AGRANULOCYTOSIS OCCURRING DURING METHIMAZOLE ("TAPAZOLE") THERAPY

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Abstract
A relatively new substance, methimazole, or 1-methyl-2-mercaptoimidazole ("tapazole"), has been reported by Stanley and Astwood1and Reveno and Rosenbaum2to be an effective antithyroid drug. Methimazole acts in a manner similar to, if not identical with, thiourea and thiouracil and their derivatives, i. e., it prevents the binding of iodine to protein in the thyroid gland. Its potency as determined by Stanley and Astwood3is considerably greater than either thiouracil or propylthiouracil. In experiments utilizing I131these workers demonstrated that methimazole may be as much as 100 times as potent as thiouracil in the prevention of the binding of iodine to protein in the thyroid gland. The optimal dose of this new compound remains to be established. It probably depends to a large extent on the individual patient. Reveno and Rosenbaum reported doses of 6 to 9 mg. per day to be effective, whereas Stanley and