SYNTHROID- levothyroxine sodium tablet

Dangerous side effects or death can occur from the misuse of levothyroxine, especially if you are taking any other weight-loss medications or appetite suppressants. Synthroid is a prescription medicine used to treat hypothyroidism (low thyroid hormone). Levothyroxine is given when your thyroid does not produce enough of this hormone on its own. Evaluate the need for dosage adjustments when regularly administering within one hour of certain foods that may affect SYNTHROID absorption see Dosage and Administration (2.2 and 2.3), Drug Interactions (7.9), andClinical Pharmacology (12.3). SYNTHROID is administered as a single daily dose, preferably one-half to one-hour before breakfast.

Use of oral thyroid hormone drug products is not recommended to treat myxedema coma. Administer thyroid hormone products formulated for intravenous administration to treat myxedema coma. HypothyroidismSYNTHROID® (levothyroxine sodium) tablets, for oral use is indicated as a replacement therapy in primary (thyroidal), secondary (pituitary), and tertiary (hypothalamic) congenital or acquired hypothyroidism. Absorption of orally administered T4 from the gastrointestinal tract ranges from 40% to 80%.

• Pregnancy, infectious hepatitis, estrogens, estrogen-containing oral contraceptives, and acute intermittent porphyria increase TBG concentration.
• Importantly, clock gene expression across different TH states is largely unaffected, suggesting that the diurnal effects of THs are downstream of the circadian clock103,104.
• Activated charcoal or cholestyramine may also be used to decrease absorption.
• Titrate the dosage (every 2 weeks) as needed based on serum TSH or free- T4 until the patient is euthyroid see Important Considerations For Dosing.

Acute adrenal crisis in patients with concomitant adrenal insufficiency

Grapefruit juice may delay the absorption of levothyroxine and reduce its bioavailability. Inquire whether patients are taking biotin or biotin-containing supplements. If so, advise them to stop biotin supplementation at least 2 days before assessing TSH and/or T4 levels see Dosage and Administration (2.4) and Drug Interactions (7.10). Caution should be exercised when administering SYNTHROID to patients with underlying cardiovascular disease, to the elderly, and to those with concomitant adrenal insufficiency (see PRECAUTIONS ).

Many drugs can exert effects on thyroid hormone pharmacokinetics and metabolism (e.g., absorption, synthesis, secretion, catabolism, protein binding, and target tissue response) and may alter the therapeutic response to SYNTHROID (Tables 5 to 8). Assess the adequacy of therapy by periodic assessment of laboratory tests and clinical evaluation. Persistent clinical and laboratory evidence of hypothyroidism despite an apparent adequate replacement dose of SYNTHROID may be evidence of inadequate absorption, poor compliance, drug interactions, or a combination of these factors. SYNTHROID is indicated in adult and pediatric patients, including neonates, as an adjunct to surgery and radioiodine therapy in the management of thyrotropin-dependent well-differentiated thyroid cancer. Several adipokines exhibit diurnal rhythms and their release is modulated by internal or environmental factors such as light or food intake114. Leptin, for example, displays a strong circadian fluctuation with the highest levels during the inactive phase and the lowest levels during the light phase in healthy humans and other diurnal mammals14,117.

Adequacy of therapy should be assessed by measuring serum free- T4 levels, which should be maintained in the upper half of the normal range in these patients. Exercise caution when administering levothyroxine to patients with nontoxic diffuse goiter or nodular thyroid disease in order to prevent precipitation of thyrotoxicosis (see WARNINGS ). If the serum TSH is already suppressed, levothyroxine sodium should not be administered (see CONTRAINDICATIONS ).

FDA Drug Information

Pseudotumor cerebri and slipped capital femoral epiphysis have been reported in pediatric patients receiving levothyroxine therapy. Overtreatment may result in craniosynostosis in infantswho have not undergone complete closure of the fontanelles, and in premature closure of the epiphyses in pediatric patients still experiencing growth with resultant compromised adult height. Addition of levothyroxine therapy in patients with diabetes mellitus may worsen glycemic control and result in increased antidiabetic agent or insulin requirements. Carefully monitor glycemic control after starting, changing, or discontinuing SYNTHROID see Drug Interactions (7.2). Titrate the dose of SYNTHROID carefully and monitor response to titration to avoid these effects see Dosage and Administration (2.4). Consider the potential for food or drug interactions and adjust the administration or dosage of SYNTHROID as needed see Dosage and Administration (2.1), Drug Interactions (7.1), and Clinical Pharmacology (12.3).

Dosage Forms And Strengths

The goal is to achieve steady TSH levels within the appropriate therapeutic range. Euthyrox (levothyroxine) is used to treat hypothyroidism and to treat or prevent goiter. Armour Thyroid is used for hashimoto’s disease, hypothyroidism, after thyroid removal, thyroid synthroid vitex … It may take several weeks before your body starts to respond to Synthroid. Synthroid works best if you take it on an empty stomach, 30 to 60 minutes before breakfast.

1 Important Administration Instructions

If cardiac symptoms develop or worsen, reduce the SYNTHROID dose or withhold for one week and restart at a lower dose. Concurrent use of ketamine and SYNTHROID may produce marked hypertension and tachycardia. Seizures have been reported rarely with the institution of levothyroxine therapy. Administer SYNTHROID at least 4 hours before or after drugs known to interfere with SYNTHROID absorption see DRUG INTERACTIONS. Our Synthroid Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

• This coordination is crucial for optimal physiological functioning, as misalignment between different body clocks can lead to metabolic, cardiovascular, and psychological disorders38.
• Large doses of antithyroid drugs (e.g., methimazole or propylthiouracil) followed in one to two hours by large doses of iodine may be given to inhibit synthesis and release of thyroid hormones.
• Store at 25°C (77°F); excursions permitted to 15°-30°C (59°-86°F) see USP Controlled Room Temperature.
• Titrate the dosage (every 2 weeks) as needed based on serum TSH or free-T4 until the patient is euthyroid.
• It may take several weeks before your body starts to respond to Synthroid.

1 Drugs Known to Affect Thyroid Hormone Pharmacokinetics

Doctors often may have to slowly increase the dose; patients should not increase or decrease this medication themselves. Because some preparations of the drug may contain iodine or lactose, patients should tell their doctors about such allergies or reactions to these components. Patients need to feel comfortable to alert me of any changes in their status in terms of their symptoms. But also specific medical changes that may indicate there may be a need for a dose change or something that could have affected their thyroid hormone levels.

3 Oral Anticoagulants

Additionally, estrogen interacts with the hypothalamic-pituitary-thyroid (HPT) axis, modulating thyroid hormone levels, which are critical for basal metabolic rate regulation85. Testosterone contributes to muscle mass maintenance86, which indirectly influences metabolic rate and glucose utilization. These metabolic effects underscore the broader role of sex hormones in coordinating endocrine hierarchies beyond their reproductive functions, including their interaction with the HPA axis to modulate stress responses and energy balance. GC interactions with metabolic hormones are complex and have been reviewed elsewhere60,64,65. Briefly, GCs attenuate leptin signaling and disturb insulin signaling and reception. Ghrelin levels rise under chronic and acute stress contributing to increased food intake and weight gain.