methimazole withdrawal symptoms

The https:// ensures that you are connecting to the Do not double doses. With a short-acting opioid, these withdrawal symptoms can be intense, but they typically peak within a couple of days and then begin to resolve. Thyroid ultrasonography and TSH receptor antibodies (TRAb) were evaluated in basal conditions and then one month after MMI withdrawal. For example, a person might feel anxious and cold one minute then depressed and hot a few minutes later. Drug-induced acute liver failure: results of a U.S. multicenter, prospective study. Adults. Bad dreams Depression Difficulty thinking clearly Fatigue Feeling jumpy or nervous Irritability or becoming excited easily Rapid mood swings Shakiness Physical Symptoms Clammy skin Elevated blood pressure Headache Insomnia Loss of appetite Nausea and vomiting Paleness Rapid heart rate or palpitations Treatment of graves' disease with antithyroid drugs in the first trimester of pregnancy and the prevalence of congenital malformation. Vitti P, Rago T, Mancusi F, Pallini S, Tonacchera M, Santini F, Chiovato L, Marcocci C, Pinchera A. Acta Endocrinol (Copenh). On presentation, she was jaundiced but had no signs of chronic liver disease. The symptoms went away and I enjoyed a medication-free pregnancy. Do not keep outdated medicine or medicine no longer needed. Vita R, Di Bari F, Perelli S, Capodicasa G, Benvenga S. J Clin Transl Endocrinol. You may report side effects to the FDA at 1-800-FDA-1088. Methimazole Uses, Side Effects & Warnings - Drugs.com Here in this paper, we report a 31-year-old case admitted with symptoms of hyperthyroidism that was then diagnosed with Grave's disease (GD) and underwent treatments with a low dosage of methimazole (10 mg/day). Design: Many times, cravings may be mistaken for thirst or hunger. Stealing the drug and/or money from others. Research shows that roughly 3 in 4 people who complete opioid detoxification relapse within 2 to 3 years. Results: This site complies with the HONcode standard for trustworthy health information: verify here. An altered perception of time. You are right that beta blocker heart and blood pressure medications such as atenolol, carvedilol, metoprolol and propranolol should never be stopped suddenly. Methaqualone Addiction and Detox - Signs, Symptoms and Withdrawal The primary goal of long-term treatment is to prevent relapse. Withdrawal symptoms such as tremors, anxiety, sweating, insomnia, pain, or hallucinations when you are unable to take the next dose of methaqualone. Common Alcohol Withdrawal Symptoms - Verywell Mind Methimazole and Drug withdrawal syndrome, a phase IV clinical study of Methimazole Side Effects: Common, Severe, Long Term - Drugs.com Every effort has been made to ensure that all information is accurate, up-to-date, and complete, but no guarantee is made to that effect. Symptoms of Too Much Methimazole in Cats | Raise a Cat FDA approves the first non-opioid treatment for management of opioid withdrawal symptoms in adults. Sudden onset agranulocytosis and hepatotoxicity after taking methimazole. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. People take methadone for months or years at a time. Anxiety is a major symptom of hyperthyroidism. This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information. TheWorld Health Organization recommends reducing your dose by 5 to 10mg per week until you reach a dose of 40mg. Be careful when using a regular toothbrush, dental floss, or toothpick. May make these conditions worse. Isolation. Drug withdrawal syndrome is found among people who take Methimazole, especially for people who are female, 50-59 old. After you detox from methadone, your opioid tolerance will be much lower than it used to be. Withdrawal from depressants may also bring about mental health symptoms such as anxiety, perceptual disturbances, hallucinations, and other perceptual disturbances, or delirium. Werner MC, Romaldini JH, Bromberg N, Werner RS, Farah CS. Call your doctor for medical advice about side effects. Continue giving methimazole and talk to your veterinarian if your pet experiences headache, drowsiness, dizziness; mild nausea, or vomiting; itching; muscle, joint, or nerve pain; swelling; hair loss. Cappelli C, Gandossi E, Castellano M, Pizzocaro C, Agosti B, Delbarba A, Pirola I, De Martino E, Rosei EA. Zhang M, Zhou H, He R, Di F, Yang L, Yang T. Steroids for the treatment of methimazole-induced severe cholestatic jaundice in a 74-year-old woman with type 2 diabetes. This is a decision you and your doctor will make. 2011;9. doi:10.1002/14651858.CD005031.pub4. Before Take methimazole with food or milk. Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellow eyes or skin. The onset of hepatotoxicity is usually within 2 to 12 weeks of starting and the pattern of enzyme elevations is typically cholestatic or mixed, although hepatocellular patterns have also been described. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Methimazole is also capable of causing clinically apparent, idiosyncratic liver injury. Methadone Withdrawal Symptoms, Timeline & Detox Treatment Low iodine diet aas applied from 7 days . Helpful - 0 Comment gimel Wang MT, Lee WJ, Huang TY, Chu CL, Hsieh CH. Withdrawal: Symptoms, Timeline, Treatment, and Coping - Verywell Mind This may sound depressing, but it doesn't have to be. To use the sharing features on this page, please enable JavaScript. At first, symptoms of withdrawal may feel like the flu. Lucemyra works by reducing the release of norepinephrine, a neurotransmitter that researchers believe plays a role in the symptoms of opioid withdrawal. Antithyroid drugs. She improved and jaundice resolved within 4 weeks and other liver test abnormalities within 8 weeks. In both these scenarios, the goal of doctors is to find an immediate solution to a serious problem. The thyroid hypoechogenicity score at withdrawal was normal in 23/29 (79.3%) of patients still euthyroid and in 4/10 (40%) of those who relapsed up to the 12th month (P < 0.05); it was normal in 19/21 (90.4%) of patients still euthyroid and in 7/17 (41.2%) of those who relapsed up to the 24th month (P < 0.05). To get a better idea of the scale, you can check out theClinical Opiate Withdrawal Scale (COWS) that doctors use to diagnose their patients. With medical big data and AI algorithms, eHealthMe is running millions of phase IV trials and makes the results available to the public. Peter SA. Clonidine,a hypertension drug regularly used off-label to treat opioid withdrawal symptoms. Duplication for commercial use must be authorized by ASHP. Long-term Methimazole Therapy in Juvenile Graves' Disease: A Randomized What special precautions should I follow? Mayo Clinic is a nonprofit organization and proceeds from Web advertising help support our mission. Carbimazole should only be administered if hyperthyroidism has been confirmed by laboratory tests. Even if you are frustrated and sick of going to a clinic or pharmacy every day for a supervised dose, it is best to avoid abrupt cessation. Our phase IV clinical studies alone cannot establish cause-effect relationship. Stage 2 (24-72 hours after the last drink): The common symptoms during this stage are high blood pressure . Store it at room temperature and away from excess heat and moisture (not in the bathroom). Jaundice during methimazole (Tapazole) administration. These side effects come from organ damage. 2023 Dotdash Media, Inc. All rights reserved. Hormonal derivatives and related drugs. Both drug; she was reluctant to other types of therapy, not diseases are more common in females and in younger visiting endocrinologist regularly. Other drugs that have the same active ingredients (e.g. Ranging from mild to moderate to severe, you may experience any or all the following: 4 Urges and cravings that vary in intensity Sleep disturbances such as insomnia and nightmares Heart rate and blood pressure increases 2019. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Methimazole: Uses & Side Effects | Cleveland Clinic Arab DM, Malatjalian DA, Rittmaster RS. Endocr J. Reuben A, Koch DG, Lee WM., Acute Liver Failure Study Group. Your experience with methadone withdrawal will depend on a variety of factors, including your past experiences and expectations. Methimazole has been associated with transient, asymptomatic elevations in serum aminotransferase levels, typically during the first 3 months after starting during high dose, induction therapy. Thank you, {{form.email}}, for signing up. If you are taking more than one dose per day, it is best to take the doses at evenly spaced times. nausea, vomiting, upset stomach; headache, dizziness, drowsiness; numbness or tingly feeling; rash, itching, skin discoloration; muscle or joint pain; hair loss; or decreased sense of taste. The American Society of Health-System Pharmacists, 4500 East-West Highway, Suite 900, Bethesda, Maryland. Keep this medication in the container it came in, tightly closed, and out of reach of children. * Approximation only. No information is available on the relationship of age to the effects of methimazole in geriatric patients. Estimated Study Completion Date : December 20, 2019. Methimazole may harm the fetus. Fatal cases are rare. At the withdrawal evaluation a score < 2 and a TRAb value < 10 U/l were considered as normal. Ji H, Yue F, Song J, Zhou X. FOIA Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings, feeling of constant movement of self or surroundings, general feeling of discomfort, illness, or weakness, sores, ulcers, or white spots on the lips or in the mouth, swelling of the face, feet, or lower legs, swollen, painful, or tender lymph glands in the neck, armpit, or groin, pain or discomfort in the chest, upper stomach, or throat. Post-acute withdrawal, which is also known as protracted withdrawal, begins in the weeks following your detox. In, Zimmerman HJ. Yang J, Li LF, Xu Q, Zhang J, Weng WW, Zhu YJ, Dong MJ. Ramos-Bonner LS, Goldberg TH, Moyer S, Anastasopoulou C. Methimazole-induced cholestatic jaundice in an elderly hyperthyroid patient. Hepatic injury during propylthiouracil therapy in patients with hyperthyroidism. Liver dysfunction and anti-thyroid therapy. Drug-induced liver disease. It is also used before thyroid surgery or radioactive iodine treatment. As part of this process, you may need to get support or treatment if you experience uncomfortable withdrawal symptoms, which may make it significantly harder to stop using. Naltrexone binds to the opioid receptors and acts like a blockade, preventing other opioids from binding to those same receptors. Could the anxiety be stemming from you actually still needing the methimazole? Methimazole is used to treat hyperthyroidism, a condition where the thyroid gland produces too much thyroid hormone. You can find a meeting near you with theirsearchable directory. Its important to keep in touch with both an obstetrician (OBGYN) and an addiction doctor throughout your pregnancy. 2020 Dec 1;105(12):3704-20. doi: 10.1210/clinem/dgaa646. If you miss a dose of this medicine, take it as soon as possible. Loss of appetite. Propranolol therapy was restarted but methimazole was held. Analysis of 90 cases of antithyroid drug-induced severe hepatotoxicity over 13 years in China. Kang H, Choi JD, Jung IG, Kim DW, Kim TB, Shin HK, et al. Posology. If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. A cohort study. When used correctly, methadone allows people to quit heroin and prescription pain killers without going into withdrawal. This can take as long as 14 days. Methadone isproven safe and effective for use during pregnancy. changes in skin coloring. Baker B, Shapiro B, Fig LM, Woodbury D, Sisson JC, Beierwaltes WH. Do not miss any doses. inflammation of the blood vessels. Methadone withdrawal: Symptoms, treatment, and more - Medical News Today Advertising revenue supports our not-for-profit mission. The only time I actually went off of Methimazole was when I was pregnant (I had reached euthyroid a couple months before) and I think I experienced similar symptoms of anxiety and headaches for a couple weeks. Because naltrexone can bring on instantaneous withdrawal, you shouldnt start using it until all the methadone is out of your system. The fentanyl withdrawal timeline begins quickly. You can find out more about our use, change your default settings, and withdraw your consent at any time with effect for the future by visiting Cookies Settings, which can also be found in the footer of the site. How Long Does Withdrawal From Suboxone Last? But unlike with the flu, withdrawal symptoms can remain severe for several days. Takiing Armour (thyroid hormone replacement) has seemed to cause your hyperthyroidism. Withdrawal symptoms of suddenly stopping certain antidepressants include anxiety, chills, difficulty sleeping, dizziness, headaches, increased depression symptoms, irritability, muscle aches, nausea, sensations of electric shock, sleepiness, and vivid dreams. Feeling like you have a bad flu, vomiting, diarrhea, sweating, and insomnia are all common. Propranolol Side Effects: Important Things You Need To Know 432 Objectives To evaluate whether 3-day withdrawal of methimazole (MMI) prior to radioactive iodine therapy (RAI) is adequate in Graves' disease with adjunctive MMI treatment. Withdrawal symptoms can start as soon as 12 to 30 hours after your last dose. [Updated 2020 Jan 22]. Mixing methimazole and Cocaine | Worlds Best Rehab You are likely to experience withdrawal symptoms each time your dose is cut. National Institute on Drug Abuse and Addiction. Methimazole-induced lupus erythematosus: a case report Lack of sleep, irregular heartbeat, and dehydration are just a few of the symptoms of methadone withdrawal that can turn severe if not treated immediately. This content does not have an English version. Recovery is usually rapid once methimazole is stopped, and the first priority should be immediate discontinuation of antithyroid therapy at the first sign of clinically apparent liver disease. If your dose is different, do not change it unless your doctor tells you to do so. In severe cases, however, more definitive therapy of the hyperthyroidism with radioactive iodide or surgery may be more appropriate. Russo MV, Galanko JA, Shrestha R, Fried MW, Watkins P. Liver transplantation for acute liver failure from drug induced liver injury in the United States. Lying or other unusual negative behavior such as sudden hostility or aggression. Abnormal loss of hair. Relapse rates among people with opioid use disorders are very high. Death due to agranulocytosis induced by methimazole therapy. The ASAM National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use. Chills or shivering Congestion Depression Fatigue Irritability Muscle pain Nausea Restlessness Runny nose Shakiness Sleeping difficulties Sweating Tremors Vomiting In some instances, more severe symptoms such as hallucinations, seizures, and delirium may also occur. The starting dose is 0.4 mg per kilogram (kg) of body weight per day, divided in 3 equal doses and given about every 8 hours. They acknowledge that this is only a general recommendation and that the taper schedule should be tailored to each individuals needs. Low blood cell counts have happened with methimazole. Using this medicine during the first three months of your pregnancy can harm your unborn baby. Toxic hepatitis during treatment with methimazole (Tapazole). Report of a case with apparent recovery. In some instances, certain formulations of methadone may . Agranulocytosis and toxic hepatitis from methimazole. methimazole withdrawal symptoms You should also talk to your doctors about your plans after giving birth. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Follow your doctor's orders or the directions on the label. Successful treatment with carbimazole of a hyperthyroid pregnancy with hepatic impairment after propylthiouracil administration: a case report. Graves' disease | Office on Women's Health When this happens, your doctor can pause the taper at that level and wait several weeks before reducing the dose again. A rare case of methimazole-induced cholestatic jaundice in an elderly man of Asian ethnicity with hyperthyroidism: A case report. inflammation of the parotid gland . After recovery from the liver injury, her hyperthyroidism was treated successfully with radioactive iodine. In case of overdose, call the poison control helpline at 1-800-222-1222. abnormal sensations (tingling, prickling, burning, tightness, and pulling) swelling joint and muscle pain drowsiness dizziness decreased white blood cells decreased platelets If you experience any of the following symptoms, call your doctor immediately: sore throat fever headache chills unusual bleeding or bruising Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco. Breastfeeding is generally considered safe during methadone treatment. Once you have tapered down, you might want to find something more convenient, like a therapist in private practice or at a local community health clinic. Among them, 9 people (0.16%) have Drug withdrawal syndrome. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program. These symptoms are most common in long-term opioid abusers. Low thyroid levels (hypothyroidism)unusual weakness or fatigue, increased sensitivity to cold, constipation, hair loss, dry skin, weight gain, feelings of depression. coming off tapazole what to expect | Other Drugs discussions Methimazole may cause an upset stomach. 2023 eHealthMe.com. Chalasani N, Bonkovsky HL, Fontana R, Lee W, Stolz A, Talwalkar J, Reddy KR, et al. In several instances, patients with methimazole induced liver injury have been switched to propylthiouracil without evidence of recurrence, but in at least one case, recurrent jaundice appeared. It is the most common cause of hyperthyroidism (overactive thyroid gland). Methimazole was introduced into use in 1954 and is still widely used for the temporary amelioration of hyperthyroidism in Graves disease, particularly in patients with mild or self-limited hyperthyroidism or who wish to avoid thyroidectomy or radiation therapy. Intestinal Microbiota and Treatment of GD - Full Text View Typical cholestatic hepatitis arising one month after starting therapy with methimazole. http://www.upandaway.org. Mayo Clinic does not endorse any of the third party products and services advertised. A normal thyroid hypoechogenicity score at withdrawal of MMI had a higher specificity (0.95) and sensitivity (0.59) with respect to TRAb values (0.86 and 0.53, respectively) for the prediction of the relapse of hyperthyroidism at the 24th month. Methimazole - LiverTox - NCBI Bookshelf If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911. Common side effects of methimazole may include: nausea, vomiting, upset stomach; headache, dizziness, drowsiness; numbness or tingly feeling; rash, itching, skin discoloration; muscle or joint pain; hair loss; or decreased sense of taste. Subekti I, Kartiko GJ, Suhardi ZF, Muhadi, Wisnu W. PLoS One. Please enable it to take advantage of the complete set of features! Specht NW, Boehme EJ. Peak withdrawal symptoms: Withdrawal will be fully developed around 3-4 days after the last dose of methadone. Dose reductions can occur once a week, once every two weeks, or less often. It is the first non-opioid medication clinically proven to do so. We study millions of patients and 5,000 more each day. The site is secure. When taken as directed, methadone is able to reduce the symptoms of opioid withdrawal, decrease opioid cravings, and induce a significant amount of cross-tolerance to other opioidswhich may block some or all of the euphoric effects of drugs such as heroin, oxycodone, and hydrocodone. The Most Common Symptoms of Too Much Methimazole in Cats Symptoms of Methimazole Overdose in Cats Diarrhea or Loose Stool Gastrointestinal Upset Overgrooming Blood Abnormalities Haircoat and Skin Abnormalities Vocalization Abnormalities Weakness and Agitation Change in Appetite Frequently Asked Questions (IMPORTANT) how long for methimazole to work? - Thyroid Disorders - MedHelp Fear . Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: Other side effects not listed may also occur in some patients. Drug-induced hepatic injury during methimazole therapy. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. Successful outcome with methimazole and lithium combination therapy for propylthiouracil-induced hepatotoxicity. Indications Status Purpose Phase; DBCOND0045924 (Drug Withdrawal Symptoms) DBCOND0029058 (Graves' Disease) DBCOND0048020 (Drug Relapse) Side Effects of Tapazole (methimazole) - MedicineNet Ondansetronto treat nausea and vomiting. Mamianetti A, Muoz A, Ronchetti RD, Maccione E, Poggi U, Mugnolo R, et al. For more mental health resources, see our National Helpline Database. Measurements: Everyones experience getting off methadone is different. Methimazole. Drug withdrawal syndrome (interfere with normal social, occupational, or other functioning. Withdrawal: Types, Symptoms, Treatment - Verywell Health All rights reserved. Most notably, pregnant women. Methimazole comes as a tablet and usually is taken three times a day, approximately every 8 hours, with food. Feeling like you have a bad flu, vomiting, diarrhea, sweating, and insomnia are all common. Analysis of antithyroid drug-induced severe liver injury in 18,558 newly diagnosed patients with Graves' disease in Japan. Mikhail NE. Just take things one step at a time and dont get discouraged by the rate of your progress. SAGE Open Med Case Rep 2015; 3: 2050313X14568335. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements. He has since'd It can also lower the number of platelets, which are necessary for proper blood clotting. A characteristic thyroid ultrasonographic picture with diffuse or scattered low echogenicity has been described in Graves' disease (GD). decreased blood platelets. Akmal A, Kung J. Propylthiouracil, and methimazole, and carbimazole-related hepatotoxicity. The absence or a low grade of thyroid hypoechogenicity after MMI treatment seems to be a favourable prognostic index of remission of hyperthyroidism in GD. Sweating and/or chills. You can use the study as a second opinion to make health care decisions. Muscle aches and pain. Tapering methadone means gradually taking smaller doses over the course of several weeks or months. Rare instances of prolonged cholestasis have been described, but no instance of vanishing bile duct syndrome. A burning, numbness, or tingling feeling that is not normal. 2nd ed. decreased sense of taste. Drug information provided by: IBM Micromedex. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. Methimazole has been linked to serum aminotransferase elevations during therapy as well as to a clinically apparent, idiosyncratic liver injury that is typically cholestatic and self-limited in course. Worsening of constipation or GI issues Worsening memory function Increased pain And other symptoms of hypothyroidism These side effects usually mimic the side effects of hypothyroidism, because if you stop taking your medication your body will not be able to produce it naturally for some time. They do better controlling their thyroid hormones using Regular L-Carnitine. Rosenbaum H, Reveno WS. Otsuka F, Noh JY, Chino T, Shimizu T, Mukasa K, Ito K, Ito K, Taniyama M. Hepatotoxicity and cutaneous reactions after antithyroid drug administration. burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings chest pain chills cough dark urine difficulty in breathing dizziness or lightheadedness drowsiness feeling of constant movement of self or surroundings fever general feeling of discomfort, illness, or weakness headache hoarseness itching, skin rash Copyright 2023 IBM Watson Health. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. Results of our real-world drug study have been referenced on 600+ medical publications, including The Lancet, Mayo Clinic Proceedings, and Nature. Greenberger NJ, Milligan FD, DeGroot LJ, Isselbacher KJ. Problems sleeping, including insomnia and/or fatigue. All rights reserved. Methadone withdrawal can resemble the symptoms of withdrawal from other opioids. Sadoul JL, Canivet B, Freychet P. Toxic hepatitis induced by antithyroid drugs: four cases including one with cross-reactivity between carbimazole and benzylthiouracil. Knowing that using an opioid wont get you high should discourage you from impulsively relapsing. Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. One last warning: Relapse is common among opioid users. Copyright, 2023. Opiate Withdrawal Driving People To Abuse Diarrhea Medication Imodium Because of the hepatotoxicity of propylthiouracil which can be fatal, methimazole is now considered the first line treatment for hyperthyroidism when there is a need to avoid surgery or radioiodine therapy. How Long Does Withdrawal From Antidepressants Last? Unauthorized use of these marks is strictly prohibited. Finally, social support is a key aspect of relapse prevention. Philadelphia: Lippincott, 1999, pp. It can take up to six months for your brain to return to normal. Do not take other medicines unless they have been discussed with your doctor. Deidiker R, deMello DE. If you become pregnant while taking methimazole, call your doctor immediately. Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. average of thyroid weight 68g) who have been treated by MMI for 1 to 6 years were enrolled. Along with its needed effects, a medicine may cause some unwanted effects. She had no history of liver disease or alcohol abuse and no risk factors for viral hepatitis. A 15-year-old girl had a history of diffuse goiter and received methimazole treatment 2 months before admission to the hospital. J Clin Endocrinol Metab. Becker CE, Gorden P, Robbins J. In patients who are not candidates for definitive therapy, chronic low-dose methimazole may be appropriate (Ross 2016). Blood and urine tests may be needed to check for unwanted effects. The mechanism by which methimazole causes acute liver injury is unknown, but is likely due to an immunological reaction to a metabolic product of its metabolism. Hung YT, Yu WK, Chow E. Delayed cholestatic hepatitis due to methimazole.

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