Hyperthyroidism (overactive thyroid) most commonly caused by Graves’ disease (autoimmune TSH-receptor antibody-mediated), toxic multinodular goitre, or solitary toxic adenoma. Symptoms include weight loss with normal/increased appetite, palpitations, tremor, heat intolerance, anxiety, frequent stools, and (in Graves’) eye signs (proptosis, lid lag, ophthalmopathy). The MedsBase Overactive Thyroid Treatment catalogue carries the antithyroid thionamide drugs that block thyroid peroxidase and reduce hormone synthesis.
Voorradige opties. Methimazole (the modern preferred thionamide — once-daily dosing, less hepatotoxic than propylthiouracil except in pregnancy first-trimester and thyroid storm) is stocked as Methimez. Carbimazole (the prodrug of methimazole, widely used in UK / Europe / India / Asia) as Neomercazole.
Hoe te gebruiken. Initial dose for moderate Graves’ disease: methimazole 15–30 mg daily or carbimazole 20–40 mg daily, titrated based on TSH and free T4 measured every 4–6 weeks. Most patients achieve euthyroid state within 6–12 weeks. Long-term options: continue antithyroid drug for 12–18 months (40% remission rate after stopping in Graves’), radioactive iodine ablation (definitive but causes permanent hypothyroidism), or surgical thyroidectomy. Beta-blockers (propranolol — see Hart & Bloeddruk) for symptomatic control of palpitations, tremor, and anxiety while awaiting antithyroid drug effect.
Belangrijk. Mandatory pre-treatment baseline FBC and LFTs. Antithyroid drugs cause agranulocytosis in 0.1–0.5% of patients (typically within 90 days, higher dose risk) — sudden fever, sore throat, mouth ulcers warrant immediate FBC and treatment cessation if neutropenic. Hepatotoxicity — propylthiouracil more than methimazole; LFT monitoring during early treatment. Pregnancy: propylthiouracil preferred in first trimester (less teratogenic — methimazole-induced aplasia cutis and choanal atresia), then switch to methimazole second trimester. Subacute thyroiditis presents with hyperthyroidism but does NOT respond to antithyroid drugs (NSAIDs and beta-blockers are appropriate; thyroid scan helps differentiate). All MedsBase products ship from WHO-GMP gecertificeerde fabrikanten and are covered by our Reshipment Assurance Policy.