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Levothyroxine Dose

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Last Updated: 24 October 2020

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General | Latest Info

Thyroid gland in your neck makes a hormone called thyroxine. Thyroxine controls how much energy your body use.Sss It's also involved in digestion, how your heart and muscles work, brain development and bone health. When the thyroid gland does not make enough thyroxine, many OF the body's functions slow down. Some OF the most common symptoms OF underactive Thyroid gland ARE: tiredness, feeling cold, difficulty concentrating, weight gain feeling depressed. Levothyroxine is a synthetic version of thyroxine. You take Levothyroxine tablets to replace thyroxine that your Thyroid gland cannot produce and prevent symptoms OF HYPOTHYROIDISM. One OF symptoms OF underactive Thyroid gland is weight gain. So, once you start taking Levothyroxine, you may lose weight as your body's hormones rebalance. Losing weight can also be a sign that your dose of Levothyroxine is too high. Once your Thyroid hormone levels have returned to normal, your tendency to gain or lose weight is the same as for people who do not have Thyroid problems. If you have underactive Thyroid, you are entitled to free prescriptions for all OF your medicines. To claim your free prescriptions you 'll need to have a medical exemption certificate. The application form for medical exemption certificate is called FP92A. You can get this from your doctor's surgery. You will need to fill in the form, then your doctor will sign it and send it off. It's having underactive Thyroid that causes hair loss - not treatment WITH Levothyroxine. Because the natural hair growth cycle takes several months, hair loss related to Thyroid DISEASE might only be seen months after illness has begin. If treatment WITH Levothyroxine has already start, it may seem like medicine - rather than underlying illness - is causing hair loss. Hair usually regrow after treatment with Levothyroxine, but it may take many months.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Levothyroxine Dosage

5 to 25 mcg orally once day - Adjust DOSE at 6 to 8 - week intervals until clinically euthyroid and TSH returns to normal MAINTENANCE DOSE: Full replacement DOSES may be less than 1 mcg / kg / day. Maximum DOSE: 200 to 300 mcg / day Comments: - Dosing should be individualized with consideration give to age, cardiovascular status, concomitant medical conditions, and specific nature OF condition; follow clinical response and laboratory parameters Closely As DOSE is Adjust. - Peak effect OF give DOSE may not be attained FOR 4 to 6 week; Full recovery DOSE s. - Not indicate FOR TREATMENT OF Hypothyroidism during recovery phase OF subacute thyroiditis. - Co - administer food and concomitant medications may significantly affect absorption; Take on empty stomach and at least 4 hours before or after Drugs know to interfere with levothyroxine absorption. Use: As replacement therapy in Primary, Secondary, and Tertiary Congenital or acquire Hypothyroidism

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

What is Synthroid?

Table

HormoneRatio in ThyroglobulinBiologic Potencyt 1/2 (days)Protein Binding (%) a
Levothyroxine (T4)10 - 2016-7 b99.96
Liothyronine (T3)14299.5

Fast or irregular heartbeats, chest pain, shortness of breath, fever, hot flashes, sweating, tremors, feeling cold, weakness, tiredness, sleep problems, memory problems, feeling depress, nervous or irritable, headache, leg cramps, muscle aches, dryness of skin or hair, hair loss, changes in your menstrual periods, vomiting, diarrhea, appetite changes, weight changes get medical help right away, if you have any of symptoms list above. Muscle weakness, headache, leg cramps, nervousness, trouble sleeping, diarrhea, skin rash, partial hair loss tell doctor if you have any side effects that bother you or that do not go away. These are not all possible side effects of SYNTHROID. For more information, ask your doctor or pharmacist. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1 - 800 - FDA - 1088. Thyroid hormones, including SYNTHROID, either alone or with other therapeutic agents, should not be used for treatment of obesity or for weight loss. In euthyroid patients, doses within the range of daily hormonal requirements are ineffective for weight reduction. Larger doses may produce serious or even life threatening manifes tations of toxicity, particularly when given in association with sympathomimetic amines such as those used for their anorectic effects.


Effectiveness

Synthroid is approved for TSH suppression and to treat hypothyroidism. And although Armour Thyroid is also prescribed for these purposes, drug isnt FDA - approved for these uses. Use of levothyroxine and Armour Thyroid in treating hypothyroidism has been directly compared in clinical study. However, Synthroid and levothyroxine are always equivalent to each other. So this study might not have shown actual difference between Armour Thyroid and Synthroid. Higher T3 and TSH levels than do people taking levothyroxine lower T4 levels than do people taking levothyroxine. Keep in mind that T3 and T4 are the main Thyroid hormones in your body. And TSH levels indicate how much your body needs Thyroid hormones. So higher TSH level means that your body needs more Thyroid hormones than it has. The study also shows that after using both drugs over a period of 16 weeks each, 48. 6% of people preferred Armour Thyroid over levothyroxine. This may be because people lose, on average, 4 pounds more while taking Armour Thyroid than while taking levothyroxine. In addition, people report having fewer Thyroid symptoms when taking Armour Thyroid than when taking levothyroxine. There is also an ongoing clinical trial comparing Armour Thyroid with levothyroxine. But remember that Synthroid and levothyroxine are always equivalent to each other. So this study might not show difference between Armour Thyroid and Synthroid.


Side Effects

In some cases, Synthroid may cause weight loss. This is because thyroid hormones are responsible for your body's metabolism. * If you dont have enough Thyroid hormones in your body, your metabolism will be slower than usual. And this may lead to weight gain. However, if youre taking Synthroid, your thyroid hormone level should be within normal range. So, with Synthroid treatment, your metabolism rate may increase, and you may lose weight. It is important to note that even though Synthroids may cause weight loss, drugs shouldnt be used specifically to aid in weight loss. In fact, Synthroid has boxed warning advising against using Drug for weight loss. A Boxed warning is the strongest warning required by the Food and Drug Administration. Boxed warnings alert doctors and patients about drug effects that may be dangerous. The Synthroid box warning states that it shouldnt be used to treat obesity or to help with weight loss. If your thyroid function is normal, synthroid will help you lose weight. In fact, using drugs at typical dosages in people without certain Thyroid problems wo lead to weight loss. And using doses larger than those recommended by manufacturer may cause serious side effects. These side effects can include confusion, seizures, coma, and even death. In addition, taking Synthroid along with drugs used for weight loss may cause very serious or even life - threatening side effects. If you have concerns or questions about weight loss while youre taking Synthroid, talk with your doctor. They can recommend ways to help you manage body weight that healthy for you. There isnt any clinical study information that shows how many people lose weight while taking Synthroid.S However, small studies look at how many people lose weight while taking levothyroxine. This study shows that 52% of people taking levothyroxine lose weight after taking the drug for up to 24 months. And peoples average weight loss was 3.


Uses

Levothyroxine is used to treat underactive thyroid. It replaces or provides more thyroid hormone, which are normally produced by thyroid gland. Low thyroid hormone levels can occur naturally or when the thyroid gland is injured by radiation / medications or removed by surgery. Having enough thyroid hormone is important for maintaining normal mental and physical activity. In children, having enough thyroid hormones is important for normal mental and physical development. This medication is also used to treat other types of thyroid disorders. This medication should not be used to treat infertility unless it is caused by low thyroid hormone levels.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

Table2

Strength (mcg)Color additive(s)
25FDC Yellow No. 6 Aluminum Lake a
50None
75FDC Red No. 40 Aluminum Lake, FDC Blue No. 2 Aluminum Lake
88FDC Blue No. 1 Aluminum Lake, FDC Yellow No. 6 Aluminum Lake a , DC Yellow No. 10 Aluminum Lake
100DC Yellow No. 10 Aluminum Lake, FDC Yellow No. 6 Aluminum Lake a
112DC Red No. 27 30 Aluminum Lake
125FDC Yellow No. 6 Aluminum Lake a , FDC Red No. 40 Aluminum Lake, FDC Blue No. 1 Aluminum Lake
137FDC Blue No. 1 Aluminum Lake
150FDC Blue No. 2 Aluminum Lake
175FDC Blue No. 1 Aluminum Lake, DC Red No. 27 30 Aluminum Lake
200FDC Red No. 40 Aluminum Lake
300DC Yellow No. 10 Aluminum Lake, FDC Yellow No. 6 Aluminum Lake a , FDC Blue No. 1 Aluminum Lake
* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Proper Use

Table

HormoneRatio in ThyroglobulinBiologic Potencyt 1/2 (days)Protein Binding (%) a
Levothyroxine (T4)10 - 2016-7 b99.96
Liothyronine (T3)14299.5

If you will be taking this medicine for a long time, it is very important that your doctor check the progress of you or your child at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it. Blood tests will be needed to check for unwanted effects. Levothyroxine should not be used for treatment of obesity or for the purpose of losing weight. This medicine is not effective for weight reduction. If taken in large amounts, levothyroxine may cause serious unwanted effects. Hypothyroidism can sometimes cause infertility in men and women. Levothyroxine should not be used for treatment of infertility unless it is caused by hypothyroidism. For patients with Diabetes: It is very important that you keep track of your blood or urine sugar levels as instructed by your doctor. Check with your doctor right away if you notice any changes in your sugar levels. If you think you have become pregnant while using this medicine, tell your doctor right away. You may need a larger dose of levothyroxine while you are pregnant. Women who are post - menopausal or who use this medicine for a long time may have some bone loss, which could lead to Osteoporosis. Talk with your doctor if you have questions or concerns about this. Call your doctor right away if you or your child start to have rapid or irregular heartbeats, chest pain, leg cramps, headaches, 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. These could be symptoms of too much medicine in your body. Do not suddenly stop taking this medicine without first checking with your doctor. Your doctor may want you or your child to gradually reduce the amount you are using before stopping completely. Make sure any doctor or dentist who treats you knows that you or your child are using this medicine. You or your child may need to stop using this medicine several days before having surgery or medical tests. Temporary loss of hair may occur during the first few months of levothyroxine therapy. Ask your doctor about this if you have any concerns. Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription - medicines and herbal or vitamin supplements. Over - treatment with levothyroxine may cause an increase in heart rate, cardiac wall thickness, and cardiac contractility and may precipitate Angina or arrhythmias, particularly in patients with cardiovascular disease and in elderly patients. Initiate SYNTHROID therapy in this population at lower doses than those recommended in younger individuals or in patients without cardiac disease. Monitor for cardiac arrhythmias during surgical procedures in patients with coronary artery disease receiving suppressive SYNTHROID therapy. Monitor patients receiving concomitant SYNTHROID and sympathomimetic agents for signs and symptoms of coronary insufficiency. If cardiac symptoms develop or worsen, reduce SYNTHROID dose or withhold it for one week and restart at lower dose.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

Table 1. SYNTHROID Dosing Guidelines for Pediatric Hypothyroidism

AGEDaily Dose Per Kg Body Weight a
0-3 months10-15 mcg/kg/day
3-6 months8-10 mcg/kg/day
6-12 months6-8 mcg/kg/day
1-5 years5-6 mcg/kg/day
6-12 years4-5 mcg/kg/day
Greater than 12 years but growth and puberty incomplete2-3 mcg/kg/day
Growth and puberty complete1.6 mcg/kg/day

Table2

Strength (mcg)Color additive(s)
25FDC Yellow No. 6 Aluminum Lake a
50None
75FDC Red No. 40 Aluminum Lake, FDC Blue No. 2 Aluminum Lake
88FDC Blue No. 1 Aluminum Lake, FDC Yellow No. 6 Aluminum Lake a , DC Yellow No. 10 Aluminum Lake
100DC Yellow No. 10 Aluminum Lake, FDC Yellow No. 6 Aluminum Lake a
112DC Red No. 27 30 Aluminum Lake
125FDC Yellow No. 6 Aluminum Lake a , FDC Red No. 40 Aluminum Lake, FDC Blue No. 1 Aluminum Lake
137FDC Blue No. 1 Aluminum Lake
150FDC Blue No. 2 Aluminum Lake
175FDC Blue No. 1 Aluminum Lake, DC Red No. 27 30 Aluminum Lake
200FDC Red No. 40 Aluminum Lake
300DC Yellow No. 10 Aluminum Lake, FDC Yellow No. 6 Aluminum Lake a , FDC Blue No. 1 Aluminum Lake
* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

5. Side effects

Levothyroxine should not be used to treat obesity or weight problems. Dangerous side effects or death can occur from misuse of levothyroxine, especially if you are taking any other weight - loss medications or appetite suppressants. Since thyroid hormones occur naturally in the body, almost anyone can take levothyroxine. However, you may not be able to take this medicine if you have certain medical conditions. Tell your doctor if you have: untreated or uncontrolled adrenal gland disorder; thyroid disorder called Thyrotoxicosis; or symptoms of heart attack. To make sure levothyroxine is safe for you, tell your doctor if you have ever had: thyroid nodule; heart disease, blood clot, or blood - clotting disorder; Diabetes; kidney disease; Anemia; Osteoporosis, or low bone mineral density; problems with your pituitary gland; or any food or drug allergies. Tell your doctor if you have recently received radiation therapy with iodine. If you become pregnant while taking levothyroxine, do not stop taking medicine without your doctor's advice. Having low thyroid hormone levels during pregnancy could harm both mother and baby. Your dose needs may be different during pregnancy. Tell your doctor if you are breast - feeding. Your dose needs may be different while you are nursing. Do not give this medicine to child without medical advice. Tirosint is not approved for use by anyone younger than 6 years old.


What is levothyroxine?

Many other medicines can affect your thyroid hormone levels. Certain other medicines may also increase or decrease the effects of levothyroxine. Certain medicines can make this medicine less effective if taken at the same time. If you use any of the following drugs, avoid taking them within 4 hours before or 4 hours after you take levothyroxine: Calcium carbonate; cholestyramine, colesevelam, colestipol; ferrous sulfate iron supplement; sucralfate; sodium polystyrene sulfonate; stomach acid reducers - esomeprazole, lansoprazole, omeprazole, rabeprazole, Nexium, Prilosec, Prevacid, Protonix, Zegerid, and others; or antacids that contain aluminum or magnesium - Gaviscon, Maalox, Milk of Magnesia, Mintox, Mylanta, Pepcid Complete, and others. Many drugs can interact with levothyroxine. This includes prescription and over - counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any medicine you start or stop using.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

8. Cautions with other medicines

Some medicines can interfere with thyroid hormones, so the dose of Levothyroxine may need to be change. They include: medicines for fits or seizures - such as carbamazepine and Phenytoin rifampicin amiodarone oestrogens - such as in combined contraceptive pills or hormone replacement therapy. Levothyroxine can change how other medicines work, so their doses may need to be alter. These medicines include: medicines for Diabetes - either insulin or tablets, Blood thinning medicine, warfarin. Some medicines should not be taken at the same time of day as Levothyroxine as they can reduce the amount of Levothyroxine your body takes in, including: antacids, Calcium salts, Iron salts orlistat, medicine used for weight loss sucralfate, medicine used to treat stomach ulcers, some cholesterol - lowering medicines such as colestyramine, colestipol or colesevelem read Information Leaflet supply WITH these medicines or speak to your pharmacist For advice on how much time to leave between taking these medicines and taking Levothyroxine.


Side Effects

Get emergency medical help if you have signs of allergic reaction to levothyroxine: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Fast or irregular heartbeats; chest pain, pain spreading to your jaw or shoulder; shortness of breath; fever, hot flashes, sweating; tremors, or if you feel unusually cold; weakness, tiredness, sleep problems; memory problems, feeling depressed or irritable; headache, leg cramps, muscle aches; feeling nervous or irritable; dryness of your skin or hair, hair loss; irregular menstrual periods; or vomiting, diarrhea, appetite changes, weight changes. Certain side effects may be more likely in older adults. Chest pain, irregular heartbeats; shortness of breath; tremors, muscle pain or weakness; headache, leg cramps; feeling nervous or irritable, trouble sleeping; increased appetite; feeling hot; weight loss; changes in your menstrual periods; diarrhea; or skin rash, partial hair loss. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1 - 800 - FDA - 1088.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Warnings

For people with heart problems: Levothyroxine can increase your risk of serious heart problems, such as heart attack, abnormal heart rhythm, and heart failure. This risk is increased if youve already had these problems. Tell your doctor if you have heart problems or a history of heart problems. Your doctor may decide to start you on lower dosage of Levothyroxine. For people with Diabetes: Let your doctor know if you have Diabetes. Taking Levothyroxine can make your diabetes worse. Your doctor may monitor your blood sugar level more closely while you take this drug and adjust your diabetes drugs if needed For people with Osteoporosis: Using Levothyroxine for a long time can cause decreases in your bone mineral density and put you at higher risk of bone fractures. For people with adrenal or Pituitary gland problems: Let your doctor know if you have any adrenal or Pituitary gland problems. Using Levothyroxine can cause changes to your levels of thyroid hormone that could make these problems worse. For people with blood clotting disorders: Let your doctor know if you have any blood clotting disorders. Taking Levothyroxine may make it more difficult for your blood to clot and make bleeding more likely.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Take as directed

Levothyroxine oral tablet is used for long - term treatment. It comes with serious risks if you do take it as prescribe. If you stop taking drug or do take it at all: Your thyroid hormones will remain low, which may result in low energy levels, tiredness, weakness, slower speech, constipation, or thickened skin. It may even lead to coma. If you miss doses or do take drugs on schedule: Your medication may not work as well or may stop working completely. For this drug to work well, certain amount needs to be in your body at all times. If you take too much: you could have dangerous levels of drugs in your body. Symptoms of overdose can include: confusion, disorientation, stroke, shock coma. If you think youve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 911 or go to the nearest emergency room right away. What to do if you miss dose: Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects. How to tell if a drug is working: You should feel your symptoms of low thyroid hormone decrease. For instance, you should have more energy, less tiredness, and less weakness.


What happens if I miss a dose?

Levothyroxine is best absorbed when the stomach environment is acidic and is absorbed mainly in the jejunum and ileum. It is primarily metabolise by de - iodination, but also metabolise by conjugation, decarboxylation, and deamination. Base on this route into and out of the body, there are many medical conditions and medications that can impact these steps and alter levothyroxine dose requirement. Two studies illustrate the combined impact of medical conditions and medications. A study of pharmaceutical company - sponsored database identified gastrointestinal conditions and medications such as iron, calcium, and acid - lowering therapies as being associated with difficulty controlling hypothyroid symptoms and frequent changes in levothyroxine doses. Gastrointestinal conditions and interfering medications were also identified as being associated with the finding of patients requiring higher than predicted doses of levothyroxine in an audit of patients being treated by physicians in the national health system in Scotland.


What should I avoid while taking levothyroxine?

Many other medicines can affect your thyroid hormone levels. Certain other medicines may also increase or decrease the effects of levothyroxine. Certain medicines can make levothyroxine less effective if taken at the same time. If you use any of the following drugs, avoid taking them within 4 hours before or 4 hours after you take levothyroxine: Calcium carbonate; cholestyramine, colesevelam, colestipol; ferrous sulfate iron supplement; sucralfate; sodium polystyrene sulfonate; stomach acid reducers - esomeprazole, lansoprazole, omeprazole, rabeprazole, Nexium, Prilosec, Prevacid, Protonix, Zegerid, and others; or antacids that contain aluminum or magnesium - Gaviscon, Maalox, Milk of Magnesia, Mintox, Mylanta, Pepcid Complete, and others. Many drugs can affect levothyroxine. This includes prescription and over - counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any medicine you start or stop using.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

ADMINISTRATION

A total number of 54 patients between 18 and 67 years were recruited for study. Two patients discontinued study due to fear that changing therapeutic regimen their disease might deteriorate and two patients were lost to follow - up, while 50 remaining patients were analyze. The full participant flow diagram is depicted in figure 1. The average administered dose of Levothyroxine for the whole study population was 0. 1 mg / day. The study population was young as the majority of patients were less than 40 years. Old Fifteen patients were newly diagnosed with hypothyroidism. The most common symptoms among these patients were: dyspnea, excessive weight gain and hypersomnia. In remaining patients, 14 patients were asymptomatic at the time of referred to the physician, 6 patients had excessive weight gain, 7 patients with dyspnea and sense of suffocation, 8 patients had weight gain, dyspnea, alopecia, hypersomnia, fatigue, restlessness and edema. In both groups, within group differences in serum TSH and T4 levels as result of changing administration time were similar. There was a significant increase in average TSH level, whereas, decrease in average T4 level was insignificant. Since results in both cross over groups were the same, two groups could be regarded as one. From 50 patients included in the study, in 38 patients changing Levothyroxine administration time from morning to evening increased serum levels of TSH significantly, and for the remaining 12 patients, TSH levels decreased or remained constant; With regard to T4, in 33 patients, serum levels of T4 decrease, whereas in the remaining 17 patients, serum levels of T4 increase as result of changing Levothyroxine administration time from morning to evening; however, difference was not significant. Average values of TSH and T4 at different points during trial are depicted in tables 2 - 3. 3. To investigate the effect of age on dependent variables, data was evaluated regarding different age groups. There were neither any significant differences in values of TSH or T4 between two age groups when Levothyroxine was administered before breakfast nor when Levothyroxine was administered before dinner. Thus, it seems that patients ' age does not influence therapeutic outcome.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

CONTRAINDICATIONS / PRECAUTIONS

In deciding to use medicine, risks of taking medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, following should be Consider: tell your doctor IF you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also, tell your health care professional IF you have any other types of allergies, such as foods, dyes, preservatives, or animals. For non - prescription products, read the label or package ingredients carefully. Appropriate studies performed to date have not demonstrated Pediatric - Specific problems that would limit the usefulness of Levothyroxine in children. Appropriate studies performed to date have not demonstrated GERIATRIC - Specific problems that would limit the usefulness of Levothyroxine in the elderly. However, elderly PATIENTS are more likely to have age - related heart or blood vessel problems, which may require caution and adjustment in dose for PATIENTS receiving Levothyroxine. Studies in WOMEN suggest that this medication poses minimal risk to infants when used during breastfeeding. Although certain medicines should not be used together at all, in other cases, two different medicines may be used together even IF interaction might occur. In these cases, your doctor may want to change dose, or other PRECAUTIONS may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know IF you are taking any OF medicines listed below. Following INTERACTIONS have been selected on the basis of their potential significance and are not necessarily all - inclusive. Using this medicine WITH any OF the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both OF medicines. Midodrine Using this medicine WITH any OF following medicines may cause increased risk OF certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both OF medicines. Aluminum Carbonate, Basic Aluminum Hydroxide Aluminum Phosphate Calcium Acetate Calcium Carbonate Calcium Citrate Chlorotrianisene Cholestyramine Chromium Ciprofloxacin Colesevelam conjugate Estrogens conjugate Estrogens Synthetic conjugate Estrogens Synthetic B Dexlansoprazole Dienestrol Diethylstilbestrol Dihydroxyaluminum Aminoacetate Dihydroxyaluminum Sodium Carbonate Eltrombopag Esomeprazole esterify Estrogens Estradiol Estramustine Estriol Estropipate Ethinyl Estradiol Fosphenytoin Imatinib Iron Kelp Lansoprazole Lanthanum Carbonate Lopinavir Magaldrate Magnesium Carbonate Magnesium Hydroxide Magnesium Oxide Magnesium Trisilicate Mestranol Omeprazole Pantoprazole Patiromer Phenytoin Polyestradiol Phosphate Promestriene Quinestrol Rabeprazole Rifampin Ritonavir Semaglutide Sevelamer Simvastatin Tibolone certain medicines should not be Use at or around time OF eating food or eating certain types OF food since INTERACTIONS May occur. Using alcohol or tobacco WITH certain medicines may also cause INTERACTIONS to occur. Following INTERACTIONS have been selected on the basis of their potential significance and are not necessarily all - inclusive.


ADVERSE REACTIONS

Adverse reactions associated with Levothyroxine sodium tablets therapy are primarily those of hyperthyroidism due to therapeutic OVERDOSAGE. They include the following: general: fatigue, increased appetite, weight loss, heat intolerance, fever, excessive sweating Central nervous system: headache, hyperactivity, nervousness, anxiety, irritability, emotional lability, insomnia, musculoskeletal: tremors, muscle weakness, muscle spasm, Cardiovascular: palpitations, tachycardia, arrhythmias, increased pulse and blood pressure, heart failure, angina, myocardial infarction, cardiac arrest, Respiratory: dyspnea Gastrointestinal: diarrhea, vomiting, abdominal cramps, elevations in liver function tests Dermatologic: hair loss, flushing, rash Endocrine: decrease bone mineral density Reproductive: menstrual irregularities, impaired fertility seizures have been report rarely with institution of Levothyroxine therapy.


DESCRIPTION

Levothyroxine Sodium tablets, USP contain synthetic crystalline L - 3 3 55 - tetraiodothyronine Sodium salt. Synthetic T4 is chemically identical to that produced in human thyroid gland. Levothyroxine Sodium has an empirical formula of C15H10I4NNaO4 xH2O, molecular weight of 798. 86 g / mol and structural formula as show: Levothyroxine Sodium tablets for oral administration are supplied in following strengths: 25 mcg, 50 mcg, 75 mcg, 88 mcg, 100 mcg, 112 mcg, 125 mcg, 137 mcg, 150 mcg, 175 mcg, 200 mcg and 300 mcg. Each Levothyroxine Sodium tablet contains inactive ingredients Magnesium Stearate, NF; Microcrystalline Cellulose, NF; Colloidal Silicone Dioxide, NF; and Sodium Starch Glycolate, NF. Each tablet strength meets USP Dissolution Test 2. Table 6 provides a listing of color additives by tablet strength:

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

ADVERSE REACTIONS

If OTHERWISE HEALTHY: May initiate a full replacement dosage of roughly 1. 6 mcg / kg / day PO. Adjust dose by 12. 5 mcg to 25 mcg increments every 4 to 6 weeks until the desired response. Geriatric PATIENTS or IF CARDIAC DISEASE PRESENT: Initiate WITH 12. 5 to 25 mcg PO once daily WITH gradual increments at 6 to 8 - week intervals as needed Elderly PATIENTS or those WITH subclinical HYPOTHYROIDISM target dose may be less than 1 mcg / kg / day PO. Patients WITH SEVERE LONGSTANDING HYPOTHYROIDISM: Initially, 12. 5 to 25 mcg / day PO WITH an increase of 12. 5 to 25 mcg / day every 2 to 4 weeks until at effective target dose. Pregnant WOMEN WITH NEW - ONSET HYPOTHYROIDISM: For moderate to SEVERE signs and symptoms, Initiate at full replacement dosage of roughly 1. 6 mcg / kg / day PO. For mild HYPOTHYROIDISM, Initiate at 1 mcg / kg / day PO. Max: Greater than 200 mcg / day PO is rarely require. Rare PATIENTS may require up to 300 mcg / day PO. Inadequate response to more than 300 mcg / day may indicate poor compliance, malabsorption, drug interactions, or a combination of these factors. 1. 6 mcg / kg / day PO once daily. Adjust by increments of 12. 5 to 25 mcg / day every 4 to 6 weeks until PATIENT has proper clinical and TSH response. Hyperactivity can be minimized IF initiated at a dose that is 25% of recommended replacement dose, WITH weekly titration of approximately 25% of full recommended replacement dose to attain clinical goals. In SEVERE LONGSTANDING HYPOTHYROIDISM, Initiate WITH 12. 5 mcg to 25 mcg / day, and increase by 12. 5 mcg to 25 mcg every 2 to 4 weeks until PATIENT is clinically euthyroid and Serum TSH level has normalize. Max: Greater than 200 mcg / day PO is rarely require. Rare PATIENTS may require up to 300 mcg / day PO. Inadequate response to more than 300 mcg / day may indicate poor compliance, malabsorption, drug interactions, or a combination of these factors.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Dosing Considerations

Avoid under - treatment or over - treatment with this drug. This may result in adverse effects. Initiate lower dose of medicine in the elderly, those with angina pectoris, cardiovascular disease, or in those with severe hypothyroidism. Long - term therapy decreases bone mineral density; use lowest dose in postmenopausal women and women using suppressive doses. Lower dose of Tirosint capsules may be required compared with standard T4 tablets for hypothyroidism in patients with impaired gastric acid secretion to reach their target TSH levels; Tirosint has shown improved absorption compared with conventional T4 tablets. Check for bioequivalence if switching brands / generics, or every week after switching from one levothyroxine sodium preparation to another.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Sources

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

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