methimazole withdrawal symptoms

She improved and jaundice resolved within 4 weeks and other liver test abnormalities within 8 weeks. * Approximation only. Knowing that using an opioid wont get you high should discourage you from impulsively relapsing. Clients may be affected by less intense versions of the acute signs and symptoms of withdrawal as well as by other conditions such as impaired ability to check impulses, negative emotional states, sleep disturbances, and cravings. Becker CE, Gorden P, Robbins J. A single copy of these materials may be reprinted for noncommercial personal use only. Drug withdrawal syndrome is found among people who take Methimazole, especially for people who are female, 50-59 old. Other Drugs in the Class: Propylthiouracil. In general, a handful of common physical withdrawal symptoms include: 4. Methimazole Recruiting Phase 4 Trials for Drug Withdrawal Symptoms / Graves' Disease / Drug Relapse / Treatments Treatment. Sequential liver and bone biochemical changes in hyperthyroidism: prospective controlled follow-up study. American Society of Health-System Pharmacists, Inc. Disclaimer, U.S. Department of Health and Human Services. Insomnia or inability to sleep. Yoshihara A, Noh J, Yamaguchi T, Ohye H, Sato S, Sekiya K, Kosuga Y, et al. Just like your mind gets irritated without nicotine at first, the rest of your body can, too. 2019 Jan 19;15:65-69. doi: 10.1016/j.jcte.2019.01.001. The abnormalities resolve rapidly with treatment of hyperthyroidism either with surgery, radioactive iodine or antithyroid medications. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements. Phase IV trials are used to detect adverse drug outcomes and monitor drug effectiveness in the real world. Instead, the best way to dispose of your medication is through a medicine take-back program. Rivkees SA, Mattison DR. Propylthiouracil (PTU) hepatotoxicity in children and recommendations for discontinuation of use. Finally, social support is a key aspect of relapse prevention. Feeling jumpy and restless. age 21-78yrs. Drug-induced hepatic injury during methimazole therapy. This product is available in the following dosage forms: In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. Ask your pharmacist any questions you have about refilling your prescription. Low blood cell counts have happened with methimazole. It is the most common cause of hyperthyroidism (overactive thyroid gland). National Institute of Diabetes and Digestive and Kidney Diseases. When using methadone, you may experience . News NAVC Blog Spark! A study of four cases. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. When taken as directed, methadone is able to reduce the symptoms of opioid withdrawal, decrease opioid cravings, and induce a significant amount of cross-tolerance to other opioidswhich may block some or all of the euphoric effects of drugs such as heroin, oxycodone, and hydrocodone. Drug information provided by: IBM Micromedex. When used correctly, methadone allows people to quit heroin and prescription pain killers without going into withdrawal. Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings, feeling of constant movement of self or surroundings, general feeling of discomfort, illness, or weakness, sores, ulcers, or white spots on the lips or in the mouth, swelling of the face, feet, or lower legs, swollen, painful, or tender lymph glands in the neck, armpit, or groin, pain or discomfort in the chest, upper stomach, or throat. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). tell your doctor if you have or have ever had any blood disease, such as decreased white blood cells (leukopenia), decreased platelets (thrombocytopenia), or aplastic anemia, or liver disease (hepatitis, jaundice). Avoid contact sports or other situations where bruising or injury could occur. Treating Opioid Use Disorder During Pregnancy. A 43 year old woman with Graves disease developed pruritus and jaundice one month after starting therapy with methimazole (10 mg) and propranolol (20 mg), both given three times daily. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Profile of idiosyncratic drug induced liver injury in Latin America: an analysis of published reports. Changes in social circles. Shortness of breath. In Fig 3, we show the Kaplan-Meier curve for relapse of hyperthyroidism. 3. Results: Twelve and 24 months after withdrawal, there were 10 (25.6%) and 17 (44.7%) relapses, respectively . Its symptoms are fever, diarrhea, vomiting, nausea, abdominal pain, anxiety, delirium. and transmitted securely. Feeling like you have a bad flu, vomiting, diarrhea, sweating, and insomnia are all common. Schmidt G, Boerach G, Mueller KM, Wegener M. Methimazole associated cholestatic liver injury: case report and brief literature review. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Methimazole has been associated with transient, asymptomatic elevations in serum aminotransferase levels, typically during the first 3 months after starting during high dose, induction therapy. People take methadone for months or years at a time. Could you be swinging back into hyperthyroid? The following information includes only the average doses of this medicine. Goosebumps or gooseflesh. . A burning, numbness, or tingling feeling that is not normal. Zimmerman HJ. How Long Does Withdrawal From Antidepressants Last? Rapid heart rate and palpitations. If you are currently using methadone or other opioids, it is best to continue with methadone until the end of your pregnancy. To use the sharing features on this page, please enable JavaScript. Rare instances of prolonged cholestasis have been described, but no instance of vanishing bile duct syndrome. Thyroid hypoechogenicity score (assessed by the same observer with the same equipment) was graded as: 0 absent; 1 mild; 2 moderate; 3 marked. generic drugs) are not considered. Although not all of these side effects may occur, if they do occur they may need medical attention. Drug-induced acute liver failure: results of a U.S. multicenter, prospective study. Once you have tapered down, you might want to find something more convenient, like a therapist in private practice or at a local community health clinic. If you drink alcohol while taking a beta-blocker and your blood pressure drops too much, you may experience the following symptoms: dizziness lightheadedness fainting, especially if you get up. MMI treatment induces evident changes in thyroid hypoechogenicity, mainly in patients who subsequently go into remission. It is based on methimazole (the active ingredients of Methimazole) and Methimazole (the brand name). Read our, Oxycodone Withdrawal: Symptoms, Timeline, and Treatment. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). The liver test elevations are most frequent in patients with high output heart failure. FDA approves the first non-opioid treatment for management of opioid withdrawal symptoms in adults. Along with its needed effects, a medicine may cause some unwanted effects. We are surprised that your doctor prescribed atenolol as a first-line treatment for . Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of methimazole in children. Cooper DS, Rivkees SA. Methimazole has been linked to serum aminotransferase elevations during therapy as well as to a clinically apparent, idiosyncratic liver injury that is typically cholestatic and self-limited in course. With a short-acting opioid, these withdrawal symptoms can be intense, but they typically peak within a couple of days and then begin to resolve. symptoms related to substance abuse may be felt for weeks, months, and sometimes years. muscle pain, cramps, or stiffness. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. It is very important that your doctor check your or your child's progress at regular visits to make sure that the medicine is working properly. Make sure any doctor or dentist who treats you knows that you are using this medicine. They can be extremely frustrating for both people in recovery and their loved ones. de Campos Mazo DF, de Vasconcelos GB, Pereira MA, de Mello ES, Bacchella T, Carrilho FJ, et al. If you notice any other effects, check with your healthcare professional. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding. Research shows that a combination of talk therapy and medication management is more effective at treating opioid use disorders than medication alone. Bahn RS, Burch HS, Cooper DS, Garber JF, Greenlee CM, Klein IL, et al. 2016;2016:1-7. doi:10.1155/2016/7620860, Amato L, Minozzi S, Davoli M, Vecchi S. Psychosocial and pharmacological treatments versus pharmacological treatments for opioid detoxification.Cochrane Database of Systematic Reviews. Side effects of steroid nasal sprays. Swollen gland. Do not miss any doses. Waseem M, Seshadri KG, Kabadi UM. With a short-acting opioid, these withdrawal symptoms can be intense, but they typically peak within a couple of days and then begin to resolve. Muscle aches and pain. With medical big data and proven AI algorithms, eHealthMe provides a platform for everyone to run phase IV clinical trials. 2023 Dotdash Media, Inc. All rights reserved. A cohort study. Both drug; she was reluctant to other types of therapy, not diseases are more common in females and in younger visiting endocrinologist regularly. If you want to stop taking methadone, your doctor will talk to you about an appropriate tapering timeline. This option should be considered for those people with Graves' disease, and not other types of hyperthyroid conditions (i.e. Methimazole should not be used during pregnancy or breast-feeding. Methadone isproven safe and effective for use during pregnancy. The most common signs you should watch for include: Vomiting or regurgitating undigested food No appetite (refusing to eat) Rash Swelling of the face OTC pain relievers, like Tylenol or Advil, to treat aches and pains. Detoxing from methadone is a great step, but it doesnt mean that youve beaten your addiction. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. This is a decision you and your doctor will make. These elevations are rarely clinically significant and usually resolve even with continuation of therapy. This patient is probably relatively pain free, but providing emergency treatment is the priority. Disclaimer. The starting dose is 0.4 mg per kilogram (kg) of body weight per day, divided in 3 equal doses and given about every 8 hours. Methimazole is used to treat hyperthyroidism, a condition that occurs when the thyroid gland produces too much thyroid hormone. J Clin Endocrinol Metab. Dehydration is common during withdrawal. Newsletters Subscribe Press NAVC Brands Menu Articles Back Topics Back Anesthesiology Behavior Cardiology Clinical Pathology Cytology Dentistry Call your doctor for medical advice about side effects. It is available as a pill or a transdermal patch. What special dietary instructions should I follow? HHS Vulnerability Disclosure, Help In severe cases, however, more definitive therapy of the hyperthyroidism with radioactive iodide or surgery may be more appropriate. Even if you are frustrated and sick of going to a clinic or pharmacy every day for a supervised dose, it is best to avoid abrupt cessation. A case of methimazole-induced acute hepatic failure in a patient with chronic hepatitis B carrier. Ask your healthcare professional how you should dispose of any medicine you do not use. Methimazole-induced cholestatic jaundice. The medication methimazole works by preventing the thyroid gland from making too much thyroid hormone. loss of taste. Naltrexone is whats known as an opioid antagonist (similar to the naloxone in Suboxone). 2007 Dec;54(5):713-20. doi: 10.1507/endocrj.k06-069. Reuben A, Koch DG, Lee WM., Acute Liver Failure Study Group. Liver dysfunction and anti-thyroid therapy. Keep this medication in the container it came in, tightly closed, and out of reach of children. Antithyroid drugs. If you notice any other effects, check with your healthcare professional. Verywell Mind's content is for informational and educational purposes only. decreased blood platelets. [. Stomach and digestion problems (e.g.,abdominal cramping, nausea, vomiting, diarrhea, etc.) Woeber KA. A characteristic thyroid ultrasonographic picture with diffuse or scattered low echogenicity has been described in Graves' disease (GD). Other people think its worse than withdrawing from a short-acting opioid like heroin. Li X, Jin S, Fan Y, Fan X, Tang Z, Cai W, Yang J, et al. [Updated 2020 Jan 22]. Lucemyra is a new medication; it's similar to clonidine and recently approved by theFDA to treat the symptoms of opioid withdrawal. You can find a meeting near you with theirsearchable directory. Methimazole has active ingredients of methimazole. TheAmerican Society for Addiction Medicinerecommends doctors consider prescribing the following medications: There is another option that you may want to talk to your doctor aboutLucemyra (lofexidine hydrochloride). Suzuki N, Noh JY, Hiruma M, Kawaguchi A, Morisaki M, Ohye H, Suzuki M, et al. Likelihood score: A (well known but rare cause of clinically apparent liver injury). If your dose is different, do not change it unless your doctor tells you to do so. Report of a case with apparent recovery. Make sure you tell your doctor if you have any other medical problems, especially: Take this medicine only as directed by your doctor. The severity of methimazole induced liver injury varies from mild, transient serum aminotransferase elevations to moderately severe cholestatic hepatitis. Otsuka F, Noh JY, Chino T, Shimizu T, Mukasa K, Ito K, Ito K, Taniyama M. Hepatotoxicity and cutaneous reactions after antithyroid drug administration. Vita R, Di Bari F, Perelli S, Capodicasa G, Benvenga S. J Clin Transl Endocrinol. Kwon H, Kim WG, Jang EK, Kim M, Park S, Jeon MJ, Kim TY, Ryu JS, Shong YK, Kim WB. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. No information is available on the relationship of age to the effects of methimazole in geriatric patients. This medicine is available only with your doctor's prescription. Design: In fact, there are some serious side effects that may come about if you try to use methimazole long-term. More serious side effects may include: Liver damage Yellow eyes or skin Severe abdominal pain/stomach pain Very dark-colored urine Nausea/vomiting that doesn't stop Typical cholestatic hepatitis arising one month after starting therapy with methimazole. She developed bilateral lower leg edema 5 days before admission and the laboratory examinations revealed leukopenia, anemia, proteinuria, and granular cast. Some people may also be allergic to the herb. Papachristos DA, Huynh J, Grossman M, MacIsaac RJ. The common symptoms of methimazole overdosage are nausea, vomiting, epigastric discomfort, fever, joint pain, itching, body ache, and swelling. nausea, vomiting, upset stomach; headache, dizziness, drowsiness; numbness or tingly feeling; rash, itching, skin discoloration; muscle or joint pain; hair loss; or. This is not a complete list of side effects and others may occur. 614-5. Unusual weakness or fatigue, fever, headache, skin rash, muscle or joint pain, loss of appetite, pain, tingling, or numbness in the hands or feet. Advertisements. Vitti P, Rago T, Mancusi F, Pallini S, Tonacchera M, Santini F, Chiovato L, Marcocci C, Pinchera A. Acta Endocrinol (Copenh). These symptoms are most common in long-term opioid abusers. Your symptoms may start off mild and become more severe over the course of a few days. Abrupt discontinuation has led to chest pain, irregular heart rhythms or even heart attacks. Symptoms of Graves' disease may include bulging eyes, weight loss, and a fast metabolism. Withdrawal symptoms can start as soon as 12 to 30 hours after your last dose. Thyroid vascularization is an important ultrasonographic parameter in untreated Graves' disease patients. Stick to a structured sleep schedule. It is not unusual for people with opioid use disorders to go on and off methadone over the course of several months or years. Continue giving methimazole and talk to your veterinarian if your pet experiences headache, drowsiness, dizziness; mild nausea, or vomiting; itching; muscle, joint, or nerve pain; swelling; hair loss. This medicine may cause hypothyroidism (low levels of thyroid hormone in the blood). Careers. WARNING: Please DO NOT STOP MEDICATIONS without first consulting a physician since doing so could be hazardous to your health. Methimazole (oral and transdermal) is a safe and effective medication for the treatment of feline hyperthyroidism. nausea, vomiting, upset stomach; headache, dizziness, drowsiness; numbness or tingly feeling; rash, itching, skin discoloration; muscle or joint pain; hair loss; or decreased sense of taste. She continued taking methimazole for 4 days after the appearance of jaundice and presented to the hospital two weeks later because of persistent jaundice and pruritus. heartburn. This medicine works best when there is a constant amount in the blood. Drug information provided by: IBM Micromedex. Heightened sensory perception. A. Unable to load your collection due to an error, Unable to load your delegates due to an error. Vitug AC, Goldman JM. Cappelli C, Gandossi E, Castellano M, Pizzocaro C, Agosti B, Delbarba A, Pirola I, De Martino E, Rosei EA. Different individuals may respond to medication in different ways. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. In order to avoid this risk, Zakavi et al evaluated methimazole (MMI) discontinuation before RAIT and reported that a short duration of ATD withdrawal before RAIT is safe and useful [4]. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. Copyright 2023 IBM Watson Health. Journal of Addiction. In some instances, certain formulations of methadone may . Advertising revenue supports our not-for-profit mission. Relapse rates among people with opioid use disorders are very high. You should also talk to your doctors about your plans after giving birth. For more mental health resources, see our National Helpline Database. Pregnancy affects the way your body metabolizes methadone, so your dose may need adjusting as your pregnancy advances. Took methimazole for 5 yrs, dropping it once after to to see on doc's orders. Huang MJ, Li KL, Wei JS, Wu SS, Fan KD, Liaw YF. Sudden onset agranulocytosis and hepatotoxicity after taking methimazole. An official website of the United States government. sharing sensitive information, make sure youre on a federal Toxic hepatitis during treatment with methimazole (Tapazole). Dr. Bruyette discusses drug administration and monitoring. The aim of this study was to evaluate the usefulness of thyroid hypoechogenicity changes in predicting GD relapse. Methimazole is an antithyroid medication which is now considered the first line agent for medical therapy of hyperthyroidism and Graves disease. Everyones experience getting off methadone is different. The cholestatic hepatitis caused by methimazole can be prolonged, but fatalities are rare and symptoms and jaundice usually clear within 2 to 8 weeks of stopping therapy. American Society for Addiction Medicine. Methods Thirty-eight patients with Graves' hyperthyroidism (M15/F23. Chalana H, Kundal T, Gupta V, Malhari AS. AHFS Patient Medication Information. Keep from freezing. Vomiting and diarrhea. To find more information about Narcotics Anonymous (NA) meetings in your area, check out theirwebsite. Basal thyroid hypoechogenicity cannot be used as an index of relapse of GD. A 15-year-old girl had a history of diffuse goiter and received methimazole treatment 2 months before admission to the hospital. Common acute withdrawal symptoms include: Methadone withdrawal symptoms vary from mild to moderate. At the withdrawal evaluation a score < 2 and a TRAb value < 10 U/l were considered as normal. Lung diseaseUse with caution. Content is reviewed before publication and upon substantial updates. Withdrawal symptoms such as tremors, anxiety, sweating, insomnia, pain, or hallucinations when you are unable to take the next dose of methaqualone. Mayo Clinic does not endorse any of the third party products and services advertised. He has since'd Swelling. Portions of this document last updated: Feb. 01, 2023. Worsening of constipation or GI issues Worsening memory function Increased pain And other symptoms of hypothyroidism These side effects usually mimic the side effects of hypothyroidism, because if you stop taking your medication your body will not be able to produce it naturally for some time. Use an effective form of birth control to keep from getting pregnant. Tennenbaum JI, Dreskin OH. Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Measurements: toxic multinodular goiter, subacute thyroiditis, etc.). Hernndez N, Bessone F, Snchez A, di Pace M, Brahm J, Zapata R, A, Chirino R, et al. Methimazole is also capable of causing clinically apparent, idiosyncratic liver injury. Methimazole-induced hepatotoxicity. Mamianetti A, Muoz A, Ronchetti RD, Maccione E, Poggi U, Mugnolo R, et al. Hepatotoxicity: the adverse effects of drugs and other chemicals on the liver. Ways to manage: Doing some physical activity can help shake loose your jumpiness. Antithyroid drug-related hepatotoxicity in hyperthyroidism patients: a population-based cohort study. Shen C, Zhao CY, Liu F, Wang YD, Yu J. Acute-on-chronic liver failure due to thiamazole in a patient with hyperthyroidism and trilogy of Fallot: case report. Be careful when using a regular toothbrush, dental floss, or toothpick. If your loved one is trying to recover from opioid addiction, you may want to consider a support group for friends and family, such asNar-Anon. These elevations are rarely clinically significant and usually resolve even with continuation of therapy. Methimazole resembles propylthiouracil both in chemical structure and activity. official website and that any information you provide is encrypted low levels of granulocytes, a type of white blood cell. Geneva: World Health Organization. Twelve and 24 months after withdrawal, there were 10 (25.6%) and 17 (44.7%) relapses, respectively. Isolation. Some people go into it thinking its going to be a nightmare, but it turns out to be milder than they anticipated. Clinical review: Clinical utility of TSH receptor antibodies. Do not let anyone else take your medication. Hopefully, never more. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Doctors prescribe it for two reasonsthe first is to give opioid addicts a safe, long-term option for relapse prevention, the second to treat stubborn cases of severe chronic pain. After you detox, your brain is operating with depleted stores of neurotransmitters. Talk to your veterinarian about any side effect that seems unusual or bothersome to the animal. 3rd ed. The patient had several produce neuromuscular symptoms that sometimes relapses due to non-compliance with her thyrostatic resemble each other (weakness and fatigue). Maci-Bobes C, Ronzn-Fernndez A, Macas-Robles MD, Fau-Cubero C. Regelmann MO, Miloh T, Arnon R, Morotti R, Kerkar N, Rapaport R. Graves disease presenting with severe cholestasis. Sato H, Minagawa M, Sasaki N, Sugihara S, Kazukawa I, Minamitani K, Wataki K, et al. If you miss a dose of this medicine, take it as soon as possible. Grlek A, Cobankara V, Bayraktar M. Liver tests in hyperthyroidism: effect of antithyroid therapy. The American Society of Health-System Pharmacists, 4500 East-West Highway, Suite 900, Bethesda, Maryland. The https:// ensures that you are connecting to the Deidiker R, deMello DE. Didn't tell doc. Hepatotoxicity from antithyroid drugs. 3. Successful outcome with methimazole and lithium combination therapy for propylthiouracil-induced hepatotoxicity. The site is secure. ChildrenDose is based on body weight and must be determined by your doctor. The onset of hepatotoxicity is usually within 2 to 12 weeks of starting and the pattern of enzyme elevations is typically cholestatic or mixed, although hepatocellular patterns have also been described. When it comes to therapy, you have a variety of options. Coughing up blood. Baker B, Shapiro B, Fig LM, Woodbury D, Sisson JC, Beierwaltes WH. This can take as long as 14 days. The usual dose in adults is 15 to 60 mg daily in three divided doses until the patient is euthyroid, followed by a maintenance dose of 5 to 15 mg daily. Do not take a double dose to make up for a missed one. Results of our real-world drug study have been referenced on 600+ medical publications, including The Lancet, Mayo Clinic Proceedings, and Nature. For example, a person might feel anxious and cold one minute then depressed and hot a few minutes later. Patients: Findor J, Bruch Igarta E, Sorda J, Jury R. Sola J, Pardo-Mindn FJ, Zozaya J, Quiroga J, Sangro B, Prieto J. Liver changes in patients with hyperthyroidism. Posology. Dosage of drugs is not considered in the study. Breastfeeding is generally considered safe during methadone treatment. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program. Amsterdam: Elsevier, 2013, pp. The .gov means its official. Adverse effects of hormones and hormone antagonists on the liver. methimazole withdrawal and she was fully recovered in 4 days with no more signs of arthritis or arthralgia, so we discontinued Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellow eyes or skin. Withdrawal from depressants may also bring about mental health symptoms such as anxiety, perceptual disturbances, hallucinations, and other perceptual disturbances, or delirium. Kontoleon P, Ilias I, Koutras DA, Kontogiannis D, Papapetrou PD. What should I know about storage and disposal of this medication? Four days is nothing when it comes to thyroid meds. Endocrinol Metab (Seoul). Clonidine,a hypertension drug regularly used off-label to treat opioid withdrawal symptoms. Rosenbaum H, Reveno WS. Carella C, Mazziotti G, Sorvillo F, Piscopo M, Cioffi M, Pilla P, Nersita R, Iorio S, Amato G, Braverman LE, Roti E. Thyroid. if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking methimazole. It works by making it harder for the body to make thyroid hormone. Methimazole has been associated with transient, asymptomatic elevations in serum aminotransferase levels, typically during the first 3 months after starting during high dose, induction therapy. This site needs JavaScript to work properly. In several instances, patients with methimazole induced liver injury have been switched to propylthiouracil without evidence of recurrence, but in at least one case, recurrent jaundice appeared. Methimazole is an antithyroid medicine. Antithyroid drugs. Check with your medical doctor before having any dental work done.

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