Carbimazole

H03B - Antithyroid preparations ATC H03BB01 Small molecule Natural product

JFDA label: NEOMERCAZOLE TAB

Mechanism of Action

Inhibitor of Thyroid peroxidase — Thyroid peroxidase inhibitor

Target	Action	Gene / class
Thyroid peroxidase efficacy	INHIBITOR	TPO

Indications

Approved

Thyroid Diseases — Abnormality of the thyroid gland

Off-label

Thyrotoxicosis

Adverse Reactions

Very Common >10%Common 1–10%Uncommon 0.1–1% Rare 0.01–0.1%Very Rare <0.01%Not Known

Vascular disorders (1)

Not Known Haemorrhage

Nervous system disorders (1)

Not Known Headache

Hepatobiliary disorders (8)

Not Known Foetor hepaticus · Hepatitis · Hepatitis cholestatic · Hepatocellular injury · Jaundice · Jaundice cholestatic · Liver disorder · Liver function test abnormal

Blood and lymphatic system disorders (9)

Not Known Agranulocytosis · Aplastic anaemia · Eosinophilia · Haemoglobin · Haemolytic anaemia · Leukopenia · Neutropenia · Pancytopenia · Thrombocytopenia

Immune system disorders (1)

Not Known Hypersensitivity

Gastrointestinal disorders (2)

Not Known Nausea · Stomatitis

Skin and subcutaneous tissue disorders (7)

Not Known Alopecia · Angioedema · Dermatitis · Pruritus · Rash · Skin disorder · Urticaria

Musculoskeletal and connective tissue disorders (4)

Not Known Arthralgia · Musculoskeletal discomfort · Myalgia · Myopathy

Psychiatric disorders (1)

Not Known Emotional distress

Infections and infestations (1)

Not Known Infection

Investigations (2)

Not Known Body temperature increased · Feeling abnormal

General disorders and administration site conditions (12)

Not Known Ageusia · Angiopathy · Contusion · Cutaneous vasculitis · Discomfort · Hypogeusia · Ill-defined disorder · Malaise · Mouth ulceration · Nervous system disorder · Oropharyngeal discomfort · Oropharyngeal pain

Pregnancy & Lactation

Pregnancy

FDA category D

Caution

PTU preferred in T1 (less embryopathy but more maternal hepatotoxicity). Switch to carbimazole in T2 (less maternal hepatotoxicity). Lowest effective dose to keep maternal FT4 at upper normal

Lactation

Caution Hale L3

Monit

Chemistry & Properties

Formula	C7H10N2O2S
Molecular weight	186.24 g/mol
IUPAC name	ethyl 3-methyl-2-sulfanylideneimidazole-1-carboxylate
CAS	22232-54-8
PubChem CID	31072
InChIKey	`CFOYWRHIYXMDOT-UHFFFAOYSA-N`
logP	1.56 (XLogP 0.7)
Polar surface area	36.16 Å²
H-bond acceptors / donors	5 / 0
Drug-likeness (QED)	0.62
Lipinski violations	0

SMILES

CCOC(=O)n1ccn(C)c1=S

Biology & Pharmacokinetics

Pharmacokinetics

BBB penetrant	No

Enzyme interactions

Enzyme	Role	Detail
CYP2B6	Inhibitor	—
CYP2C19	Inhibitor	—

Transporters

BCRP (Inhibitor)BSEP (Inhibitor)BSEP (Inhibitor)MRP1 (Inhibitor)OATP1B1 (Inhibitor)OATP1B1 (Inhibitor)OATP1B3 (Inhibitor)OATP1B3 (Inhibitor)P-gp (Inhibitor)P-gp (Substrate)

Registered Products (3)

Brand	Form / strength	Pack	Agent	Citizen (JOD)
Antithyrox	Tablet 5 mg	100 tab	Sun Set Drug Store	2.830
NEOMERCAZOLE TAB	Tablet 5 mg	100 tab	Shawi & Rushedat Drug Store	4.070
Carbimazole 5 Tablet	Tablet 5 mg	100 tab	JAWEDA INT. DRUD STORE	4.660