Dosing & Administration SYNTHROID® levothyroxine sodium tablets

Tell your doctor if you have an untreated or uncontrolled adrenal gland disorder, a thyroid disorder called thyrotoxicosis, or if you have any recent or current symptoms of a heart attack. Adding plans allows you to compare formulary status to other drugs in the same class. SYNTHROID is contraindicated in patients with uncorrected adrenal insufficiency see Warnings and Precautions (5.4). Administer SYNTHROID at least 4 hours before or after drugs known to interfere with SYNTHROID absorption see Drug Interactions (7.1). A portion of the conjugated hormone reaches the colon unchanged and is eliminated in the feces. SYNTHROID is contraindicated in patients with uncorrected adrenal insufficiency see WARNINGS AND PRECAUTIONS.

Use the serum free-T4 level to titrate SYNTHROID dosing until the patient is clinically euthyroid and the serum free-T4 level is restored to the upper half of the normal range.
The recommended starting daily dosage of SYNTHROID in adults with primary, secondary, or tertiary hypothyroidism is based on age and comorbid cardiac conditions, as described in Table 1.
Doctors often may have to slowly increase the dose; patients should not increase or decrease this medication themselves.
Pregnancy, infectious hepatitis, estrogens, estrogen-containing oral contraceptives, and acute intermittent porphyria increase TBG concentration.

Addition of SYNTHROID therapy in patients with diabetes mellitus may worsen glycemic control and result in increased antidiabetic agent or insulin requirements. Carefully monitor glycemic control, especially when thyroid therapy is started, changed, or discontinued see Warnings and Precautions (5.5). Addition of levothyroxine therapy in patients with diabetes mellitus may worsen glycemic control and result in increased antidiabetic agent or insulin requirements.

Dosage Forms & Strengths

In patients on a stable and appropriate replacement dosage, evaluate clinical and biochemical response every 6 to 12 months and whenever there is a change in the patient’s clinical status. Thyroid hormones, including SYNTHROID, either alone or with other therapeutic agents, should not be used for the treatment of obesity or for weight loss. In euthyroid patients, doses within the range of daily hormonal requirements are ineffective for weight reduction. Larger doses may produce serious or even life-threatening manifestationsof toxicity, particularly when given in association with sympathomimetic amines such as those used for their anorectic effects. Larger doses may produce serious or even life-threatening manifestations of toxicity, particularly when given in association with sympathomimetic amines such as those used for their anorectic effects. For secondary or tertiary hypothyroidism, serum TSH is not a reliable measure of SYNTHROID dosage adequacy and should not be used to monitor therapy.

To view updated drug label links, paste the RSS feed address (URL) shown below into a RSS reader, or use a browser which supports RSS feeds, such as Safari for Mac OS X. Pregnant and lactating females need to discuss the dose and use of this medication with their caregivers. This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects. Notify your doctor if you experience serious side effects of Synthroid including rapid heartbeat, fluttering in your chest, or chest pain.

SYNTHROID DOSING & MONITORING

Carefully monitor glycemic control after starting, changing, or discontinuing SYNTHROID see Drug Interactions (7.2). Thyroid hormone increases metabolic clearance of glucocorticoids. Initiation of thyroid hormone therapy prior to initiating glucocorticoid therapy may precipitate an acute adrenal crisis in patients with adrenal insufficiency. Treat patients with adrenal insufficiency with replacement glucocorticoids prior to initiating treatment with SYNTHROID see Contraindications (4). Carefully monitor glycemic control after starting, changing, or discontinuing SYNTHROID see DRUG INTERACTIONS.

Protein-bound thyroid hormones exist in reverse equilibrium with small amounts of free hormone.
Reduce the SYNTHROID dosage or discontinue temporarily if signs or symptoms of overdosage occur.
Larger doses may produce serious or even life-threatening manifestations of toxicity, particularly when given in association with sympathomimetic amines such as those used for their anorectic effects.

Warnings and Precautions

The peak therapeutic effect of a given dose of SYNTHROID may not be attained for 4 to 6 weeks. Administer SYNTHROID at least 4 hours before or after drugs known to interfere with SYNTHROID absorption. Biochemical assessment incorporated measurement of serum TSH, T3, and T4. TSH lower limit of quantification was 0.2 mIU/L and upper limit of normal was 5.6 mIU/L, as indicated by the shaded area. SYNTHROID is not indicated for treatment of hypothyroidism during the recovery phase of subacute thyroiditis. Enter medications to view a detailed interaction report using our Drug Interaction Checker.

The goal is to achieve steady TSH levels within the appropriate therapeutic range. 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.

WARNINGS AND PRECAUTIONS

Stop biotin and biotin-containing supplements for at least 2 days before assessing TSH and/or T4 levels see DRUG INTERACTIONS.
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Many other medicines can be affected by your thyroid hormone levels.

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 … It may take several weeks before your body starts to respond to Synthroid. Your child’s dose needs may change if the child gains or loses weight. DailyMed will deliver this notification to synthroid side your desktop, Web browser, or e-mail depending on the RSS Reader you select to use.

Because of the increased prevalence of cardiovascular disease among the elderly, initiate SYNTHROID at less than the full replacement dose see Dosage and Administration (2.3) and Warnings and Precautions (5.2). Atrial fibrillation is the most common of the arrhythmias observed with levothyroxine overtreatment in the elderly. Over-treatment with levothyroxine may cause an increase in heart rate, cardiac wall thickness, and cardiac contractility and may precipitate angina or arrhythmias, particularly in patients with cardiovascular disease and in elderly patients. Initiate SYNTHROID therapy in this population at lower doses than those recommended in younger individuals or in patients without cardiac disease see Dosage and Administration (2.3) and Use in Specific Populations (8.5). For adult patients with primary hypothyroidism, titrate until the patient is clinically euthyroid and the serum TSH returns to normal see Dosage and Administration (2.3).

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 prescribed in tablets that range from 25 to 300 mcg in strength and is usually taken once a day with a full glass of water (about 8 ounces) 30 to 60 minutes before breakfast for best adsorption into the body. Children can take the medicine if the tablet is crushed and put into about 1 to 2 teaspoons of water; do not store or delay giving this crushed pill suspension. 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.