Levothyroxine Wikipedia

All pregnancies have a background risk of birth defect, loss, or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively. Biotin supplementation is known to interfere with thyroid hormone immunoassays that are based on a biotin and streptavidin interaction, which may result in erroneous thyroid hormone test results. Stop biotin and biotin-containing supplements for at least 2 days prior to thyroid testing.

Patients with coronary artery disease who are receiving SYNTHROID should be closely monitored for cardiac arrhythmias during surgical procedures. If you become pregnant while taking Synthroid, do not stop taking the medicine without your doctor’s advice. Having low thyroid hormone levels during pregnancy could harm both mother and baby. Rapid restoration of normal serum T4 concentrations is essential for preventing the adverse effects of congenital hypothyroidism on intellectual development as well as on overall physical growth and maturation. Therefore, SYNTHROID therapy should be initiated immediately upon diagnosis and is generally continued for life.

DAW-1 indicates that substitution is not allowed, based on the prescriber’s preference, and ensures your patient will receive the treatment you prescribe. It also helps your patient pay the lowest possible price for the product you write if it is billed through insurance. SYNTHROID is not indicated for treatment of hypothyroidism during the recovery phase of subacute thyroiditis. Some key points that I discuss with the patients during appointments are, one, is that this is an open conversation.

• In this instance, however, the physician should carefully monitor the child and repeat the thyroid function tests if any signs or symptoms of hypothyroidism develop.
• For pregnant patients with pre-existing hypothyroidism, measure serum TSH and free-T4 as soon as pregnancy is confirmed and, at minimum, during each trimester of pregnancy.
• In adult patients with primary (thyroidal) hypothyroidism, serum TSH levels (using a sensitive assay) alone may be used to monitor therapy.
• Oral levothyroxine sodium is a synthetic T4 hormone that exerts the same physiologic effect as endogenous T4, thereby maintaining normal T4 levels when a deficiency is present.

Pregnancy and breastfeeding

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 and DRUG INTERACTIONS. This is a key issue for some of the elemental things like calcium and iron, that can interfere with thyroid hormone absorption and thus should be taken approximately 4 hours apart.

Dosing here should be individualized based on whether the patients were diagnosed with hypothyroidism prior to pregnancy or during the pregnancy. Please see the additional Important Safety Information at the end of this video, phentermine synthroid including the BOXED WARNING regarding inappropriate treatment for obesity or for weight loss. In the treatment of benign nodules and nontoxic multinodular goiter, TSH is generally suppressed to a higher target (e.g., 0.1 to either 0.5 or 1.0 mU/L) than that used for the treatment of thyroid cancer.

Treatment of Overdosage

The presence of concomitant medical conditions should be considered in certain clinical circumstances and, if present, appropriately treated (see PRECAUTIONS ). Your doctor will use a TSH, or thyroid stimulating hormone, test to determine whether you have hypothyroidism. Closely monitor infants during the first 2 weeks of SYNTHROID therapy for cardiac overload and arrhythmias. Concurrent use of ketamine and SYNTHROID may produce marked hypertension and tachycardia. That’s because substitutions can be made at the pharmacy if the prescription is not properly protected with the Dispense as Written (DAW) state-specific language. It’s very important to remind the patients, in addition to these factors, that they need to check their pills on a consistent basis.

Side Effects for Synthroid

Published studies report that levothyroxine is present in human milk following the administration of oral levothyroxine. No adverse effects on the breastfed infant have been reported and there is no information on the effects of levothyroxine on milk production. Adequate levothyroxine treatment during lactation may normalize milk production in hypothyroid lactating mothers with low milk supply.

Carefully monitor glycemic control, especially when thyroid therapy is started, changed, or discontinued see WARNINGS AND PRECAUTIONS. Start at a lower starting dosage and increase the dosage every 4 to 6 weeks as needed based on clinical and laboratory response. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using. 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.

During the first three years of life, the serum total- or free- T4 should be maintained at all times in the upper half of the normal range. While the aim of therapy is to also normalize the serum TSH level, this is not always possible in a small percentage of patients, particularly in the first few months of therapy. TSH may not normalize due to a resetting of the pituitary-thyroid feedback threshold as a result of in utero hypothyroidism.

PRECAUTIONS

• If the results of the levothyroxine withdrawal test are inconclusive, careful follow-up and subsequent testing will be necessary.
• The peak therapeutic effect of a given dose of SYNTHROID may not be attained for 4 to 6 weeks.
• That is primary, secondary, or tertiary hypothyroidism, either due to congenital or acquired state.
• Levothyroxine sodium is contraindicated if the serum TSH is already suppressed due to the risk of precipitating overt thyrotoxicosis (see CONTRAINDICATIONS – WARNINGS and PRECAUTIONS).
• The therapeutic effects of digitalis glycosides may be reduced by levothyroxine.

Levothyroxine increases the response to oral anticoagulant therapy. Therefore, a decrease in the dose of anticoagulant may be warranted with correction of the hypothyroid state or when the SYNTHROID dose is increased. Prothrombin time should be closely monitored to permit appropriate and timely dosage adjustments (see Table 2). Synthroid is a man-made hormone, identical to the hormone made by the thyroid gland and has the same effect on the body. It replaces the amount of hormone the thyroid is unable to or can no longer make, helping to restore your thyroid hormone levels to the range they need to be.