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Active Ingredient: Levothyroxine
Levothroid is indicated for the treatment of hypothyroidism as a replacement or supplemental therapy in congenital or acquired hypothyroidism of any etiology, except transient hypothyroidism during the recovery phase of subacute thyroiditis.

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Indications for use

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Levothyroxine, a thyroid hormone, is used to treat hypothyroidism, a condition in which the thyroid gland does not produce enough thyroid hormone. Without this hormone, the body can not function properly, as a result: poor growth; Slow speech; Lack of energy; Weight gain; hair loss; Dry, thick skin; And hypersensitivity to cold. When taken correctly, levothyroxine changes these symptoms. Levothyroxine is also used to treat congenital hypothyroidism (cretinism) and goiter (enlargement of the thyroid gland). This drug is sometimes prescribed for other purposes; Ask your doctor or pharmacist for more information.

Precautionary measures

Before taking levothyroxine, tell your doctor and pharmacist if you are allergic to levothyroxine, thyroid hormone, other drugs, or any of the ingredients in levothyroxine. Ask your pharmacist for a list of ingredients. Tell your doctor and pharmacist that prescription and over-the-counter medicines you are taking, in particular amphetamines; Anticoagulants ("blood solvents"), such as warfarin (Coumadin); Antidepressants or sedatives; Arthritis medicine; aspirin; Beta-blockers, such as metoprolol (Lopressor, Toprol), propranolol (anaprilin) ??or timolol (Blocadren, Timoptic); Chemotherapy cancer agents; Diabetes drugs (insulin and tablets); Digoxin (Lanoxin); Estrogens; Methadone; Oral contraceptives; Phenytoin (Dilantin); steroids; Theophylline (TheoDur); And vitamins. If you take antacids, calcium carbonate (Tums), cholestyramine (Questran), colestipol (colestide), iron, orlistat (Alli, Xenical), simethicone (Phazyme, Gas X), polystyrene sodium sulfonate (Kayexalate), or sucralfate (Carafate) , Take it at least 4 hours before or 4 hours after taking levothyroxine. Tell your doctor if you have or have ever had diabetes; Hardening of the arteries (atherosclerosis); Kidney disease; hepatitis; Cardiovascular diseases such as high blood pressure, chest pain (angina pectoris), arrhythmia, or heart attack; Or a decreased adrenal or pituitary gland. If you have surgery, including dental surgery, tell the doctor or dentist that you are taking levothyroxine.

Overdose

In case of an overdose, call the local poison control center 1-800-222-1222. If the victim collapses or does not breathe, call the local emergency services at 911.

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Side effects

Levothyroxine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • loss in weight
  • tremor
  • headache
  • nausea
  • vomiting
  • diarrhea
  • spasms of the stomach
  • nervousness
  • irritability
  • insomnia
  • increased sweating
  • increased appetite
  • fever
  • changes in the menstrual cycle
  • sensitivity to heat
  • temporary hair loss, especially in children during the first month of therapy

If you experience any of the following symptoms, seek medical advice immediately or get emergency medical help:

  • chest pain (angina)
  • fast or irregular heartbeat or pulse

Pharmachologic effect

The drug is the hormones of the thyroid gland. Synthetic levorotatory isomer of thyroxine. In small doses has an anabolic effect. In medium doses stimulates growth and development, raises the need for tissues in oxygen, stimulates the metabolism of proteins, fats and carbohydrates, stimulates the activity of the cardiovascular system and the central nervous system. In high doses oppresses the production of the TTRG of the hypothalamus and TTG of the pituitary gland.

Indications

Primary and secondary hypothyroidism; Mixed goiter; Complex treatment of toxic goiter and autoimmune thyroiditis, euthyroid hyperplasia of the thyroid gland; Prevention of relapse after surgical treatment of nodular and malignant tumors of the thyroid gland; cretinism.

Differential diagnostic test of thyroid suppression.

Dosing regimen

Set individually according to the indications. Apply in a dose of 12.5-200 mcg 1 time / day for 20-30 minutes before meals.

When carrying out a differential diagnostic test of thyroid suppression - once in a dose of 3 mg or for 2 weeks at 200 mcg 1 time / day.

Side effect

Symptoms of hyperthyroidism: possible (when used in high doses, including with too rapid increase in the dose at the beginning of the course of treatment) tachycardia, palpitation, arrhythmias, angina attacks, headache, nervousness, tremor, sleep disorders, feelings of inner anxiety, muscle Weakness and cramps, weight loss, diarrhea, menstrual irregularities, vomiting.

Contraindications

Hyperfunction of the thyroid gland of various genesis, acute myocardial infarction, untreated adrenocortical insufficiency, increased sensitivity to levothyroxine sodium.

Pregnancy and lactemia

In pregnancy and during lactation, levothyroxine sodium should be administered under the supervision of a doctor. The use in combination with thyreostatic drugs in pregnancy is contraindicated in connection with an increased risk of hypothyroidism in the fetus.

Application in old age

In elderly patients and with prolonged course of hypothyroidism, treatment should be started gradually.

Special instructions

With extreme caution apply in patients with cardiovascular diseases (including coronary heart disease, heart failure, arterial hypertension). In such cases, levothyroxine sodium should be used in a low initial dose, increasing it slowly and at large intervals.

In elderly patients and with prolonged course of hypothyroidism, treatment should be started gradually.

With substitutive thyroid therapy in patients with adrenal cortex deficiency without adequate maintenance therapy with corticosteroids, an acute adrenal crisis is possible.

Use with caution in diabetes and diabetes insipidus.

When carrying out a differential diagnostic test for thyroid suppression, patients with diabetes mellitus are advised to increase doses of antidiabetic drugs.

In some cases, thyroid hormones can cause or exacerbate the previous myasthenic syndrome.

Drug Interactions

Levotiroksin sodium potentiates the effect of indirect anticoagulants (coumarin derivatives), reduces the effectiveness of oral hypoglycemic agents.

In patients with hypothyroidism and concomitant diabetes mellitus, the need for insulin or oral hypoglycemic agents may be increased at the onset of thyroid hormone replacement therapy.

Salicylates, dicoumarin, furosemide (250 mg), clofibrate can displace levothyroxine from the connection with plasma proteins.

Sucralfate, aluminum hydroxide, calcium carbonate reduce the absorption of levothyroxine from the gastrointestinal tract.

Kolestyramin reduces the absorption of levothyroxine sodium from the digestive tract.

When ritonavir is used, there may be an increase in the need for levothyroxine.

When sertraline is used in patients with hypothyroidism, the effects of sodium levothyroxine may be reduced.

With rapid intravenous injection of phenytoin against the background of taking levothyroxine sodium, an increase in the level of free levothyroxine in the blood plasma is possible, and arrhythmias can be observed.

With the simultaneous use of chloroquine may increase the metabolism of levothyroxine, apparently due to the induction of chloroquine microsomal enzymes of the liver. In patients receiving levothyroxine sodium, the use of proguanil or chloroquine may increase the concentration of TSH.

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