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Methimazole may cause rash in which skin is discolored but not raised or elevated - "macular rash" in 5% of people. This drug may also cause the following symptoms that are related to rash in which skin is discolored but not raised or elevated - "macular rash":
Medical Source Information Yellow highlights indicate symptoms related to rash in which skin is discolored but not raised or elevated - "macular rash". Dermatologic side effects including urticaria (5%), macular rash (5%), rash, pruritus, abnormal loss of hair, and skin pigmentation have been reported. Aplasia cutis congenita has also been reported. A 5-year-old female experienced aplasia cutis congenita coincident with in utero exposure to methimazole. She presented with hairless scars on her scalp. At birth the lesions were friable and bled easily, however, over time they became scar-like and thicker. At the time of conception, her mother was receiving therapy for Graves' disease with methimazole 20 mg daily. Aplasia cutis congenita has been reported as a possible teratogenic effect of methimazole therapy in multiple case reports. However, the causal relationship between the therapy and the skin defect is controversial, and anomalies related to methimazole have low birth prevalence. Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop taking methimazole and call your doctor at once if you have any of these serious side effects: fever, chills, sore throat, body aches, flu symptoms; easy bruising or bleeding, unusual weakness; blood in your urine or stools; severe blistering, peeling, and red skin rash; or nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes). Less serious side effects may include: headache, drowsiness, dizziness; mild nausea, vomiting, or stomach upset; itching, minor skin rash; muscle, joint, or nerve pain; swelling; or hair loss. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. You may report side effects to FDA at 1-800-FDA-1088. Because methimazole is excreted in milk, the drug is contraindicated in nursing mothers. Since agranulocytosis is a potentially serious side effect associated with methimazole therapy, patients should be instructed to report any signs of agranulocytosis, such as fever and sore throat, to their physician. Leukopenia, thrombocytopenia and aplastic anemia may also occur. The drug should be discontinued in the presence of agranulocytosis, aplastic anemia, hepatitis, or exfoliative dermatitis. Patients receiving methimazole should undergo monitoring of bone marrow function. Severe hepatic effects including rare reports of fulminant hepatitis, hepatic necrosis, encephalopathy, and death have been reported during methimazole therapy. Therefore, symptoms suggestive of hepatic dysfunction (anorexia, pruritis, right upper quadrant pain, etc.) should prompt evaluation of liver function. Treatment should be discontinued immediately if clinical evidence of liver abnormality including hepatic transaminase values exceeding 3 times the upper limit of normal. Methimazole-induced agranulocytosis is generally associated with doses of 40 mg or more in persons older than 40 years of age. Hematologic side effects have included inhibition of myelopoiesis (agranulocytosis (0.35%), granulocytopenia, and thrombocytopenia), aplastic anemia, and hypoprothrombinemia. Approximately 10% of patients with untreated hyperthyroidism have experienced leukopenia, often with relative granulopenia. The onset of aplastic anemia (pancytopenia) or agranulocytosis may occur in hours to days. Most cases of agranulocytosis occur within the first 90 days of treatment, but this complication can occur even a year or more after starting therapy. Studies have suggested that the risk of agranulocytosis is greater in older patients and that they have a higher rate of death. Immunologic side effects have included insulin autoimmune syndrome and lupus-like syndrome. Side Effects to Watch Watch closely for the following side effects and notify your physician immediately should any of these develop:
Lab and Diagnostic Tests If certain symptoms develop, ask your physician whether you need the following lab tests or other diagnostic tests (if you've not already had them):
References
Multum version: 154.0
(Jun 16, 2010)
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