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This safety information outlines the potential risks and precautions associated with using methimazole. It is important to read this carefully and consult with your healthcare provider if you have any questions or concerns.

• Risk of Birth Defects: Methimazole may cause birth defects if used during the first trimester of pregnancy. It is not recommended for women who are pregnant or planning to become pregnant during this time. Consult your healthcare provider for safer alternatives.

• Reduced White Blood Cell Count (Agranulocytosis): Methimazole can decrease white blood cell levels, impairing your body's ability to combat infections. This condition can be life-threatening. Contact your healthcare provider immediately if you experience a sore throat or fever, especially if you are taking other immune-suppressing medications or have conditions that weaken the immune system.

• Liver Damage: Methimazole may cause liver damage, though the risk is generally lower compared to other antithyroid drugs, particularly in children. Be vigilant for symptoms such as yellowing of the skin or eyes, upper right stomach pain, dark urine, nausea, or vomiting. If these occur, inform your healthcare provider promptly, as you may need to undergo liver function tests or discontinue the medication.

• Hypothyroidism: Methimazole can lead to low thyroid hormone levels, resulting in symptoms like fatigue, dry skin, or constipation. If you experience these symptoms, your healthcare provider may need to adjust your dosage to maintain normal thyroid hormone levels.

• Vasculitis: Although rare, methimazole may cause inflammation of blood vessels. Symptoms can vary depending on the affected vessels and may include rashes, chest pain, shortness of breath, stomach pain, and discolored urine. Contact your healthcare provider if you notice any of these symptoms, as further treatment might be necessary.

Please ensure you discuss any concerns with your healthcare provider to manage these potential risks effectively.

Common side effects:

• Nausea
• Vomiting
• Stomach upset
• Raised, itchy rash

Less common but important to monitor:

• Loss of taste
• Unusual hair loss
• Drowsiness
• Vertigo
• Headache
• Muscle pain
• Joint pain

Serious side effects:

• Low white blood cell count (fever, fatigue, chills, sore throat)
• Inflamed blood vessels (rash, nerve pain, chest pain, stomach pain)
• Unusual bleeding or bruising
• Black stools
• Blood in urine
• Persistent bleeding or bruising
• Liver problems (upper right stomach pain, loss of appetite, jaundice)
• Serious allergic reaction (rash, itching or swelling, severe dizziness, trouble breathing)

Interactions with high risk of serious adverse effects and should be avoided:

• Bupropion
• Tegafur

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Warfarin
• Acenocoumarol
• Anisindione
• Dicumarol
• Phenindione
• Phenprocoumon
• Digoxin