Clinical decision-support only. For use by licensed dental professionals. Not a substitute for professional judgment or a complete drug reference. Always verify with primary sources.
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Medication

Propylthiouracil (PTU)

Antithyroid agent

Brand names: PTU

Oral health effects

  • Agranulocytosis risk (oral ulceration/infection)

    Same agranulocytosis concern as methimazole, with sialadenitis also reported.

    Clinical management: Be alert to unexplained oral infection/ulceration; coordinate CBC with the physician.

  • Bleeding tendency (hypoprothrombinemia)

    Propylthiouracil may cause hypoprothrombinemia and bleeding; the label advises monitoring prothrombin time, especially before surgical procedures. Thrombocytopenia can also occur as part of drug-induced marrow suppression.

    Clinical management: Ask about unusual bruising or gum bleeding; before extractions or periodontal surgery, confirm with the physician that recent coagulation tests/blood counts are acceptable and use local hemostatic measures.

  • Taste loss or distortion (dysgeusia)

    Loss of taste and taste perversion are listed among adverse reactions (label).

    Clinical management: Reassure, exclude oral causes, and let the prescriber know if taste change is distressing or affecting nutrition.

Sources

  1. A review and guide to drug-associated oral adverse effects-Oral mucosal and lichenoid reactions. Part 2. Teoh L, Moses G, McCullough MJ. Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology, 2019.
  2. Propylthiouracil prescribing information (FDA label) Teva Pharmaceuticals, Inc. / DailyMed, 2023.