dosage adjustment of Carbimazole in renal failure




Carbimazole.JPG

Carbimazole

CLINICAL USE

Treatment of hyperthyroidism

DOSE IN NORMAL RENAL FUNCTION

5–40 mg daily

PHARMACOKINETICS

  • Molecular weight                           :186.2
  • %Protein binding                           :Unbound (methimazole is 5%)
  • %Excreted unchanged in urine     : <12 (methimazole)
  • Volume of distribution (L/kg)       :0.5 (methimazole)
  • half-life – normal/ESRD (hrs)      :3–6.4 (methimazole)/Increased

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50     : Dose as in normal renal function
  • 10 to 20     : Dose as in normal renal function
  • <10           : Dose as in normal renal function

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                :Not dialysed. Dose as in normal renal function
  • HD                     :Not dialysed. Dose as in normal renal function
  • HDF/high flux   :Unknown dialysability. Dose as in normal renal function
  • CAV/VVHD      :Unknown dialysability. Dose as in normal renal function

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs
  • None known

    ADMINISTRATION

    Reconstition

    Route

    Oral

    Rate of Administration

    Comments

    OTHER INFORMATION

    C
  • arbimazole is a prodrug which is rapidly and completely metabolised to methimazole the active moiety
  • There have been reports of glomerulonephritis associated with the development of antineutrophil cytoplasmic antibodies in patients receiving thiourea anti-thyroid drugs.