4  
Drug NameMethimazole
PubMed HealthMethimazole (By mouth)
Drug ClassesAntithyroid Agent
Drug LabelMethimazole (1-methylimidazole-2-thiol) is a white, crystalline substance that is freely soluble in water. It differs chemically from the drugs of the thiouracil series primarily because it has a 5- instead of a 6-membered ring.Each tablet contains 5...
Active IngredientMethimazole
Dosage FormTablet
Routeoral; Oral
Strength5mg; 10mg; 20mg
Market StatusPrescription
CompanyVintage Pharms; Cedar Pharms; Sun Pharm Inds; Sandoz; Emcure Pharms Usa; Mylan

4 of 4  
Drug NameTapazole
PubMed HealthMethimazole (By mouth)
Drug ClassesAntithyroid Agent
Drug LabelTAPAZOLE (Methimazole Tablets, USP) (1-methylimidazole-2-thiol) is a white, crystalline substance that is freely soluble in water. It differs chemically from the drugs of the thiouracil series primarily because it has a 5- instead of a 6-membered r...
Active IngredientMethimazole
Dosage FormTablet
RouteOral
Strength5mg; 10mg
Market StatusPrescription
CompanyKing Pharms

4.2 Therapeutic Uses

Antithyroid Agents

National Library of Medicine's Medical Subject Headings online file (MeSH, 1999)


METHIMAZOLE IS APPROX 10 TIMES AS POTENT AS PROPYLTHIOURACIL & IS MORE PROMPT IN ELICITING ANTITHYROID RESPONSE. DRUG ALSO EXHIBITS MORE PROLONGED ACTION THAN PROPYLTHIOURACIL...

Osol, A. and J.E. Hoover, et al. (eds.). Remington's Pharmaceutical Sciences. 15th ed. Easton, Pennsylvania: Mack Publishing Co., 1975., p. 911


...USED IN TREATMENT OF HYPERTHYROIDISM...(1) AS DEFINITIVE TREATMENT, TO CONTROL DISORDER IN ANTICIPATION OF SPONTANEOUS REMISSION IN GRAVE'S DISEASE; (2) IN CONJUNCTION WITH RADIOIODINE, TO HASTEN RECOVERY WHILE AWAITING EFFECTS OF RADIATION; & (3) TO CONTROL DISORDER IN PREPN FOR SURGICAL TREATMENT. /ANTITHYROID DRUGS/

Hardman, J.G., L.E. Limbird, P.B. Molinoff, R.W. Ruddon, A.G. Goodman (eds.). Goodman and Gilman's The Pharmacological Basis of Therapeutics. 9th ed. New York, NY: McGraw-Hill, 1996., p. 1400


THERE ARE NO COMMERCIAL PREPN AVAIL FOR PARENTERAL USE IN RARE EVENT THAT TREATMENT CANNOT BE GIVEN BY MOUTH. FOR THIS EVENTUALITY & FOR EXPTL PURPOSES, FREELY WATER-SOL COMPD, METHIMAZOLE, CAN BE DISSOLVED IN SALINE SOLN & STERILIZED BY HEAT.

Goodman, L.S., and A. Gilman. (eds.) The Pharmacological Basis of Therapeutics. 5th ed. New York: Macmillan Publishing Co., Inc., 1975., p. 1412


Methimazole /is/ indicated in the treatment of hyperthyroidism, including prior to surgery or radiotherapy, and as adjunct in the treatment of thyrotoxicosis or thyroid storm. Propylthiouracil may be preferred over methimazole for use in thyroid storm, since propylthiouracil inhibits peripheral conversion of thyroxine (T4) to triiodothyronine (T3). /Included in US product labeling/

USP Convention. USPDI - Drug Information for the Health Care Professional. 17th ed. Volume I. Rockville, MD: Convention, Inc., 1997. (Plus Updates)., p. 436


4.3 Drug Warning

...WOMEN TAKING THESE AGENTS SHOULD NOT BREAST-FEED THEIR INFANTS. /ANTITHYROID DRUGS/

Goodman, L.S., and A. Gilman. (eds.) The Pharmacological Basis of Therapeutics. 5th ed. New York: Macmillan Publishing Co., Inc., 1975., p. 1413


BECAUSE AGRANULOCYTOSIS CAN DEVELOP RAPIDLY, PERIODIC WHITE-CELL COUNTS ARE OF LITTLE HELP. PATIENTS SHOULD IMMEDIATELY REPORT DEVELOPMENT OF SORE THROAT OR FEVER, WHICH USUALLY HERALDS ONSET OF THIS REACTION.

Hardman, J.G., L.E. Limbird, P.B. Molinoff, R.W. Ruddon, A.G. Goodman (eds.). Goodman and Gilman's The Pharmacological Basis of Therapeutics. 9th ed. New York, NY: McGraw-Hill, 1996., p. 1399


MAIN DRAWBACK TO THERAPY WITH ANTITHYROID DRUGS IS HIGH INCIDENCE OF RELAPSE WHEN TREATMENT IS STOPPED. ... FREQUENT TAKING OF MEDICATION FOR LONG PERIODS OF TIME IS ANOTHER DISADVANTAGE &, ALTHOUGH UNTOWARD REACTIONS...ARE NOT FREQUENT & RARELY SERIOUS, THEY CONSTITUTE FURTHER DISADVANTAGE.

Goodman, L.S., and A. Gilman. (eds.) The Pharmacological Basis of Therapeutics. 5th ed. New York: Macmillan Publishing Co., Inc., 1975., p. 1414


CROSS SENSITIVITY TO OTHER THIOAMIDE DERIVATIVES MAY OCCUR IN SUSCEPTIBLE PT.

American Medical Association, AMA Department of Drugs, AMA Drug Evaluations. 3rd ed. Littleton, Massachusetts: PSG Publishing Co., Inc., 1977., p. 611


For more Drug Warnings (Complete) data for METHIMAZOLE (13 total), please visit the HSDB record page.


4.4 Drug Indication

In the United States, methimazole is indicated for the treatment of hyperthyroidism in patients with Graves' disease or toxic multinodular goiter for whom thyroidectomy or radioactive iodine therapy are not appropriate treatment options. Methimazole is also indicated for the amelioration of hyperthyroid symptoms in preparation for thyroidectomy or radioactive iodine therapy. In Canada, methimazole carries the above indications and is also indicated for the medical treatment of hyperthyroidism regardless of other available treatment options.


5 Pharmacology and Biochemistry
5.1 Pharmacology

Methimazole inhibits the synthesis of thyroid hormones resulting in an alleviation of hyperthyroidism. Onset of action occurs within 12 to 18 hours, and its duration of action is 36 to 72 hours, likely due to concentration of methimazole and some metabolites within the thyroid gland after administration. The most serious potential side effect of methimazole therapy is agranulocytosis, and patients should be instructed to monitor for, and report, any signs or symptoms of agranulocytosis such as fever or sore throat. Other cytopenias may also occur during methimazole therapy. There also exists the potential for severe hepatic toxicity with the use of methimazole, and monitoring for signs and symptoms of hepatic dysfunction, such as jaundice, anorexia, pruritus, and elevation in liver transaminases, is prudent in patients using this therapy.


5.2 MeSH Pharmacological Classification

Antithyroid Agents

Agents that are used to treat hyperthyroidism by reducing the excessive production of thyroid hormones. (See all compounds classified as Antithyroid Agents.)


5.3 FDA Pharmacological Classification
5.3.1 Active Moiety
METHIMAZOLE
5.3.2 FDA UNII
554Z48XN5E
5.3.3 Pharmacological Classes
Thyroid Hormone Synthesis Inhibitors [MoA]; Thyroid Hormone Synthesis Inhibitor [EPC]
5.4 ATC Code

H03BB02

S76 | LUXPHARMA | Pharmaceuticals Marketed in Luxembourg | Pharmaceuticals marketed in Luxembourg, as published by d'Gesondheetskeess (CNS, la caisse nationale de sante, www.cns.lu), mapped by name to structures using CompTox by R. Singh et al. (in prep.). List downloaded from https://cns.public.lu/en/legislations/textes-coordonnes/liste-med-comm.html. Dataset DOI:10.5281/zenodo.4587355


H - Systemic hormonal preparations, excl. sex hormones and insulins

H03 - Thyroid therapy

H03B - Antithyroid preparations

H03BB - Sulfur-containing imidazole derivatives

H03BB02 - Thiamazole


5.5 Absorption, Distribution and Excretion

Absorption

Absorption of methimazole after oral administration is rapid and extensive, with an absolute bioavailability of approximately 0.93 and a Tmax ranging from 0.25 to 4.0 hours. Cmax is slightly, but not significantly, higher in hyperthyroid patients, and both Cmax and AUC are significantly affected by the oral dose administered.


Route of Elimination

Urinary excretion of unchanged methimazole has been reported to be between 7% and 12%. Elimination via feces appears to be limited, with a cumulative fecal excretion of 3% after administration of methimazole. Enterohepatic circulation also appears to play a role in the elimination of methimazole and its metabolites, as significant amounts of these substances are found in the bile post-administration.


Volume of Distribution

The apparent volume of distribution of methimazole has been reported as roughly 20 L. Following oral administration, methimazole is highly concentrated in the thyroid gland - intrathyroidal methimazole levels are approximately 2 to 5 times higher than peak plasma levels, and remain high for 20 hours after ingestion.


Clearance

Following a single intravenous bolus injection of 10mg of methimazole, clearance was found to be 5.70 L/h. Renal impairment does not appear to alter clearance of methimazole, but patients with hepatic impairment showed a reduction in clearance roughly proportional to the severity of their impairment - moderate insufficiency resulted in a clearance of 3.49 L/h, while severe insufficiency resulted in a clearance of 0.83 L/h. There does not appear to be any significant differences in clearance based on thyroid status (i.e. no difference between euthyroid and hyperthyroid patients).


FOUR DAYS AFTER IV ADMIN OF (14)C-METHIMAZOLE TO RATS, RETENTION OF (14)C WAS GREATEST IN THYROID & ADRENALS; 76% OF DOSE HAD BEEN EXCRETED IN URINE & 6% IN FECES.

The Chemical Society. Foreign Compound Metabolism in Mammals. Volume 2: A Review of the Literature Published Between 1970 and 1971. London: The Chemical Society, 1972., p. 114


(14)C-METHIMAZOLE RADIOACTIVITY CONCENTRATES MORE IN THE THYROID THAN IN ANY OTHER TISSUE, WITH THYROID:PLASMA RATIO REACHING 62.5 AFTER 4 DAYS' CONTINUOUS DOSING.

The Chemical Society. Foreign Compound Metabolism in Mammals Volume 3. London: The Chemical Society, 1975., p. 164


COMPLETE ABSORPTION...FROM ORAL DOSES...DEMONSTRATED IN RATS. ...IS NEGLIGIBLY BOUND TO PLASMA PROTEINS &...EXHIBITS SINGLE-COMPARTMENT KINETICS EVEN AFTER IV DOSES. ...ATTRIBUTED TO FASTER TISSUE PENETRATION BY METHIMAZOLE DUE TO ITS HIGHER LIPID:WATER PARTITION COEFFICIENT.

The Chemical Society. Foreign Compound Metabolism in Mammals Volume 3. London: The Chemical Society, 1975., p. 164


BILIARY EXCRETION OF RADIOACTIVITY FROM...(35)S-METHIMAZOLE...AMOUNTED TO ONLY 21%...OF IV DOSES. BILIARY RADIOACTIVITY WAS ALMOST ENTIRELY DUE TO METABOLITES...

The Chemical Society. Foreign Compound Metabolism in Mammals Volume 3. London: The Chemical Society, 1975., p. 163


For more Absorption, Distribution and Excretion (Complete) data for METHIMAZOLE (9 total), please visit the HSDB record page.


5.6 Metabolism/Metabolites

Methimazole is rapidly and extensively metabolized by the liver, mainly via the CYP450 and FMO enzyme systems. Several metabolites have been identified, though the specific enzyme isoforms responsible for their formation are not entirely clear. One of the first methimazole metabolites identified, 3-methyl-2-thiohydantoin, may contribute to antithyroid activity - its antithyroid activity has been demonstrated in rats and may explain the prolonged duration of iodination inhibition following administration despite methimazole's relatively short half-life. A number of metabolites have been investigated as being the culprits behind methimazole-induced hepatotoxicity. Both glyoxal and N-methylthiourea have established cytotoxicity and are known metabolic products of methimazole's dihydrodiol intermediate. Sulfenic and sulfinic acid derivatives of methimazole are thought to be the ultimate toxicants responsible for hepatotoxicity, though their origin is unclear - they may arise from direct oxidation of methimazole via FMO, or from oxidation of N-methylthiourea further downstream in the metabolic process.


ADMIN...TO SPRAGUE-DAWLEY RATS...UP TO 21% OF DOSE...EXCRETED UNCHANGED IN 24-HR URINE, IN WHICH MAJOR METABOLITE WAS...GLUCURONIDE (36-48%); REMAINING URINARY METABOLITE HAS NOT BEEN IDENTIFIED.

The Chemical Society. Foreign Compound Metabolism in Mammals Volume 3. London: The Chemical Society, 1975., p. 307


INCUBATION OF METHIMAZOLE WITH RAT HEPATIC MICROSOMES LED TO FORMATION OF 3-METHYL-2-THIOHYDANTOIN & N-METHYLIMIDAZOLE.

LEE PW, NEAL RA; DRUG METAB DISPOS 6(5) 591 (1978)


5.7 Biological Half-Life

Following a single intravenous bolus injection of 10mg of methimazole, the t1/2 of the distribution phase was 0.17 hours and the t1/2 of the elimination phase was 5.3 hours. Methimazole's primary active metabolite, 3-methyl-2-thiohydantoin, has a half-life approximately 3 times longer than its parent drug. Renal impairment does not appear to alter the half-life of methimazole, but patients with hepatic impairment showed an increase in half-life roughly proportional to the severity of their impairment - moderate insufficiency resulted in a elimination t1/2 of 7.1 hours, while severe insufficiency resulted in an elimination t1/2 of 22.1 hours. There does not appear to be any significant differences in half-life based on thyroid status (i.e. no difference between euthyroid and hyperthyroid patients).


Plasma half-life is 3-5 hr

Ellenhorn, M.J., S. Schonwald, G. Ordog, J. Wasserberger. Ellenhorn's Medical Toxicology: Diagnosis and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams and Wilkins, 1997.


The elimination half-life of methimazole reportedly ranges from about 5-13 hours.

McEvoy, G.K. (ed.). American Hospital Formulary Service-Drug Information 19 98. Bethesda, MD: American Society of Health-System Pharmacists, Inc. 1998 (Plus Supplements)., p. 2650


T/2...IN PLASMA...FOR METHIMAZOLE IS ABOUT 4-6 HR. ...

Hardman, J.G., L.E. Limbird, P.B. Molinoff, R.W. Ruddon, A.G. Goodman (eds.). Goodman and Gilman's The Pharmacological Basis of Therapeutics. 9th ed. New York, NY: McGraw-Hill, 1996., p. 1399


5.8 Mechanism of Action

Methimazole's primary mechanism of action appears to be interference in an early step in thyroid hormone synthesis involving thyroid peroxidase (TPO), however the exact method through which methimazole inhibits this step is unclear. TPO, along with hydrogen peroxide, normally catalyzes the conversion of iodide to iodine and then further catalyzes the incorporation of this iodine onto the 3 and/or 5 positions of the phenol rings of tyrosine residues in thyroglobulin. These thyroglobulin molecules then degrade within thyroid follicular cells to form either thyroxine (T4) or tri-iodothyronine (T3), which are the main hormones produced by the thyroid gland. Methimazole may directly inhibit TPO, but has been shown in vivo to instead act as a competitive substrate for TPO, thus becoming iodinated itself and interfering with the iodination of thyroglobulin. Another proposed theory is that methimazoles sulfur moiety may interact directly with the iron atom at the centre of TPOs heme molecule, thus inhibiting its ability to iodinate tyrosine residues. Other proposed mechanisms with weaker evidence include methimazole binding directly to thyroglobulin or direct inhibition of thyroglobulin itself.


ANTITHYROID DRUGS INHIBIT FORMATION OF THYROID HORMONE LARGELY BY INTERFERING WITH INCORPORATION OF IODINE INTO ORGANIC FORM. ...IMPLIES THAT THEY INTERFERE WITH OXIDATION OF IODIDE ION.../WHICH/ IS PROBABLY BROUGHT ABOUT BY PEROXIDASE. /ANTITHYROID DRUGS/

Goodman, L.S., and A. Gilman. (eds.) The Pharmacological Basis of Therapeutics. 5th ed. New York: Macmillan Publishing Co., Inc., 1975., p. 1411


ANTITHYROID DRUGS INHIBIT THE FORMATION OF THYROID HORMONES BY ITERFERING WITH THE INCORPORATION OF IODINE INTO TYROSYL RESIDUES OF THYROGLOBULIN; THEY ALSO INHIBIT THE COUPLING OF THESE IODOTYROSYL RESIDUES TO FORM IODOTHYRONINES.

Hardman, J.G., L.E. Limbird, P.B. Molinoff, R.W. Ruddon, A.G. Goodman (eds.). Goodman and Gilman's The Pharmacological Basis of Therapeutics. 9th ed. New York, NY: McGraw-Hill, 1996., p. 1398


Methimazole inhibits the synthesis of thyroid hormones by interfering with the incorporation of iodine into tyrosyl residues of thyroglobulin; the drug also inhibits the coupling of these iodotyrosyl residues to form iodothyronine. Although the exact mechanism(s) has not been fully elucidated, methimazole may interfere with the oxidation of iodide ion and iodotyrosyl groups. Based on limited evidence, it appears that the coupling reaction is more sensitive to antithyroid agents than the iodination reaction. Methimazole does not inhibit the action of thyroid hormones already formed and present in the thyroid gland or circulation nor does the drug interfere with the effectiveness of exogenously administered thyroid hormones.

McEvoy, G.K. (ed.). American Hospital Formulary Service-Drug Information 19 98. Bethesda, MD: American Society of Health-System Pharmacists, Inc. 1998 (Plus Supplements)., p. 2650


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28-May-2021
29-Oct-2024
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