Neomercazole 20

NEOMERCAZOLE 20

Name

• Brand Name: Neo Mercazole 20
• Common Name (Active Ingredient): Carbimazole

Composition Each Neo Mercazole 20 tablet contains Carbimazole 20 mg as the active ingredient.

Uses Neo Mercazole 20 is an anti-thyroid medicine used for the treatment of hyperthyroidism (an overactive thyroid gland). It works by decreasing the production of thyroid hormones (thyroxine) by the thyroid gland, thus helping to balance hormone levels and alleviate symptoms such as rapid heartbeat, weight loss, and anxiety.

It is also prescribed for:

• Preparation for thyroidectomy (surgical removal of the thyroid gland) in hyperthyroidism.
• Therapy prior to and after radioactive iodine treatment for hyperthyroidism and thyroid cancer.

Dosage and Administration Neo Mercazole 20 should be taken orally as directed by a doctor. It can be taken with or without food, and it is advised to take it regularly at the same time each day for better results. Do not exceed the recommended dose or discontinue the medicine without consulting your doctor.

• Adults: The initial dose is typically in the range of 20-60 mg per day, which is then titrated against thyroid function until the patient is euthyroid. Maintenance dosage usually ranges from 5-15 mg per day, which may be taken as a single daily dose.
• Children: The usual initial daily dose is 15 mg per day. Neo Mercazole 20 is not recommended for children below two years of age as safety and efficacy data are not available.

Side Effects Common side effects usually occur within the first eight weeks of treatment and are often self-limiting.

• Common Side Effects: Rapid weight loss, diarrhea, joint pain (arthralgia), itching, skin rash, fever, headache, drowsiness, nausea, mild gastric distress, mouth ulcers, sore throat, dizziness, changes in taste, and hair thinning.
• Serious Side Effects: Patients should immediately stop the medicine and consult a doctor if they experience symptoms such as:
  • Sore throat, mouth ulcers, fever, or general malaise, as these could indicate bone marrow depression (e.g., agranulocytosis, neutropenia), which reduces the body's ability to fight infection.
  • Unexplained bruising or bleeding (thrombocytopenia).
  • Signs of liver disorder such as pain in the upper abdomen, anorexia, general pruritus, yellowing of eyes or skin (jaundice), tiredness, dark urine, or loss of appetite.
  • Acute pancreatitis (inflammation of the pancreas) characterized by fever or abdominal pain.
  • Allergic reactions like severe skin rash, itching/swelling (especially of the face/tongue/throat), or breathing difficulty.

Precautions

• Allergies: Avoid use if allergic to carbimazole or any other anti-thyroid medicines like thiamazole, methimazole, or propylthiouracil.
• Pregnancy and Breastfeeding: Use with caution during pregnancy after strict benefit/risk assessment, and only at the lowest effective dose. Untreated hyperthyroidism may increase the chances of malformation in the unborn baby. Women of childbearing potential should use effective contraceptive measures. Breastfeeding is not recommended as small amounts of carbimazole may pass into breast milk.
• Liver Disorders: Use with caution in patients with mild-moderate hepatic insufficiency. It is contraindicated in severe liver disorder. Liver function tests should be performed immediately if signs of hepatic disorder occur.
• Blood Disorders: Contraindicated in patients with serious pre-existing hematological conditions or a history of bone marrow depression. Regular blood count checks are recommended, especially if symptoms like sore throat, mouth ulcers, or bruising occur.
• Intrathoracic Goitre: Caution is advised in patients with intrathoracic goitre as initial treatment may worsen it and lead to tracheal obstruction.
• Drug Interactions: Inform your doctor about all current medications, including supplements and herbal products. Neo Mercazole 20 can interact with:
  • Anticoagulants (e.g., warfarin, phenindione) as it may intensify their effect.
  • Digitalis and beta-blockers, requiring dose adjustment.
  • Theophylline, potentially increasing its serum levels.
  • Erythromycin.
• Radio-iodine Treatment: May need to be temporarily stopped before and after radioactive iodine treatment.
• Driving and Operating Machinery: May cause dizziness, so drive only if you are alert.

Storage Store Neo Mercazole 20 tablets at room temperature, in a clean and dry place, protected from moisture, sunlight, and heat. Keep the medicine away from children and pets. Do not store above 25°C or 30°C depending on specific regional guidelines.

NEOMERCAZOLE 20 contains carbimazole, an anti-thyroid agent used to treat hyperthyroidism, a condition where the thyroid gland produces too much thyroid hormone. It can also be used to prepare patients for thyroidectomy (surgical removal of the thyroid gland) or radioactive iodine treatment.

What is NEOMERCAZOLE 20 used for?

NEOMERCAZOLE 20 is primarily used to treat hyperthyroidism, also known as an overactive thyroid gland, by reducing the excessive production of thyroid hormones. It is also prescribed before thyroid gland removal surgery (thyroidectomy) and as a therapy before and after radioactive iodine treatment for hyperthyroidism and thyroid cancer.

How does NEOMERCAZOLE 20 work?

NEOMERCAZOLE is a "pro-drug" that is converted into its active form, thiamazole (also known as methimazole), in the body. Thiamazole works by inhibiting the thyroid peroxidase enzyme, which is crucial for the synthesis of thyroid hormones (T3 and T4). This action reduces the amount of thyroid hormones produced by the thyroid gland, thus balancing their levels in the body.

What is the usual dosage of NEOMERCAZOLE 20?

The dosage of NEOMERCAZOLE 20 varies depending on the severity of the condition and individual patient response. For adults, initial doses typically range from 20 mg to 60 mg per day, often given in divided doses. Once thyroid function is controlled and the patient becomes euthyroid (normal thyroid function), the dosage is gradually reduced to a maintenance level, usually between 5 mg and 15 mg daily, which may be taken as a single daily dose. Treatment is usually continued for at least six months and potentially up to 18-24 months. For children, the recommended starting dose is typically three 5 mg tablets daily, also in divided doses. Your doctor will monitor your thyroid function and adjust the dose accordingly.

What are the possible side effects of NEOMERCAZOLE 20?

Common minor side effects can include nausea, headache, joint pain (arthralgia), mild gastric distress, and mild skin rashes or itching. These rashes often respond to antihistamines. More serious, though rare, side effects include bone marrow depression, which can lead to conditions like agranulocytosis (a severe drop in white blood cells), neutropenia, leukopenia, and aplastic anemia. Patients should immediately report symptoms like sore throat, mouth ulcers, fever, unexplained bruising or bleeding, or general malaise to their doctor, as these could indicate a serious blood disorder. Other potential side effects include liver problems (e.g., jaundice, hepatitis), dizziness, hair loss or thinning, and changes in taste.

Is NEOMERCAZOLE 20 safe during pregnancy or breastfeeding?

NEOMERCAZOLE is generally not recommended during pregnancy, particularly in the first trimester and at high doses, as it is suspected to cause congenital malformations. However, untreated hyperthyroidism during pregnancy can also lead to serious maternal and fetal complications. If used during pregnancy, it should be administered only after a strict individual benefit/risk assessment and at the lowest effective dose without additional thyroid hormones. Close maternal, fetal, and neonatal monitoring is recommended. Women of childbearing potential should use effective contraceptive measures during treatment.

NEOMERCAZOLE is secreted into breast milk. If treatment continues during lactation, patients should not breastfeed their babies due to the risk of neonatal hypothyroidism and agranulocytosis at high doses.

Can it be taken with other medications?

NEOMERCAZOLE can interact with other medications. It is a vitamin K antagonist, meaning it can intensify the effect of anticoagulants (blood thinners) like warfarin, requiring careful monitoring of anticoagulant dosage. It may increase the serum levels of theophylline (used for respiratory conditions), potentially leading to toxicity. Co-administration with prednisolone may result in increased clearance of prednisolone. Serum digitalis (digoxin) levels and beta-blocker dosages may need adjustment when hyperthyroid patients become euthyroid while taking NEOMERCAZOLE.

What precautions should be taken?

Several precautions should be taken with NEOMERCAZOLE 20. It should not be used if you have a history of adverse reactions to carbimazole or its excipients, serious pre-existing blood disorders, severe liver insufficiency, or a history of acute pancreatitis after carbimazole or thiamazole administration. Caution is needed in patients with an intrathoracic goitre, as initial treatment may worsen it and potentially cause tracheal obstruction. Regular blood count checks are recommended, especially if you experience symptoms like sore throat, mouth ulcers, fever, or bruising. Liver function should also be monitored, and the medicine should be stopped if abnormal liver function is discovered. If you are receiving radio-iodine treatment, your doctor may advise you to temporarily stop NEOMERCAZOLE.

What happens if a dose is missed?

If you miss a dose of NEOMERCAZOLE 20, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take your next dose at the regular scheduled time. Do not take a double dose to make up for a missed one. If you frequently miss doses or are unsure, consult your doctor or pharmacist.

How should it be stored?

NEOMERCAZOLE 20 tablets should be kept in their original bottle in a cool, dry place where the temperature stays below 25°C. They should be protected from moisture, sunlight, and heat. It is important to store the medicine out of reach of children. Do not store it in the bathroom or near a sink, or leave it in the car or on window sills.