Usual initial dose: mcg PO qDay; May adjust dose by mcg. Administer oral levothyroxine 4 hr apart from drugs known to interfere with.Comments : -The dose should be individualized on the basis of clinical response and biochemical tests. Regular monitoring of TSH and thyroxine is recommended when starting therapy or changing the dose.
Background The treatment of hypothyroidism with levothyroxine is effective and simple; however, recommendations for the starting dose vary considerably.ALWAYS consult your doctor or pharmacist. Usual Adult Dose for: Usual Geriatric Dose for: Usual Pediatric Dose for: Additional dosage information: Usual Adult Dose for Hypothyroidism -HYPOTHYROIDISM IN ADULTS AND IN CHILDREN IN WHOM GROWTH AND PUBERTY ARE COMPLETE : Therapy may begin at full replacement doses in otherwise healthy individuals less than 50 years.
Pdf (Accessed: April 2011) Ideal Body Weight : 5 Burton, M.E., Shaw, L.M., Schentag, J.J., and Evans, W.E. (editors). Applied Pharmacokinetics Pharmacodynamics, Principles of Therapeutic Drug Monitoring. Lippincott Williams Wilkins, Baltimore, MD.8 Khan MA, Reddy IK. Pharmaceutical and clinical calculations. CRC Press, 2000: 268. Disclaimer The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical judgment.
Appropriate treatment reverses all the clinical manifestations of hypothyroidism. This review will discuss the major issues that must be addressed in the treatment of patients with overt primary hypothyroidism. Our approach described below is largely consistent with the American Thyroid Association Guidelines for the Treatment of Hypothyroidism 1.Hypothyroidism (Levothyroxine) Calculator (Adults) BETA version Background This calculator provides very basic initial levothyroxine dosage and follow-up guidelines for adult patients with hypothyroidism. The starting dose, frequency of dose titration, and the optimal full replacement dose should be based on several key parameters including 1 : (1) Patient age - e.g.
Therapy consists of thyroid hormone replacement unless the hypothyroidism is. The starting dose of levothyroxine in primary hypothyroidism.In severe cases of hypothyroidism (T4 less than 5 mcg/dL a higher initial dose of 12 to 17 mcg/kg/day may be considered. -Age
Literature review current through: Nov 2015. This topic last updated: Wed Jan 21 00:00:The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment.Doses greater than 200 mcg/day orally are seldom required. An inadequate response to oral daily doses of 300 mcg/day or greater is rare and may indicate poor compliance, malabsorption, and/or drug interactions -FOR MOST PATIENTS OLDER THAN 50 YEARS OR FOR PATIENTS UNDER 50 YEARS OF AGE WITH UNDERLYING CARDIAC DISEASE : -Initial dose: 25.
-This drug should be taken in the morning on an empty stomach with water, at least one-half hour before any food is eaten. -This drug should be taken at least 4 hours apart from drugs that are known to interfere with its absorption.Situations Associated with Thyroid-stimulating Hormone Suppression 2. Physiologic states Autonomous thyroid function (nodular thyroid disease, subclinical Graves disease) -Nonthyroidal illness. -Chorionic gonadotropin excess (first trimester of pregnancy, hyperemesis gravidarum, molar pregnancy, choriocarcinoma) -Recovery after therapy for hyperthyroidism or after painless or postpartum thyroiditis -Central hypothyroidism.
American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of hyperthyroidism and hypothyroidism. Endocr Pract. 2002;. 2 Mandel SJ, Brent GA, Larsen PR. Levothyroxine therapy in patients with thyroid disease.Primary hypothyroidism may result from functional deficiency, primary atrophy, partial or total congenital absence of the thyroid gland, or from the effects of surgery, radiation, or drugs, with or without the presence of goiter.
Ann Intern Med. 1993; Other : 3 American Thyroid Association: t/hypothyroidism/guidelines. Accessed April 2011. 4 Levy EG, Ridgway EC, Wartofsky L. Algorithms for diagnosis management of thyroid disorders. p, m/ExpertOpinions/ThyroidDiseaseAlgorithms.-This drug should be taken at least 4 hours apart from drugs that are known to interfere with its absorption. -The peak therapeutic effect of this drug may not be attained for 4 to 6 weeks.
This section covers recommendations regarding levothyroxine therapy. The starting dose of levothyroxine should be based on the patient s.Neither GlobalRPh Inc. nor any other party involved in the preparation of this program shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material.
When autoimmune thyroiditis is the suspected underlying cause, it is helpful to confirm antithyroid antibody titers, either antimicrosomal antibody (anti-TPO antibody) or antithyroglobulin antibody." See reference for additional info. Inputs Age : Age 15 - 40 yo 40 - 60 yo Greater than 60 yo 4.Usual Adult Dose for TSH Suppression. TSH SUPPRESSION IN WELL -DIFFERENTIATED THYROID CANCER AND THYROID NODULES : -The target level for TSH suppression in these conditions has not been established. The efficacy of TSH suppression for benign nodular disease is controversial.
Read the disclaimer.Females: IBW 45.5 kg 2.3 kg for each inch over 5 feet. 6 Devine BJ. Gentamicin therapy. Drug Intell Clin Pharm 1974;. 7 Murphy JE. Clinical pharmacokinetics, 4th ed. ASHP, 2008:250, 397.
Applies to the following strength(s 25 mcg (0.025 mg) ; 50 mcg (0.05 mg) ; 75 mcg (0.075 mg) ; 100 mcg (0.1 mg) ; 125 mcg (0.125 mg) ; 150 mcg (0.15 mg) ; 200 mcg (0.2 mg) ; 300 mcg (0.3 mg) ; 500 mcg (0.5 mg) ; 88 mcg (0.088 mg) ;.Use: As replacement or supplemental therapy in congenital or acquired hypothyroidism of any etiology, except transient hypothyroidism during the recovery phase of subacute thyroiditis. Specific indications include: primary (thyroidal secondary (pituitary and tertiary (hypothalamic) hypothyroidism and subclinical hypothyroidism.
-In the treatment of benign nodules and nontoxic multinodular goiter, TSH is generally suppressed to a higher target (e.g., 0.1 to 0.5 mU/L for nodules and 0.5 to 1.0 mU/L for multinodular goiter) than that used for the treatment of thyroid cancer.Older patients: start lower and titrate more slowly. (2) Weight ( mcg/kg lean body weight). Note: based on available research, IBW is a suitable substitute for LBW. (3) Cardiovascular status (positive history of coronary artery disease warrants initiation at a very low dose and very slow titration (4) General health.