Last Updated on February 19, 2017 by Dr.Derek Fhisher
Most popular brand: Synthroid
Active ingredient: Levothyroxine
Available dosage forms: 25, 50, 100, 200 mcg
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Levothyroxine general information
Levothyroxine is administered through the mouth (orally). Once you set out to obtain Levothyroxine you are not as likely to locate a product branded `Levothyroxine’. If you take levothyroxine for extended intervals, it might induce loss of bone, resulting in osteoporosis. Don’t forget, making developments in your diet is just a slow procedure.
Turmeric has numerous advantages to the health. Among the best methods to prevent these side results and make the most of the health benefits of turmeric is really to make use of a cutting-edge multivitamin brand that is totally natural and free from chemicals. Pick a supplement that is certainly of pharmaceutical grade, contains natural nutrients which work in synergy together, meets manufacturing standards, and one which contains standardized extracts of turmeric to ensure that you receive the ideal sum, not exceedingly little and not exceedingly much. Even if you don’t possess the disease still, you can still begin taking l-tyrosine supplements or foods which are high by it.
Underactive thyroid or hypothyroidism is oftentimes called low thyroid. Hypothyroidism can be a dangerous disease within the thyroid gland. In hypothyroidism, thyroid gland is known to create insufficient quantity of thyroid hormones needed for the appropriate performance of the thyroid gland. This is a condition that happens whenever your thyroid gland doesn’t generate enough amounts of thyroid hormones that are crucial for regulating the metabolism of the body.
Should you be suffering from hypothyroidism, slimming down can get extremely tricky and hard. Your physician can steer you on ways to safely slim down while making certain that your hypothyroidism is being treated carefully. There could be restrictions on your physician to do the entire battery of thyroid tests. In addition, There are natural hypothyroidism remedies you could apply.
Selenium is a very vital mineral, as it’s involved within the production of thyroid hormone. Besides that benefit kefir can likewise help remedy a few of the symptoms of hypothyroidism. So as to cure estrogen dominance, it is a great thought to consult a competent all-natural endocrine doctor. It’s recommended to go to a doctor that specializes in solving low thyroid difficulties.
Many have borderline hypothyroidism and go quite a long time with minor symptoms and really don’t realize they may reap the benefits of treatment. There are several symptoms connected with hypothyroidism. Patients may also use Synthroid for treating tertiary hypothyroidism that is certainly hypothalamic in origin. Conversely, hypothyroidism is really a condition at which thyroid is under-active and produces a deficient quantity of the thyroid hormone.
In regards to thyroid, the complimentary hormone is what counts. Armour thyroid is created from the descicated pig’s hormone and is wholly free from just about any dangerous side effect in comparison with synthetic hormones. The physiology is to some extent complex, but the point is that one wants to be quite attentive when taking bioidentical hormones, since this can bring about numerous health issues. It’s a hormone that’s sometimes misunderstood and it is recommended that the scope of normal be changed.
Those who have hypothyroidism will realize that it is virtually not possible to slim down without adding exercise in their routine. Yoga is just another exemplary form of exercise for people who have thyroid disease. Stress, sleep and nutritional supplementation are three crucial factors too and also play a major function in influencing the condition of your hormones and keeping up a nutritious body weight too. Even the most effective diet for hypothyroidism is not going to deliver miraculous results if you’ren’t consistent.
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Active – active substance / start: levothyroxine
L – Thyroxine; Bagotiroks; Yodtiroks; A – Tirok; L – thyroxine; L – Thyroxine – Acre; L – thyroxine Berlin – Chemie; L – Thyroxine – Farmak; levothyroxine; Levothyroxine sodium; Tyro – 4; Eutiroks; Eferoks.
Levothyroxine – a modern efficient and safe means of substitution and suppressive therapy for the majority of thyroid disease. Synthetic thyroid hormone; levorotatory isomer of thyroxine (T4). Regulates metabolism, stimulates growth, development, metabolism of proteins, fats and carbohydrates, increases the functional activity of the cardio – vascular and central nervous systems. Used in hypothyroid states of various etiologies (hypothyroidism, myxedema, cretinism), euthyroid benign goiter, multinodular goiter, thyreostatic treatment of hyperthyroidism and diffuse toxic goiter (after reaching a euthyroid state, compensation thyrotoxicosis tireostatikami), autoimmune Hashimoto’s thyroiditis, Graves’ disease, thyroid carcinoma ( complex treatment); to substitution treatment and prevention of recurrence of goiter after thyroid resection (strumectomy) and surgical treatment of malignant tumors of the thyroid gland (thyroidectomy for thyroid cancer); as a diagnostic tool.
Active – active substance:
Levothyroxine / Levothyroxine sodium / Levothyroxine / Levothyroxine sodium.
Dosage Forms:
Tablets.
Levothyroxine
Properties / Action:
Levothyroxine (L – thyroxine) – a synthetic thyroid hormone; levorotatory isomer of thyroxine (T4); means, the lack of thyroid hormone.
Action levothyroxine is identical to the natural action of thyroid hormone thyroxine produced by the thyroid gland of human. After biotransformation in the body liothyronine (liver and kidney) and entering the body’s cells have a regulating effect on the development, tissue growth and metabolism. Mechanisms include metabolic effects of receptor binding to the genome, changes in mitochondrial oxidative metabolism and regulation of the flow of cations and substrates inside and outside cells.
In small doses Levothyroxine has an anabolic effect.
The average doses Levothyroxine stimulates growth and development, increases tissue oxygen demand, stimulates the metabolism of proteins, fats and carbohydrates, increases the functional activity of the cardio – vascular and central nervous systems.
In large doses Levothyroxine inhibits the production of thyrotropin – releasing hormone from the hypothalamus (TTRG) and thyroid-stimulating pituitary hormone (TSH).
In hypothyroidism clinical benefit from therapy with levothyroxine is observed after 3-5 days, maximum – after 3 – 4 weeks and is maintained after cancellation within 1 – 3 weeks. Early diffuse hyperplastic goiter decreases or disappears within 3-6 months. In the late stages of a significant reduction of nodal thyroid size it is noted only in 30% of cases, but almost all patients prevented its further growth.
Pharmacokinetics:
Once inside absorbed up to 80% of the dose; It absorbed mainly in the small intestine. Food reduces the absorption and intake on an empty stomach increases the absorption of levothyroxine. Maximum plasma concentration is reached after about 6 hours after administration. Binding to plasma proteins (thyroxine binding globulin, thyroxine binding prealbumin and albumin) – about 99%. Distribution takes place mainly in the liver, muscle and brain, where it is approximately 80% monodeyodirovanie forming levothyroxine liothyronine (triiodothyronine, T3) and inactive ingredients. A small amount of levothyroxine undergoes deamination and decarboxylation to form tetrayodtirouksusnoy acid and sulfuric acid and conjugated with glucuronic acid (in the liver). T1 / 2 is 6 – 8 days. About 15% is excreted by the kidneys and bile in unchanged form and as conjugates.
Indications:
Substitution therapy is absolutely necessary for maintaining normal metabolism in all cases, reduce thyroid function.
Suppressive therapy is performed after surgery for thyroid cancer treatment with radioactive iodine for the prevention of tumor recurrence, as well as for recurrent nodular goiter.
Dosage and administration:
The daily dose of levothyroxine is determined individually depending on the evidence, the degree of increase of the thyroid gland and its functional state (laboratory data), age, weight, cardio – vascular system, the effect of the treatment.
Levothyroxine take 1 time a day, in the morning on an empty stomach, at least 30 minutes before a meal, washing down a pill and a small amount of liquid without chewing. Infants daily dose of levothyroxine is given in 1 reception half an hour before a meal, dissolving a tablet in a little water to form a thin slurry. The slurry is prepared immediately before using, and washed down with a little water.
levothyroxine dose and duration of treatment determined by the doctor – an endocrinologist. The following doses of levothyroxine as indicative (ug / day) may be recommended:
The initial adult dose of 25-100 mg per day (for children – 12.5 – 50 mg / day.), With a gradual increase to 25-50 mg every 2-3 weeks to maintenance dose. In severe or long-existing hypothyroidism initial dose should be lower and increase its support to be more gradual.
When thyroid cancer after subtotal thyroidectomy 150 – 300 mg / day. In hypothyroidism after surgical removal of part or all of thyroid Levothyroxine take usually lifelong.
In hyperthyroidism Levothyroxine is used in combination therapy with tireostatikami 50 – 100 mg / day to achieve a euthyroid state.
Supressionnaya scintigram of the thyroid gland: within 14 days – 200 mg / day or 3 mg 1 time for 7 days before the planned scintigrams (radioisotope research). If necessary, after 2 weeks after administration of levothyroxine can be made re-use it.
Overdose:
It is accompanied by symptoms of thyrotoxicosis, thyrotoxic crisis: palpitations, irritability, diarrhea, abdominal pain, increased sweating, tachycardia, arrhythmia, angina, heart failure, tremor, headache pain, insomnia, heat intolerance, fever; improvement of T4 and T3 in the blood serum and free thyroxin index; weight loss.
Treatment: Levothyroxine should be temporarily canceled. In stark expressed manifestations of hyperthyroidism prescribe beta – blockers, in / with the introduction of corticosteroids (prednisolone, dexamethasone, hydrocortisone..). In severe cases, plasmapheresis should be applied.
Contraindications:
For replacement therapy only absolute contraindication is hypersensitivity to levothyroxine.
Pregnancy and lactation:
During pregnancy and lactation levothyroxine should be used under medical supervision. Levothyroxine is well researched and there is no evidence to suggest toxic effects on the fetus or malformations.
If pregnancy should continue taking levothyroxine assigned about hypothyroidism.
The use of levothyroxine in combination with tireostatikami contraindicated because this can cause fetal hypothyroidism.
Caution should be used Levothyroxine lactation (breastfeeding).
Side effects:
side effects have been observed when used correctly Levothyroxine under medical supervision.
At high doses of levothyroxine may be signs of hyperthyroidism (including the very rapid increase in the dose of the beginning of treatment): tachycardia, arrhythmia, angina (chest pain), tremors, sleep disorders, insomnia, weakness , feeling of inner restlessness, increased sweating, rash, loss of body weight (in some cases – transient increase in body weight due to increased appetite), vomiting, diarrhea, and hyperglycemia;
In some cases – hair loss (alopecia), adrenal insufficiency, renal function disorder in children (with high initial doses).
Special instructions and precautions:
The treatment requires regular medical supervision.
In primary hypothyroidism, and endemic goitre therapy is carried out under the control of thyroid-stimulating hormone concentrations (higher level which indicates a lack of dose), and the secondary hypothyroidism – under the control of the level of free thyroxine. Determination of thyroid-stimulating hormone level is carried out in 2 months. after the maintenance dose, and then – once every 6 months. When applied in the II and III trimester usually increase the dose by 25%. The adequacy of thyroid suppressive therapy is estimated also to suppress the capture of radioactive iodine.
used with caution in elderly patients, patients with cardio – vascular disease (including atherosclerosis, angina, heart failure, myocardial infarction, hypertension); caution is necessary in the early treatment of patients suffering epileptic fits, with insufficient adrenocortical function in patients with severe thyroid hypofunction or if there is a reduced function for a long time. To apply caution in patients with diabetes and diabetes insipidus. In some cases, thyroid hormones can exacerbate previous myasthenic syndrome.
In such cases, treatment with levothyroxine should be started at a low initial dose which is gradually increased over large time intervals for regular monitoring of thyroid hormones. For elderly patients the initial dose should not exceed 50 g; during treatment is necessary to monitor the functions of cardio – vascular system.
When using children in extremely high initial doses may develop renal dysfunction. In children with seizures perhaps their more frequent.
In case of side effects, reduce the daily dose or for a few days to stop taking levothyroxine, and after their disappearance resume taking levothyroxine at a lower dose.
Before the start of treatment should be to exclude the possibility of pituitary or hypothalamic hypothyroidism. When hypothyroidism caused by pituitary lesion, it is necessary to find out whether there is a failure of the adrenal cortex at the same time that need to be treated prior to initiating therapy with thyroid hormones. Do not use in case of insufficiency of the adrenal cortex functions without adequate maintenance therapy with corticosteroids, as against the background of thyroid replacement therapy may develop an acute adrenal crisis.
When long-existing multinodular goiter prior to treatment should be carried out with the test stimulus thyrotropin – releasing hormone. Experience has shown that a low body weight and a large nodular goiter volume sufficient application of levothyroxine in a small dose.
During the differential – diagnostic test thyroid suppression in patients with diabetes is recommended to increase the dose of antidiabetic agents.
In the appointment of other drugs containing iodine needs control of the doctor.
Effects on ability to drive vehicles and management mechanisms:
When properly selected therapeutic dose of Levothyroxine has no influence on the ability to engage in potentially hazardous activities that require increased attention and psychomotor speed reactions
Drug Interactions:
Levothyroxine weakens the effect of insulin and oral antidiabetic agents. In patients with hypothyroidism and concomitant diabetes at the start of replacement therapy with thyroid hormone may increase the need for insulin or oral hypoglycemic agents.
Levothyroxine reduces the effect of cardiac glycosides.
Levothyroxine enhances the action of antidepressants.
Levothyroxine increases in prothrombin time, while the use of oral anticoagulants (coumarin derivatives).
phenytoin, salicylates, dikumarol, furosemide (in high doses), clofibrate increase the content of levothyroxine in the blood; This may occur when an arrhythmia.
cholestyramine, colestipol, sucralfate. aluminum hydroxide (aluminum hydroxide and magnesium), calcium carbonate, reduce the absorption of levothyroxine; It should set the interval between doses of these drugs up to 4 -. 5 hours
Estrogens increase the concentration associated with thyroglobulin fraction of levothyroxine (less effective).
With simultaneous use of chloroquine and may increase the metabolism of levothyroxine, in – apparently due to chloroquine induction of microsomal liver enzymes. Patients receiving Levothyroxine when applying proguanil or chloroquine may increase the concentration of TSH.
The protein binding of levothyroxine alter anabolic steroids, asparaginase, tamoxifen.
Amiodarone. aminoglutethimide, aminosalicylic acid. ethionamide, antithyroid drugs, beta – blockers, carbamazepine. chloral hydrate, diazepam, levodopa, dopamine. metoclopramide. lovastatin. somatostatin et al. can alter the levels of thyroid hormones and thyroid stimulating usually affecting the synthesis, secretion, distribution, metabolism, and elimination action of thyroid hormone secretion of TSH or changing.
When using ritonavir may increase in levothyroxine requirements.
When using sertraline and patients with hypothyroidism with levothyroxine may decrease the effects.
Storage:
List B. In a dry, protected from light, out of reach of children, cool (not above 25 ° C) place.
The expiration date on the package. Do not use after the expiration date.
Terms of pharmacy holiday – by prescription .
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