Comment: -The age, general physical condition, cardiac risk factors, and severity of myxedema and duration of myxedema symptoms should be considered when determining the starting and maintenance dosages. Use: Myxedema coma Usual Geriatric Dose for Hypothyroidism ELDERLY PATIENTS WITH CARDIAC DISEASE : -Initial dose: 12.5 to 25 mcg orally per day, with gradual dose increments.Levothyroxine is contraindicated in patients with uncorrected adrenal insufficiency since thyroid hormones may precipitate an acute adrenal crisis by increasing the metabolic clearance of glucocorticoids (see PRECAUTIONS ). Levothyroxine sodium is contraindicated in patients with hypersensitivity to any of the inactive ingredients in Levothyroxine sodium tablets.
Dietary fiber decreases bioavailability of T 4. Absorption may also decrease with age. In addition, many drugs and foods affect T 4 absorption (see PRECAUTIONS : Drug Interactions and Drug-Food Interactions ).For patients who have recently initiated levothyroxine therapy and whose serum TSH has normalized or in patients who have had their dosage or brand of levothyroxine changed, the serum TSH concentration should be measured after 8 to 12 weeks.
5. Take levothyroxine sodium in the morning on an empty stomach, at least one-half hour before eating any food. 6. It may take several weeks before you notice an improvement in your symptoms.When thyroid hormone levels decrease, TRH and TSH secretion increase. The mechanisms by which thyroid hormones exert their physiologic actions are not completely understood, but it is thought that their principal effects are exerted through control of DNA transcription and protein synthesis.
More frequent intervals of monitoring may be necessary if poor compliance is suspected or abnormal values are obtained. It is recommended that TSH and T4 levels, and a physical examination, if indicated, be performed 2 weeks after any change in levothyroxine sodium dosage.7. Notify your physician if you experience any of the following symptoms: rapid or irregular heartbeat, chest pain, shortness of breath, leg cramps, headache, nervousness, irritability, sleeplessness, tremors, change in appetite, weight gain or loss, vomiting, diarrhea, excessive sweating, heat intolerance, fever, changes in menstrual periods, hives or skin rash, or any other unusual medical.
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.Thyroid replacement treatment is usually taken for life. There are different brands of levothyroxine available. Do not change brands without first consulting your doctor or pharmacist. Certain medications (such as cholestyramine, colestipol, colesevelam, antacids, sucralfate, simethicone, iron, sodium polystyrene sulfonate, calcium supplements, orlistat, sevelamer, among others) can decrease the amount of thyroid hormone that is.
TSH may not normalize due to a resetting of the pituitary-thyroid feedback threshold as a result of in utero hypothyroidism. Failure of the serum T4 to increase into the upper half of the normal range within 2 weeks of initiation of levothyroxine sodium therapy and/or of the serum TSH to decrease below 20 mU/L within.Thyroid hormones are also metabolized via conjugation with glucuronides and sulfates and excreted directly into the bile and gut where they undergo enterohepatic recirculation. Elimination Thyroid hormones are primarily eliminated by the kidneys.
Routine clinical examination, including assessment of mental and physical growth and development, and bone maturation, should be performed at regular intervals. Secondary (Pituitary) an.Approximately 80 of the daily dose of T 4 is deiodinated to yield equal amounts of T 3 and reverse T 3 (rT 3 ). T 3 and rT 3 are further deiodinated to diiodothyronine.
Pituitary TSH Suppression In the treatment or prevention of various types of euthyroid goiters (see WARNINGS and PRECAUTIONS including thyroid nodules (see WARNINGS and PRECAUTIONS subacute or chronic lymphocytic thyroiditis (Hashimotos thyroiditis multinodular goiter (see WARNINGS and PRECAUTIONS ) and, as an adjunct to surgery and radioiodine therapy in the management of thyrotropin-dependent well differentiated.2 Aluminum Lake 175. D C Red No. 27 Aluminum Lake, D C Red No. 30 Aluminum Lake, FD C Blue No. 1 Aluminum Lake 200 FD C Red No. 40 Aluminum Lake 300 D C Yellow No.
Table 1: Pharmacokinetic Parameters of Thyroid Hormones in Euthyroid Patients Hormone Ratio in Thyroglobulin Biologic Potency t (days) Protein Binding Levothyroxine (T 4 ) Liothyronine (T 3 ) 10 to to 7 2 99.96 99.5 Indications and Usage for Levothyroxine Levothyroxine sodium is used for the following indications: Hypothyroidism As replacement or supplemental therapy in.8. Notify your physician if you become pregnant while taking levothyroxine sodium. It is likely that your dose of levothyroxine sodium will need to be increased while you are pregnant. 9.
If you are taking any of these drugs, separate them from this medication by at least 4 hours. Symptoms of low thyroid hormone levels include tiredness, muscle aches, constipation, dry skin, weight gain, slow heartbeat, or sensitivity to cold.Careful inquiry should then be made regarding compliance, dose of medication administered, and method of administration prior to raising the dose of levothyroxine sodium. The recommended frequency of monitoring of TSH and total or free T4 in children is as follows: at 2 and 4 weeks after the initiation of treatment; every 1 to 2.
Thyroid hormones regulate multiple metabolic processes and play an essential role in normal growth and development, and normal maturation of the central nervous system and bone. The metabolic actions of thyroid hormones include augmentation of cellular respiration and thermogenesis, as well as metabolism of proteins, carbohydrates and lipids.This drug is contraindicated if the serum TSH is already suppressed due to the risk of precipitating overt thyrotoxicosis. Usual Adult Dose for Myxedema Coma. Myxedema coma is a life-threatening emergency characterized by poor circulation and hypometabolism, and may result in unpredictable absorption of the oral dosage form of this drug from the GI.
11. Levothyroxine sodium should not be used as a primary or adjunctive therapy in a weight control program. 12. Keep levothyroxine sodium tablets out of the reach of children. Store levothyroxine sodium tablets away from heat, moisture, and light.It is recommended that a physical examination and a serum TSH measurement be performed at least annually in patients receiving levothyroxine sodium. Pediatrics In patients with congenital hypothyroidism, the adequacy of replacement therapy should be assessed by measuring both serum TSH (using a sensitive assay) and total- or free-T4.
If you have diabetes, monitor your blood and/or urinary glucose levels as directed by your physician and immediately report any changes to your physician. If you are taking anticoagulants (blood thinners your clotting status should be checked frequently.Protein-bound thyroid hormones exist in reverse equilibrium with small amounts of free hormone. Only unbound hormone is metabolically active. Many drugs and physiologic conditions affect the binding of thyroid hormones to serum proteins (see PRECAUTIONS : Drug Interactions and Drug-Laboratory Test Interactions ).