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| ln Vitro |
In human beta cells, methimazole TNF for CXC chemokine ligand 10 [3].
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| ADME/Pharmacokinetics |
Absorption, Distribution and Excretion
Methimazole is rapidly and extensively absorbed after oral administration, with an absolute bioavailability of approximately 0.93 and a time to peak concentration (Tmax) ranging from 0.25 to 4.0 hours. Peak plasma concentrations (Cmax) are slightly elevated in patients with hyperthyroidism, but the difference is not statistically significant. Both Cmax and AUC are significantly affected by the oral dose. The urinary excretion rate of unmetabolized methimazole is reported to be 7% to 12%. Fecal excretion appears to be limited, with a cumulative fecal excretion rate of 3% after methimazole administration. Enterohepatic circulation also appears to be involved in the clearance of methimazole and its metabolites, as significant amounts of these substances have been detected in bile after administration. The apparent volume of distribution of methimazole is reported to be approximately 20 liters. After oral administration, methimazole is highly concentrated in the thyroid gland—the concentration of methimazole in the thyroid is approximately 2 to 5 times the peak plasma concentration, and remains at a high level for up to 20 hours after ingestion. After a single intravenous bolus injection of 10 mg methimazole, the clearance rate was 5.70 L/h. Renal impairment did not appear to affect the clearance rate of methimazole, but the clearance rate decreased in patients with hepatic impairment in roughly proportional to the severity of hepatic impairment—moderate hepatic impairment resulted in a clearance rate of 3.49 L/h, while severe hepatic impairment resulted in a clearance rate of 0.83 L/h. There appeared to be no significant difference in clearance rate based on thyroid status (i.e., between patients with euthyroid and hyperthyroidism). Four days after intravenous injection of 14C-methimazole in rats, the highest retention of 14C was observed in the thyroid and adrenal glands; 76% of the dose was excreted in the urine and 6% in the feces. The radioactivity of 14C-methimazole was higher in the thyroid than in any other tissue, with a thyroid/plasma ratio reaching 62.5 after four consecutive days of administration. Oral administration to rats resulted in complete absorption. ...Binding to plasma proteins is negligible, and...even after intravenous injection, it exhibits unicompartmental kinetics. ...This is attributed to the high lipid-water partition coefficient of methimazole, which allows for faster tissue penetration. The amount of radioactive material excreted from...(35)S-methimazole...in bile is only 21% of the intravenously administered dose. Biliary radioactivity is almost entirely derived from metabolites... For more complete data on the absorption, distribution, and excretion of methimazole (9 types), please visit the HSDB record page. Metabolic/Metabolic Substances Methimazole is rapidly and extensively metabolized in the liver primarily through the CYP450 and FMO enzyme systems. Although several metabolites have been identified, the specific isoenzymes responsible for their formation are not fully understood. One of the earliest identified methimazole metabolites, 3-methyl-2-thiohydantoin, may possess antithyroid activity—this activity has been confirmed in rats, which may explain why iodination inhibition persists for a relatively long time after administration, despite methimazole's relatively short half-life. Many metabolites have been investigated and are considered major contributors to methimazole-induced hepatotoxicity. Glyoxal and N-methylthiourea are both known cytotoxic and are known metabolites of the methimazole dihydrodiol intermediate. Methimazole's sulfinic acid and sulfonic acid derivatives are considered the final toxicants leading to hepatotoxicity, but their origin is unclear—they may arise from direct oxidation of methimazole via FMO or from the oxidation of downstream N-methylthiourea during metabolism. In Sprague-Dawley rats, up to 21% of the dose was excreted unchanged in the urine over 24 hours, with glucuronide being the major metabolite (36-48%); the remaining urinary metabolites have not been identified. Methimazole, upon incubation with rat liver microsomes, produces 3-methyl-2-thiohydantoin and N-methylimidazole. Biological Half-Life Following a single intravenous bolus injection of 10 mg methimazole, the half-life in the distribution phase is 0.17 hours, and the half-life in the elimination phase is 5.3 hours. The half-life of 3-methyl-2-thiohydantoin, the major active metabolite of methimazole, is approximately three times that of its parent drug. Renal impairment does not appear to alter the half-life of methimazole, but the half-life is prolonged in patients with hepatic impairment, with the degree of prolongation roughly proportional to the severity of hepatic impairment—moderate hepatic impairment results in an elimination half-life of 7.1 hours, while severe hepatic impairment results in an elimination half-life of 22.1 hours. Thyroid function status does not appear to have a significant effect on the half-life (i.e., there is no difference in the half-life between patients with euthyroid and hyperthyroidism). Plasma half-life is 3–5 hours. The elimination half-life of methimazole is reported to be approximately 5-13 hours. The plasma half-life of methimazole is approximately 4-6 hours. |
| Toxicity/Toxicokinetics |
Interactions
Pentobarbital can increase bile excretion. The combined use of propylthiouracil and methimazole can lead to an increased serum triiodothyronine (T3) to thyroxine (T4) ratio in patients, possibly due to direct drug action on the thyroid gland or peripheral T4 deiodination to T3. The metabolic clearance of aminophylline and theophylline is increased in hyperthyroid patients, but this clearance returns to normal as thyroid function normalizes; when thyroid function returns to normal, the dosage of aminophylline, hydroxypropyltheophylline, or theophylline may need to be reduced. /Antithyroid Drugs/ Iodides or iodine excess may reduce the efficacy of antithyroid drugs, requiring increased dosage or prolonged treatment; amiodarone contains 37% iodine (by weight), therefore its use significantly increases iodine intake; iodine deficiency may enhance the efficacy of antithyroid drugs, thus requiring reduced dosage or shortened treatment. /Antithyroid Drugs/ As the patient's thyroid and metabolic status gradually return to normal, the efficacy of oral anticoagulants may decrease; however, if hypoprothrombinemia caused by thioamide drugs occurs, the anticoagulant effect may be enhanced; it is recommended to adjust the dosage of oral anticoagulants according to prothrombin time. /Antithyroid Drugs/ For more interaction (complete) data on methimazole (6 types in total), please visit the HSDB record page. Non-human toxicity values Rats oral LD50: 2250 mg/kg Rats subcutaneous LD50: 1050 mg/kg Mice oral LD50: 860 mg/kg Mice intraperitoneal LD50: 500 mg/kg Mice subcutaneous LD50: 345 mg/kg |
| References |
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| Additional Infomation |
Therapeutic Uses
Antithyroid Drugs Methimazole is approximately 10 times more potent than propylthiouracil and induces an antithyroid response more rapidly. Its effects are also more prolonged than propylthiouracil… …It is used to treat hyperthyroidism…(1) as a radical treatment to control the condition in the hope of observing spontaneous remission in Graves' disease;(2) in combination with radioactive iodine to accelerate recovery while awaiting the effects of radiotherapy; and(3) to control the condition during preoperative preparation. /Antithyroid Drugs/ Currently, there are no commercially available injectable formulations for the rare cases where oral administration is not possible. For such cases, and for experimental purposes, the water-soluble compound methimazole can be dissolved in physiological saline and sterilized by heat. Methimazole is indicated for the treatment of hyperthyroidism, including before surgery or radiotherapy, and as an adjunct therapy for thyrotoxicosis or thyroid storm. In the treatment of thyroid storm, propylthiouracil may be superior to methimazole because propylthiouracil inhibits the peripheral conversion of thyroxine (T4) to triiodothyronine (T3). /US product label contains/ Drug Warnings …Women taking these medications should not breastfeed their infants. /Antithyroid Drugs/ Regular white blood cell counts are not very helpful because agranulocytosis can develop rapidly. Patients should report symptoms such as sore throat or fever immediately, as these are often precursors to the reaction. The main disadvantage of antithyroid drug treatment is the high relapse rate after discontinuation. Long-term, frequent medication is another disadvantage, although adverse reactions are uncommon and rarely severe, they are still a disadvantage. Susceptible patients may have cross-sensitivity reactions to other thiamine derivatives. For more complete data on drug warnings for methimazole (13 in total), please visit the HSDB record page. Pharmacodynamics Methimazole inhibits the synthesis of thyroid hormones, thereby relieving hyperthyroidism. The onset of action is 12 to 18 hours, and the duration of action is 36 to 72 hours, likely due to the concentration of methimazole and some of its metabolites in the thyroid gland after administration. The most serious potential side effect of methimazole treatment is agranulocytosis; 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 treatment. Furthermore, there is a risk of serious hepatotoxicity with methimazole; therefore, patients receiving this therapy should be carefully monitored for signs and symptoms of liver dysfunction, such as jaundice, anorexia, pruritus, and elevated liver transaminases. |
| Molecular Formula |
C4H6N2S
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| Molecular Weight |
114.1688
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| Exact Mass |
114.025
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| CAS # |
60-56-0
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| Related CAS # |
Methimazole-d3;1160932-07-9
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| PubChem CID |
1349907
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| Appearance |
White to off-white solid powder
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| Density |
1.3±0.1 g/cm3
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| Boiling Point |
280.0±9.0 °C at 760 mmHg
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| Melting Point |
144-147 °C(lit.)
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| Flash Point |
123.1±18.7 °C
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| Vapour Pressure |
0.0±0.6 mmHg at 25°C
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| Index of Refraction |
1.633
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| LogP |
-0.34
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| Hydrogen Bond Donor Count |
1
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| Hydrogen Bond Acceptor Count |
1
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| Rotatable Bond Count |
0
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| Heavy Atom Count |
7
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| Complexity |
119
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| Defined Atom Stereocenter Count |
0
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| InChi Key |
PMRYVIKBURPHAH-UHFFFAOYSA-N
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| InChi Code |
InChI=1S/C4H6N2S/c1-6-3-2-5-4(6)7/h2-3H,1H3,(H,5,7)
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| Chemical Name |
3-methyl-1H-imidazole-2-thione
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| HS Tariff Code |
2934.99.9001
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| Storage |
Powder -20°C 3 years 4°C 2 years In solvent -80°C 6 months -20°C 1 month |
| Shipping Condition |
Room temperature (This product is stable at ambient temperature for a few days during ordinary shipping and time spent in Customs)
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| Solubility (In Vitro) |
DMSO : ≥ 100 mg/mL (~875.89 mM)
H2O : ≥ 50 mg/mL (~437.94 mM) |
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| Solubility (In Vivo) |
Solubility in Formulation 1: ≥ 2.5 mg/mL (21.90 mM) (saturation unknown) in 10% DMSO + 40% PEG300 + 5% Tween80 + 45% Saline (add these co-solvents sequentially from left to right, and one by one), clear solution.
For example, if 1 mL of working solution is to be prepared, you can add 100 μL of 25.0 mg/mL clear DMSO stock solution to 400 μL PEG300 and mix evenly; then add 50 μL Tween-80 to the above solution and mix evenly; then add 450 μL normal saline to adjust the volume to 1 mL. Preparation of saline: Dissolve 0.9 g of sodium chloride in 100 mL ddH₂ O to obtain a clear solution. Solubility in Formulation 2: ≥ 2.5 mg/mL (21.90 mM) (saturation unknown) in 10% DMSO + 90% (20% SBE-β-CD in Saline) (add these co-solvents sequentially from left to right, and one by one), clear solution. For example, if 1 mL of working solution is to be prepared, you can add 100 μL of 25.0 mg/mL clear DMSO stock solution to 900 μL of 20% SBE-β-CD physiological saline solution and mix evenly. Preparation of 20% SBE-β-CD in Saline (4°C,1 week): Dissolve 2 g SBE-β-CD in 10 mL saline to obtain a clear solution. View More
Solubility in Formulation 3: ≥ 2.5 mg/mL (21.90 mM) (saturation unknown) in 10% DMSO + 90% Corn Oil (add these co-solvents sequentially from left to right, and one by one), clear solution. Solubility in Formulation 4: 100 mg/mL (875.89 mM) in PBS (add these co-solvents sequentially from left to right, and one by one), clear solution; with ultrasonication. |
| Preparing Stock Solutions | 1 mg | 5 mg | 10 mg | |
| 1 mM | 8.7589 mL | 43.7943 mL | 87.5887 mL | |
| 5 mM | 1.7518 mL | 8.7589 mL | 17.5177 mL | |
| 10 mM | 0.8759 mL | 4.3794 mL | 8.7589 mL |
*Note: Please select an appropriate solvent for the preparation of stock solution based on your experiment needs. For most products, DMSO can be used for preparing stock solutions (e.g. 5 mM, 10 mM, or 20 mM concentration); some products with high aqueous solubility may be dissolved in water directly. Solubility information is available at the above Solubility Data section. Once the stock solution is prepared, aliquot it to routine usage volumes and store at -20°C or -80°C. Avoid repeated freeze and thaw cycles.
Calculation results
Working concentration: mg/mL;
Method for preparing DMSO stock solution: mg drug pre-dissolved in μL DMSO (stock solution concentration mg/mL). Please contact us first if the concentration exceeds the DMSO solubility of the batch of drug.
Method for preparing in vivo formulation::Take μL DMSO stock solution, next add μL PEG300, mix and clarify, next addμL Tween 80, mix and clarify, next add μL ddH2O,mix and clarify.
(1) Please be sure that the solution is clear before the addition of next solvent. Dissolution methods like vortex, ultrasound or warming and heat may be used to aid dissolving.
(2) Be sure to add the solvent(s) in order.
| NCT Number | Recruitment | interventions | Conditions | Sponsor/Collaborators | Start Date | Phases |
| NCT05607407 | RECRUITING | Drug: Methimazole Procedure: Recurrent Glioblastoma Surgical Resection Diagnostic Test: Pharmacodynamic Assays |
Glioblastoma Glioma |
Case Comprehensive Cancer Center | 2023-01-30 | Phase 2 |
| NCT01560299 | COMPLETED | Drug: Methimazole Drug: Methimazole Drug: Methimazole |
Graves Disease | Mashhad University of Medical Sciences | 2010-02 | Not Applicable |
| NCT05964452 | RECRUITING | Drug: Methimazole Tablets | Graves Disease | Cook County Health | 2022-02-14 | Observational |
| NCT02727738 | COMPLETED | Dietary Supplement: Selenium Drug: Methimazole |
Graves' Disease | University of Pisa | 2014-01 | Not Applicable |
| NCT04946123 | UNKNOWN STATUS | Dietary Supplement: L-carnitine+Selenium | Hyperthyroidism | Lo.Li.Pharma s.r.l | 2021-07-05 | Not Applicable |