drug-information.ru |
|Levothyroxine Sodium |
Drugs search, click the first letter of a drug name: | A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z | 1 | 2 | 3 | 4 | 5 | 6 | 8 | 9 Home Levothyroxine Sodium( T 4 ; L-thyroxine ) Pronouncation: (lee-voe-thigh-ROX-een SO-dee-uhm)Class: Thyroid hormone Trade Names: Trade Names: Trade Names: Mechanism of ActionPharmacologyIncreases metabolic rate of body tissues; is needed for normal growth and maturation. PharmacokineticsAbsorptionBioavailability is 48% to 79%. Fasting increases absorption. Effective by parenteral route. DistributionMore than 99% protein bound. EliminationThe t ½ is 6 to 7 days for T 4 . Indications and UsageReplacement or supplemental therapy in hypothyroidism; thyroid-stimulating hormone (TSH) suppression (in thyroid cancer, nodules, goiters, and enlargement in chronic thyroiditis). ContraindicationsAcute MI and thyrotoxicosis uncomplicated by hypothyroidism; coexistence of hypothyroidism and hypoadrenalism (Addison disease) unless treatment of hypoadrenalism with adrenocortical steroids precedes initiation of thyroid therapy. Dosage and AdministrationIndividualize dosage. Infants and ChildrenIn infants with congenital or acquired hypothyroidism, institute therapy with full doses as soon as diagnosis is made. In children with chronic or severe hypothyroidism, an initial oral 25 mcg/day dose is recommended with increments of 25 mcg q 2 to 4 wk until desired effect is achieved. The following guidelines are recommended: Children more than 12 yr (growth/puberty complete)PO 1.7 mcg/kg/day. Children more than 12 yr (growth/puberty incomplete)PO 2 to 3 mcg/kg/day. Children 6 to 12 yrPO 4 to 5 mcg/kg/day. Children 1 to 5 yrPO 5 to 6 mcg/kg/day. Children 6 to 12 moPO 6 to 8 mcg/kg/day. Children 3 to 6 moPO 8 to 10 mcg/kg/day. Children 0 to 3 moPO 10 to 15 mcg/kg/day. Consider a lower starting dose (eg, 25 mcg/day) in infants at risk for cardiac failure, increasing the dose in 4- to 6-wk intervals based on clinical and laboratory response. Hypothyroidism in Adults and Children in Whom Growth and Puberty are CompleteAdults and Children PO Average full replacement dose is approximately 1.7 mcg/kg/day (eg, 100 to 125 mcg/day for 70 kg adult). Older patients may require less than 1 mcg/kg/day. Doses greater than 200 mcg/day are seldom required. For most patients older than 50 yr or patients younger than 50 yr with underlying cardiac disease, an initial starting dose of 25 to 50 mcg/day is recommended, with gradual increments in dose at 6- to 8-wk intervals, as needed. The recommended starting dose in elderly patients with cardiac disease is 12.5 to 25 mcg/day, with gradual dose increments at 4- to 6-wk intervals. Severe HypothyroidismAdults PO Recommended starting dose is 12.5 to 25 mcg/day with increases of 25 mcg/day q 2 to 4 wk, accompanied by clinical and laboratory assessment, until TSH level in normalized. IV/IM May be substituted for oral form when oral ingestion is precluded for long periods of time. Initial parenteral dosage should be approximately 50% the previously established oral dosage. A daily maintenance dose of 50 to 100 mcg parenterally should maintain the euthyroid stat once established. Monitor the patient and adjust the dosage as needed. Subclinical HypothyroidismAdults PO If treated, a lower dose (eg, 1 mcg/kg/day) than that used for full replacement may be adequate to normalize serum TSH level. Myxedema ComaAdults IV In myxedema coma or stupor, without concomitant severe heart disease, 200 to 500 mcg may be administered as a solution containing 100 mcg/mL. Full therapeutic effect may not be evident until the following day. An additional 100 to 300 mcg or more may be given on the second day if evidence of significant and progressive improvements has not occurred. TSH Suppression in Well-Differentiated Thyroid Cancer and Thyroid NodulesAdults PO TSH suppression to less than 0.1 mU/L usually requires a levothyroxine dose greater than 2 mcg/kg/day; however, in patients with high-risk tumors, the target TSH suppression level may be less than 0.01 mU/L. In treatment of benign nodules and nontoxic multinodular goiter, TSH generally is suppressed to a higher target (eg, 0.1 to 0.5 mU/L or 1 mU/L) than that used for treatment of thyroid cancer. General Advice
Drug InteractionsAnticoagulants, oralMay increase anticoagulant effects. Cholestyramine, colestipolMay decrease thyroid hormone efficacy. Digitalis glycosidesMay reduce effects of glycosides. FastingIncreases absorption from GI tract. Iron saltsMay decrease efficacy of levothyroxine, resulting in hypothyroidism. TheophyllinesHypothyroidism; may cause decreased theophylline Cl; Cl may return to normal when euthyroid state is achieved. Laboratory Test InteractionsConsider changes in thyroxine binding globulin concentration when interpreting thyroxine (T 4 ) and triiodothyronine (T 3 ) values; medicinal or dietary iodine interferes with all in vivo tests of radioiodine uptake, producing low uptakes that may not reflect true decrease in hormone synthesis. Adverse ReactionsCardiovascularPalpitations; tachycardia; cardiac arrhythmias; angina pectoris; cardiac arrest. CNSTremors; headache; nervousness; insomnia. GIDiarrhea; vomiting. MiscellaneousHypersensitivity; weight loss; menstrual irregularities; sweating; heat tolerance; fever; decreased bone density (in women using levothyroxine long term). Precautions
PregnancyCategory A . LactationMinimal amounts excreted in breast milk. ChildrenWhen drug is administered for congenital hypothyroidism, routine determinations of serum T 4 or TSH are strongly advised in newborns. In infants, excessive doses of thyroid hormone preparations may produce craniosynostosis. Children may experience transient partial hair loss in first few months of thyroid therapy. Cardiovascular diseaseUse caution when integrity of cardiovascular system, particularly coronary arteries, is suspect (eg, angina, elderly). Development of chest pain or worsening cardiovascular disease requires decrease in dosage. Endocrine disordersTherapy in patients with concomitant diabetes mellitus, diabetes insipidus, or adrenal insufficiency (Addison disease) exacerbates intensity of symptoms. Therapy of myxedema coma requires simultaneous administration of glucocorticoids. In patients whose hypothyroidism is secondary to hypopituitarism, correct adrenal insufficiency, if present, with corticosteroids. Hyperthyroid effectsLevothyroxine rarely may precipitate hyperthyroid state or may aggravate existing hyperthyroidism. InfertilityDrug is unjustified for treatment of male or female infertility unless condition is accompanied by hypothyroidism. Morphologic hypogonadism and nephrosisRule out before therapy. Myxedema comaPatients are particularly sensitive to thyroid preparations. Sudden administration of large doses is not without cardiovascular risks. Small initial doses are indicated. OverdosageSymptomsSymptoms of hyperthyroidism: headache, irritability, nervousness, sweating, tachycardia, increased bowel motility, menstrual irregularities, palpitations, vomiting, psychosis, seizure, fever, angina pectoris, CHF, shock, arrhythmias, thyroid storm. Patient Information
Where can I get more information about Levothyroxine Sodium ? We recommend to use www.Drugs.com Typical mistypes for Levothyroxine Sodium kevothyroxine sodium, pevothyroxine sodium, oevothyroxine sodium, lwvothyroxine sodium, lsvothyroxine sodium, ldvothyroxine sodium, lrvothyroxine sodium, l4vothyroxine sodium, l3vothyroxine sodium, lecothyroxine sodium, lebothyroxine sodium, legothyroxine sodium, lefothyroxine sodium, levithyroxine sodium, levkthyroxine sodium, levlthyroxine sodium, levpthyroxine sodium, lev0thyroxine sodium, lev9thyroxine sodium, levorhyroxine sodium, levofhyroxine sodium, levoghyroxine sodium, levoyhyroxine sodium, levo6hyroxine sodium, levo5hyroxine sodium, levotgyroxine sodium, levotbyroxine sodium, levotnyroxine sodium, levotjyroxine sodium, levotuyroxine sodium, levotyyroxine sodium, levothtroxine sodium, levothgroxine sodium, levothhroxine sodium, levothuroxine sodium, levoth7roxine sodium, levoth6roxine sodium, levothyeoxine sodium, levothydoxine sodium, levothyfoxine sodium, levothytoxine sodium, levothy5oxine sodium, levothy4oxine sodium, levothyrixine sodium, levothyrkxine sodium, levothyrlxine sodium, levothyrpxine sodium, levothyr0xine sodium, levothyr9xine sodium, levothyrozine sodium, levothyrocine sodium, levothyrodine sodium, levothyrosine sodium, levothyroxune sodium, levothyroxjne sodium, levothyroxkne sodium, levothyroxone sodium, levothyrox9ne sodium, levothyrox8ne sodium, levothyroxibe sodium, levothyroxime sodium, levothyroxije sodium, levothyroxihe sodium, levothyroxinw sodium, levothyroxins sodium, levothyroxind sodium, levothyroxinr sodium, levothyroxin4 sodium, levothyroxin3 sodium, levothyroxine aodium, levothyroxine zodium, levothyroxine xodium, levothyroxine dodium, levothyroxine eodium, levothyroxine wodium, levothyroxine sidium, levothyroxine skdium, levothyroxine sldium, levothyroxine spdium, levothyroxine s0dium, levothyroxine s9dium, levothyroxine sosium, levothyroxine soxium, levothyroxine socium, levothyroxine sofium, levothyroxine sorium, levothyroxine soeium, levothyroxine soduum, levothyroxine sodjum, levothyroxine sodkum, levothyroxine sodoum, levothyroxine sod9um, levothyroxine sod8um, levothyroxine sodiym, levothyroxine sodihm, levothyroxine sodijm, levothyroxine sodiim, levothyroxine sodi8m, levothyroxine sodi7m, levothyroxine sodiun, levothyroxine sodiuk, levothyroxine sodiuj, evothyroxine sodium, lvothyroxine sodium, leothyroxine sodium, levthyroxine sodium, levohyroxine sodium, levotyroxine sodium, levothroxine sodium, levothyoxine sodium, levothyrxine sodium, levothyroine sodium, levothyroxne sodium, levothyroxie sodium, levothyroxin sodium, levothyroxinesodium, levothyroxine odium, levothyroxine sdium, levothyroxine soium, levothyroxine sodum, levothyroxine sodim, levothyroxine sodiu, elvothyroxine sodium, lveothyroxine sodium, leovthyroxine sodium, levtohyroxine sodium, levohtyroxine sodium, levotyhroxine sodium, levothryoxine sodium, levothyorxine sodium, levothyrxoine sodium, levothyroixne sodium, levothyroxnie sodium, levothyroxien sodium, levothyroxin esodium, levothyroxines odium, levothyroxine osdium, levothyroxine sdoium, levothyroxine soidum, levothyroxine soduim, levothyroxine sodimu, llevothyroxine sodium, leevothyroxine sodium, levvothyroxine sodium, levoothyroxine sodium, levotthyroxine sodium, levothhyroxine sodium, levothyyroxine sodium, levothyrroxine sodium, levothyrooxine sodium, levothyroxxine sodium, levothyroxiine sodium, levothyroxinne sodium, levothyroxinee sodium, levothyroxine sodium, levothyroxine ssodium, levothyroxine soodium, levothyroxine soddium, levothyroxine sodiium, levothyroxine sodiuum, levothyroxine sodiumm, etc.
|