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CARBIMAZOLE: It acts at 3 steps in the synthesis of thyroid hormone, inhibit of iodide, iodination of tyrosine residues, coupling of lodtrosine residues to form T3 & T4. It does no interfere with trapping of iodide and do not modify the action of t3 and T4 on peripheral tissues or on pituitary. Goiter is not the result of potentiation of TSH action on thyroid, but is due to increased TSH release as a consequence of reduction in feed back inhibition.

Indication: Primary or secondary thyrotoxicosis, throtoxicosis prior ot throidectomy, intractable congestive cardiac failure, angina pectoris and paroxysmal tacycardia.

Dosage: Mild cases, initially 15-20mg daily in divided dosage. Moderate cases : 30 mg daily in divided dosage. Main. : 2.5-25mg daily divided dosage.

Contra indication: Tracheal obstruction Lactation.

Special Precaution: Stop medication & report ot physican in case symptom like sore throat fever or rash appear, pregnancy.

Side effects: Bone narrow depression, mouth ulcers, rashes nausea, headache, arthragia. Loss or grying of hair & liver damage, agranulcoytosis.

Drug Interaction: Increased sensitivity to warfarin in hyperthyroidism