# New oral liquid for hyperthyroidism



## Ceiling Kitty (Mar 7, 2010)

Just an update!

Norbrook has just released a liquid version of methimazole (the drug in Felimazole) for cats who struggle with tablets.

It's been shown in clinical trials to work as well as the tablets and is flavoured to be (allegedly!) palatable for cats (although they do state it has added honey to increase acceptance; sweet things not enjoyed by most cats but maybe it's better than the natural taste!).

This product will carry an advantage over the transdermal methimazole produced by Summit in that it is licensed, whereas the transdermal product is not.

It's called 'Thyronorm'. I'm not a huge fan of the name because it seems there is a human HYPOthyroidism treatment of the same name; confusion could be problematic.

Anyway, I hope this is useful to somebody. AFAIK, Thyronorm is available to veterinary practices now.










PS I'm in no way affiliated with this, just passing on info!


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## Little Zooey (Feb 4, 2014)

I'm interested! @Ceiling Kitty may I ask if you think this would be preferable to crushing Felimazole? I know you're not supposed to, but Merlin is un-pillable (and I'm very, very good). Since he was diagnosed in January, he did take whole pills in prawns, EasyPill or bits of chicken breast (cooked for our ferrets). Then he had a dental and he was sore for a bit, so we had to crush it in watered down AD. Afterwards we were never able to get him back on whole pills, even though his mouth is fine. He will eat a whole prawn without a pill, but ignore the one with the pill. I checked with one of our vets who said a few of his other patients also had crushed pills. The vet can't get blood out of Merlin either, so we are monitoring him by weight alone. I weigh him monthly and he's gained a HUGE amount of weight, but now he's reached 5Kg he's tailing off nicely.

I presume this liquid has been designed to work over a period of 12 hours (and could still be dripped into a small feed of AD)? I worry about the crushed tablets not working as they were designed to do. If you think this would be better, I'll speak to my vet this week


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## TallulahCat (Dec 31, 2015)

It sounds an excellent solution as even cats that will take pills may not do so on a permanent basis. I was unable to pill Mitzi, so I had to crush her Vidalta and mix it with lick-e-lix. I would split the pill between morning and evening to at least spread out the dose, but obviously this still wasn't ideal.


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## Paddypaws (May 4, 2010)

@Littlezooey my understanding is that felimazole is not extended release in any way and that the only issue with crushing it is possible contamination for us ourselves. 
Is that right @Ceiling Kitty ?


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## kittih (Jan 19, 2014)

Oh this is good news. I shall have a chat with my vet about it.

Thank you so much for the update @Ceiling Kitty


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## TallulahCat (Dec 31, 2015)

Oh, I was confusing it with carbimazole/Vidalta, which is a slow-release tablet. But in any case, it does sound like a good option for cats who are difficult to pill.


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## kittih (Jan 19, 2014)

The Norbrook website states:

For oral use only.
The product should be administered directly into the mouth of the cat.
Do not administer in food as efficacy of the product when administered via this route has not been established.

So for my "I dont like to be held in any way or have things put in my mouth" cat unfortunately it is still likely to be problematic to administer. 

I really hope they can get some efficacy data on its use with food. <insert hopeful emoticon here>


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## Little Zooey (Feb 4, 2014)

Paddypaws said:


> @Littlezooey my understanding is that felimazole is not extended release in any way and that the only issue with crushing it is possible contamination for us ourselves.
> Is that right @Ceiling Kitty ?


That's fine, but it wasn't what one of our vets told me - I've asked three so far and get a different answer every time. I'm now confused if you can't give this new liquid with food. Surely it wouldn't matter if it's going down the cat to be mixed with food already in the stomach. Or are you supposed to give it on an empty stomach? I'm just happy Merlin seems fine with his crushed tablet. He's been taking it like this for a few months and his weight is stable. He's actually on a bit of a diet because he's been getting too chubby!


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## kittih (Jan 19, 2014)

kittih said:


> Oh this is good news. I shall have a chat with my vet about it.
> 
> Thank you so much for the update @Ceiling Kitty


Thanks once again @Ceiling Kitty for letting us have such up to date information. I discussed it with my vet today, she and her colleagues were unaware of it and were very interested and excited to hear about it. I am hoping it provides a viable alternative for many kitties out there who find the tablets difficult to administer.


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## Ceiling Kitty (Mar 7, 2010)

Oops dropped the ball on this thread - sorry!

Crushing Felimazole does not affect its effectiveness, but it does carry a significant health and safety risk for those doing the crushing. Inhaling the powder/dust from the crushed tablets, or getting it on one's fingers and absorbing it through the skin or accidentally ingesting it, is considered a real enough risk by Dechra to cause them to advise against crushing. Ongoing exposure could cause hypothyroidism, and it has been highlighted as a potential carcinogen and risk to pregnant women.

That said, a similar risk exists for tablets that get all wet during pilling. Generally I think it is sensible to wear gloves when handling these tablets, though I'm sure many of us do not. And I guess it's up to each individual to make the risk assessment for their own circumstances - I certainly know plenty of people who crush Felimazole.

Vidalta should not be crushed since it is a delayed-release formulation, and breaking the outer coating reduces its efficacy. For the same reason, it is not recommended to offer the tablet in food unless you can be certain the cat does not accidentally bite down on the tablet and break it before swallowing.


As for the Thyronorm, it's obviously early days yet and I'm sure plenty more information will come out in due course. I cannot comment on whether it is known for sure that it won't work when mixed with food, or whether Norbrook are simply obliged to state as such because they don't have the data either way. It seems that they just haven't tested it by administering in food and therefore have no choice but to advise against doing so, but I suppose time will tell if it is indeed effective. I'm sure a lot of cats all over the country will end up having Thyronorm administered in food!

I think another, slightly overlooked (so far) benefit of this new formulation is that it may be much easier to make slight dosage adjustments. Having only 2.5mg and 5mg methimazole tablets can prove restrictive in some cases, but now cats needing an 'in between' dose will be easier to dose.


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## Little Zooey (Feb 4, 2014)

Thank you for this. I had read the bit about pregnant women, but not the rest. We have thin gloves in the kitchen and I will make sure I use them from now on. I have been scraping the bits off the back of the spoon with my nail rather than my finger, but it's clearly a no-no


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## Paddypaws (May 4, 2010)

I think felimazole comes in 1.25mg size now or so my vet told me after I had spent years cutting pills in half!


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