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Levothyroxine Medication

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Last Updated: 28 September 2020

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General | Latest Info

Underactive THYROID is usually treated by taking daily HORMONE replacement tablets called Levothyroxine. Levothyroxine replaces thyroxine HORMONE, which your THYROID do not make enough OF. You 'll initially have regular blood tests until the correct dose of Levothyroxine is reach. This can take a little while to get right. You may start on a low dose of Levothyroxine, which may be increased gradually, depending on how your body respond. Some people start to feel better soon after beginning treatment, while others don't notice improvement in their symptoms for several months. Once you re taking the correct dose, you 'll usually have a blood test once a year to monitor your HORMONE levels. If blood tests suggest you may have underactive THYROID, but you don't have any symptoms or they re very mild, you may not need any treatment. In these cases, GP will usually monitor your HORMONE levels every few months and prescribe Levothyroxine if you develop symptoms.

* 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

Uses

Levothyroxine is used to treat underactive thyroid gland. 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 hormones is important for 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.

* 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

Side Effects

Hair loss may occur during the first few months of treatment. This effect is usually temporary as your body adjusts to this medication. If this effect lasts or gets worse, tell your doctor or pharmacist promptly. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. Tell your doctor right away if you have any serious side effects, including: increased sweating, sensitivity to heat, mental / mood changes, tiredness, diarrhea, shaking, headache, shortness of breath, bone pain, easily broken bones. Get medical help right away if you have any very serious side effects, including: chest pain, fast / pounding / irregular heartbeat, swelling hands / ankles / feet, seizures. Very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of serious allergic reaction, including: rash, itching / swelling, severe dizziness, trouble breathing. This is not a complete list of possible side effects. If you notice other effects not listed above, contact 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 or at www. Fda. Gov / medwatch. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1 - 866 - 234 - 2345.


About levothyroxine

Some medicines are not suitable for people with certain conditions, and sometimes medicine may only be used if extra care is take. For these reasons, before you start taking levothyroxine it is important that your doctor knows: if you are pregnant or breastfeeding. This is so your doctor can keep checking on your baby. If you have heart problem such as heart failure or angina, or if you have high blood pressure. If you have ever been told your adrenal gland is unable to produce enough of hormone cortisol, condition is called adrenal insufficiency. If you have been told your thyroid is overactive. If you have high levels of sugar in your blood if you have been told you have problem regulating levels of water in your body, rare condition known as diabetes insipidus. If you have epilepsy. If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without prescription, as well as herbal and complementary medicines. If you have ever had an allergic reaction to medicine.

* 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

Interactions

Thyroid medication levothyroxine is used to treat hypothyroidism, endocrine disorder resulting from thyroid homone deficiency that affects about 4. 6 percent of the US population. Medication is used to replace missing or deficient amount of thyroid hormone. The number of prescriptions for levothyroxine filled each yearmore than 75 million US prescriptions in 2007, making it one of mostprescribed drugs in the country. Unfortunately, use of other medications while taking levothyroxine could have one of several kinds of unintended results: some drugs may interact with levothyroxine by thwarting absorption of this thyroid drug. This effect can be avoided by taking thyroxine considerably before or, in some cases, after other drug. That allows levothyroxine to get absorbed without interacting with a second drug. Antacids are often used to treat heartburn and other intestinal distress, including calcium products such as TUMS or ROLAIDS and other antacids, may have absorption - inhibiting effects on thyroid medications. People should take levothyroxine four to six hours before or after taking these antacids. Iron supplements have been shown to reduce the effect of levothyroxine on some people, although the effect is highly variable from one person to another. Other iron preparations may also have similar effects. Again, we advise taking levothyroxine four to six hours before or after iron. Sucralfate, used to treat ulcers and other gastrointestinal diseases, appears to inhibit absorption of levothyroxine. Trials found that this interaction was avoided when thyroid drug was given eight hours after sucralfate. Sevelamer, which is Use to reduce excessive blood phosphate in persons with severe chronic kidney disease, also interferes with absorption of levothyroxine. Separating doses of two types of drugs by at least four to six hours is likely to avert interaction. Cholestyramine lowers cholesterol by increasing conversion of cholesterol to bile acids. But it also tends to reduce levothyroxine absorption and effect. Similar agents such as colestipol and cholesevelam may have the same effect, although there is not as much evidence for this. We recommend separating all of these medications, known as bile acid binders, from taking levothyroxine for at least four to six hours. Antibiotic ciprofloxacin was associated with reduced levothyroxine effect in case reports, but more information is needed to establish whether interaction occurs. Until more information is available, it would be prudent to separate doses of ciprofloxacin from those of levothyroxine by at least four hours. The same precaution should apply to other antibiotics in the same class, such as levofloxacin, lomefloxacin, monifloxacin, norfloxacin, and ofloxacin. Raloxifene, used to treat osteoporosis, may reduce absorption of levothyroxine, although evidence to date is not sufficient to establish the extent of interaction. In one case, separating two drugs by 12 hours appears to avert interaction. Enzyme inducers stimulate production of enzymes, which in turn increase levothyroxine in the body.

* 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 seizures, 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 shouldn't 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 Use 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

Pseudotumor cerebri and slip capital femoral epiphysis have been reported in children receiving levothyroxine therapy. Overtreatment may result in craniosynostosis in infants and premature closure of epiphyses in children with resultant compromise adult height. Seizures have been reported rarely with institution of levothyroxine therapy. Inadequate levothyroxine dosage will produce or fail to ameliorate signs and symptoms of hypothyroidism. Hypersensitivity reactions to inactive ingredients have occurred in patients treated with thyroid hormone products. These include urticaria, pruritus, skin rash, flushing, angioedema, various GI symptoms, fever, arthralgia, serum sickness and wheezing. Hypersensitivity to levothyroxine itself is not known to occur.

* 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 levothyroxine?

Most patients with hypothyroidism tolerate levothyroxine therapy well, but a significant minority are dissatisfied with treatment. Here, authors examine whether this could be the result of intolerance to excipients in specific levothyroxine products prescribed or dispense. Primary hypothyroidism is a clinical state resulting from reduced production of Thyroid hormones, thyroxine and triiodothyronine, with corresponding elevation in Thyroid stimulating hormone.S Patients often present with non - specific symptoms of fatigue, weakness, depression and mild weight gain. It is a common disorder affecting 0. 1% to 2% of the general population, and is more common in women, Caucasians and Hispanics, and with increasing age. 1 - 3 Epidemiological data from the UK suggests subclinical hypothyroidism has a prevalence in 8% of women and 3% of men. 1 Although in the developing world iodine deficiency is considered to be a major contributor towards hypothyroidism, chronic autoimmune thyroiditis remains the commonest cause of primary hypothyroidism in iodine - sufficient nations such as the UK. Another common aetiology is iatrogenic hypothyroidism, which develops following thyroidectomy, radioiodine therapy or external beam irradiation. Levothyroxine has been standard treatment for hypothyroidism for many decades. The typical dose requirement is 1. 6 - 1. 8g / kg is ideal body weight per day. Food, beverages, over - counter supplements and other drugs may interfere with absorption of L - T4, and it is therefore recommended for it to be taken consistently either hour before breakfast or at bedtime. Stability of TSH and free T4 levels require at least five half - lives of drug and thus thyroid function should be checked six to eight weeks after commencing or adjusting therapy before making any further dose adjustment. Once stabilise, serum TSH can be measured yearly. Levothyroxine is the third most commonly prescribed drug in the UK and the most prescribed in the USA. In the UK, number of prescriptions has risen from 2. 8 million in 1998, to 19 million in 2007, and 29. 7 million in 2015. 4 in UK, patients with hypothyroidism are entitled to an exemption certificate to allow them to obtain their NHS prescriptions at no cost. Other options for Thyroid hormone replacement include liothyronine, which is used alone or in combination with L - T4, and desiccated Thyroid extract, also know as natural desiccated Thyroid. According to US Pharmacopoeia, 1 grain of DTE must contain 38g of levothyroxine and 9g of liothyronine. The approximate T4 to T3 ratio in DTE is 4: 1, which is considered to be supra - physiological, as the normal ratio of secretion of T4 to T3 is between 13: 1 and 16: 1. Dte and liothyronine are not routinely available on NHS prescription in primary Care. Liothyronine, in combination with levothyroxine, can be trialled from Specialist Endocrinology clinics in a subset of patients who have persistent symptoms on levothyroxine alone, despite serum TSH values being within normal range. However, there is insufficient evidence that combination therapy is superior to L - T4 monotherapy.

* 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

Thyroid hormones, 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 manifestations of toxicity, particularly when given in association with sympathomimetic amines such as those used for their anorectic effects. This medication contains Levothyroxine. Do not take Synthroid, Levoxyl, L Thyroxine, Levo T, Levothroid, Levothyroxine T4, Levoxine, Tirosint, or Unithroid If you are allergic to Levothyroxine or any ingredients contained in this drug. Keep out of reach of children. In case of overdose, get medical help or contact the Poison Control Center immediately.


Levothyroxine Side Effects

Before you start this treatment, read the manufacturer's printed INFORMATION leaflet from inside your pack. The manufacturer's leaflet will give you more INFORMATION about levothyroxine and a full list of side - effects which you may experience from taking it. Take levothyroxine exactly as your doctor tells you to. Your doctor will ask you to take one dose each day, preferably before your breakfast. The number of tablets you need to take for each dose will be adjusted to suit you. There are three strengths of a tablet and your dose may be a combination of different strength tablets. As a guide, it is usual for adults to start by taking a daily dose of 50 - 100 micrograms, and for this to be increased gradually to a daily dose of 100 - 200 micrograms. Your doctor or pharmacist will tell you what dose is right for you. If levothyroxine has been prescribed for a child, doctor will tell you what dose to give. Dose for children depends upon their weight, age and what they are being treated for. Give levothyroxine to your child at least half hour before they eat their first meal of the day. Most people find that levothyroxine tablets are easily to swallow. If you do have swallowing difficulties, some brands of tablets can be added to a little water and allowed to disperse before swallowing. Ask your pharmacist to check if your brand of tablet will disperse in water. Alternatively, ask your doctor to prescribe oral liquid medicine for you. If you forget to take dose, take it as soon as you remember, if it is still within two or three hours of your usual time. If it is longer than this before you remember, skip forgotten dose. Do not take two doses together to make up for missed 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.

* 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.

* 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

Precautions

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 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 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.


General

The goal of treatment in pediatric patients with hypothyroidism is to achieve and maintain normal intellectual and physical growth and development. The initial dose of levothyroxine varies with age and body weight. Dosing adjustments are based on assessment of individual patient's clinical and laboratory parameters. In children in whom diagnosis of permanent hypothyroidism has not been establish, it is recommended that levothyroxine ADMINISTRATION be discontinued for a 30 - day trial period, but only after the child is at least 3 years of age. Serum T 4 and TSH levels should then be obtain. If T 4 is low and TSH high, diagnosis of permanent hypothyroidism is establish, and levothyroxine therapy should be reinstituted. If T 4 and TSH levels are normal, euthyroidism may be assumed AND, therefore, hypothyroidism can be considered to have been transient. In this instance, however, physicians should carefully monitor the child and repeat thyroid function tests if any signs or symptoms of hypothyroidism develop. In this setting, clinicians should have a high index of suspicion of relapse. If results of the levothyroxine withdrawal test are inconclusive, careful follow - up and subsequent testing will be necessary. Since some more severely affected children may become clinically hypothyroid when treatment is discontinued for 30 days, alternate approach is to reduce the replacement dose of levothyroxine by half during the 30 - day trial period. If, after 30 days, serum TSH is elevated above 20 mU / L, diagnosis of permanent hypothyroidism is confirm, and full replacement therapy should be resume. However, if serum TSH has not risen to greater than 20 mU / L, levothyroxine treatment should be discontinued for another 30 - day trial period followed by repeat serum T 4 and TSH testing. Presence of concomitant medical conditions should be considered in certain clinical circumstances AND, if present, appropriately treat.


Interactions

Many drugs affect thyroid hormone pharmacokinetics and metabolism and may alter therapeutic response to SYNTHROID. In addition, thyroid hormones and thyroid status have varying effects on pharmacokinetics and actions of other drugs. A Listing of drug - thyroidal axis interactions is contained in Table 2. The list of drug - thyroidal axis interactions in Table 2 may not be comprehensive due to the introduction of new drugs that interact with thyroidal axis or discovery of previously unknown interactions. Prescribers should be aware of this fact and should consult appropriate reference sources for additional information if drug - drug interaction with levothyroxine is suspect.


Side Effects

Hair loss may occur during the first few months of treatment. This effect is usually temporary as your body adjusts to this medication. If this effect persists or worsens, tell your doctor or pharmacist promptly. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. Tell your doctor right away if any of these unlikely but serious effects of high thyroid hormone levels occur: increased sweating, sensitivity to heat, mental / mood changes, tiredness, diarrhea, shaking, headache, shortness of breath, bone pain, easily broken bones. Get medical help right away if any of these rare but serious effects of high thyroid hormone levels occur: chest pain, fast / pounding / irregular heartbeat, swelling hands / ankles / feet, seizures. Very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of serious allergic reaction, including: rash, itching / swelling, severe dizziness, trouble breathing. This is not a complete list of possible side effects. If you notice other effects not listed above, contact 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 or at www. Fda. Gov / medwatch. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1 - 866 - 234 - 2345.

* 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

Drug Class: Thyroid products

Levothyroxine sodium is a drug approved by FDA as an oral and injectable prescription thyroid hormone medication that is used to treat underactive thyroid and other conditions. Hypothyroidism is a medical term that refers to any state in which a person's thyroid hormone production is below normal. This medication replaces or provides thyroid hormone support, which is normally produced by the 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 hormones is important for maintaining normal mental health and physical activity. In children, having enough thyroid hormones is important for normal mental and physical development. Levothyroxine is also know as L - thyroxine.

* 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

Symptoms of Hypothyroidism

In general, your doctor may test for underactive Thyroid if you are feeling increasingly tire, have dry skin, constipation and weight gain, or have had previous Thyroid problems or goiter. Diagnosis of hypothyroidism is based on your symptoms and results of blood tests that measure the level of TSH and sometimes the level of Thyroid hormone Thyroxine. Low levels of Thyroxine and high levels of TSH indicate underactive Thyroid. That's because your pituitary produces more TSH in an effort to stimulate your Thyroid gland into producing more Thyroid hormone. Doctors can diagnose thyroid disorders much earlier than in the past, often before you experience symptoms. Because the TSH test is the best screening test, your doctor will likely check TSH first and follow with a Thyroid hormone test if needed. Tsh tests also play an important role in managing hypothyroidism. They help your doctor determine the right dosage of medication, both initially and over time. In addition, TSH tests are used to help diagnose conditions called subclinical hypothyroidism, which usually causes no outward signs or symptoms. In this condition, you have normal blood levels of triiodothyronine and Thyroxine, but higher than normal levels of TSH. There are certain factors that can affect blood tests for Thyroid problems. One is blood - thinning medication called heparin. Another is biotin, vitamin taken as a stand - alone supplement or as part of a multivitamin. Let your doctor know about any medications or supplements you take before having blood tests


Starting on Thyroid Hormone Treatment

To determine the right dosage of levothyroxine initially, your doctor generally checks your level of TSH after six to eight weeks. After that, blood levels are generally checked six months later. Excessive amounts of hormones can cause side effects, such as: increased appetite, Insomnia, Heart palpitations Shakiness If you have coronary artery disease or severe hypothyroidism, your doctor may start treatment with a smaller amount of medication and gradually increase the dosage. Progressive hormone replacement allows your heart to adjust to an increase in metabolism. Levothyroxine causes virtually no side effects when used at an appropriate dose and is relatively inexpensive. If you change brands, let your doctor know to ensure you re still receiving the right dosage. Also, don't skip doses or stop taking drugs because you re feeling better. If you do, symptoms of hypothyroidism will gradually return.

* 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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