Levothyrox 25µg Merck treatment of thorough thyroid thyroid (2 blisters x 15 tablets)
Dosage form Box of 2 blisters x 15 tablets
Specifications Levothyroxine sodium
Ingredient
| Composition information | Content |
| Levothyroxine sodium | 25mcg |
Uses
Indications
levothyrox 25µg drug indications for treatment in the following cases:
pharmacological group: thyroid hormone.
ATC code: H03A A01.
Levothyroxin synthetic in levothyrox has the same effect as natural hormones mainly excreted by the thyroid. It is transformed into T3 at peripheral agencies and as hormones, promoting its specific effects at T3 receptor. The body cannot distinguish external and endogenous levothyroxin.
Dynamic pharmacokinetics
Used by oral, levothyroxin is absorbed almost completely at the upper part of the small intestine. Depending on the formula of the absorption amount, up to 80%. Tmax is about 5 to 6 hours.
After oral use, the onset effect is visible after 3-5 days. Levothyroxin shows a very high level of cohesion with specialized shipping protein about 99.97%. This protein hormone connection does not homosexual so the hormone is connected in plasma quickly and constantly exchanging with the free hormone.
Due to high protein cohesion, levothyroxin is not affected by hemolysis or dialysis.
The half -life of IEVothyroxin is 7 days. In hyperthyroidism, this time is shorter (3-4 days) and longer in hypothyroidism (approximately 9-10 days). Distribution volume is about 10 - 12L. The liver contains 1/3 of the total levothyroxin on the outside of the thyroid gland that they quickly talk to levothyroxin in the serum. The thyroid hormone is metabolized mainly in the liver, kidney, brain and muscle. The metabolites are eliminated through urine and feces. The general metabolic clearance of levothyroxin is 1.2L plasma/day.
Before taking Levothyrox 25µg Merck treatment of thorough thyroid thyroid (2 blisters x 15 tablets)
How to use
daily dose can be used once.
Use drugs: Use single dose in the morning when the abdomen is empty, half an hour before breakfast, with a little water (for example, half a glass of water).
Children take the entire one -time dose at least 30 minutes before the first meal of the day. Dissolve the pill with a little water into a mixture, just dissolve just before drinking, drink with more water.
The time for treatment is usually a lifetime for replacement in hypothyroidism and after removing thyroid or removal of the thyroid and in the recurrent preventive prophylaxis after removing the goiter.
Coordinate to treat hyperthyroidism after reaching the level of armor is indicated in the period of anti -thyroid drug.
For benign goiter, the necessary treatment time is usually from 6 months to 2 years. If the treatment during this time is not enough, it is advisable to consider surgery or luon radiation therapy.
DosageSodium Levothyroxine Levothyroxine tablets are available from 25 to 100 mcg to treat each patient according to the needs of each individual. Therefore, patients usually only need one tablet.
The recommended dose below is only instructed.
Dosage for each individual should be determined based on test results and clinical examination. Because some patients have high T4 and FT4 concentrations, the substrate concentration of serum thyroid hormones is a more reliable standard for the next treatment cycle.
Thyroid hormone treatment should start with low doses and gradually increase every 2 to 4 weeks until the full replacement dose is achieved.
Children: For babies and young children with congenital hypothyroidism, when fast replacement therapy is important, the recommended starting dose is 10 to 15 mcg/kg body weight per day for the first 3 months. After that, the dose should be adjusted for each individual based on clinical signs, thyroid hormone values and TSH.
In the elderly, patients with coronary artery disease, and patients with severe or prolonged hypothyroidism, should be cautious at the beginning of treatment with thyroid hormones, that is, should start with a low dose (for example, 12.5 mcg/1 day), then increase the dose slowly and the distance from each other (for example: gradually increase the dose of 12.5 mcg/1 day after every 2 weeks) and regularly monitor thyroid hormone.
It is necessary to consider when using the lower dose than the optimal dose needed for complete replacement treatment due to the failure to achieve the complete adjustment results of TSH.
Experience shows that lower dose is enough for mild weight patients and large goiter patients.
Side Effects
When exceeding the limit of personal tolerance for sodium levothyroxin or overdose, typical clinical symptoms of hyperthyroidism may occur, especially in the case of increasing dose too fast when starting treatment such as arrhythmia (such as atrial fibrillation and extra heart), tachycardia, chest pain, chest pain, muscle weakness, redness, irritation, nervousness, tremor, restlessness Sweat, weight loss, diarrhea.
In this case, the daily dose should be reduced or stop using the drug for many days. Can start treatment when the adverse reactions are lost.
In case of sensitivity to any component of Levothyrox, allergic reactions may occur on the skin and respiratory tract. There have been reports on some cases of circuit.
Warnings
Before using the drug you need to read the instructions carefully and refer to the information below.
Contraindicated
Levothyrox 25µg is contraindicated in the following cases:
Be cautious when used
Before starting thyroid hormone treatment or before conducting thyroid inhibiting tests, eliminating or treating diseases and the following condition: coronary insension, angina, arteriosclerosis, high blood pressure, saddle gland, adrenal impairment. Autonomous thyroid disease should also be excluded or treated before starting treatment with thyroid hormones.
When starting to treat levothyroxin in patients at risk of mental disorders, it is recommended to start with low doses of IEVothyroxin and increase the dose from the beginning of treatment. Need to monitor patients. If the signs of mental disorders occur, the adjustment of levothyroxin should be considered.
Hyperthus due to mild medication should also be avoided in patients with coronary heart failure, heart failure, tachycardia. Therefore, it is necessary to regularly check the thyroid hormone indicators in these cases.
In the case of secondary hypothyroidism, it is necessary to determine the cause before replacement treatment and if it is necessary to start the replacement of adrenal renal failure.
When suspected of having autonomous thyroid disease, it is advisable to conduct a test or blink of an inhibitor before treatment.
Avoid levothyroxin serum on the case of physiological level in case of hypothyroidism in menopausal women and increase the risk of osteoporosis, and thus, check the tight thyroid function.
Do not use levothyroxin in hyperthyroidism, unless used with anti -thyroid drugs when treating hyperthyroidism.
thyroid hormone is not used to lose weight. In patients with armor, treatment with levothyroxin does not cause weight loss. High doses can cause serious or even life -threatening reactions. Do not coordinate high doses of levothyrox with some drugs for weight loss, such as sympathetic drugs.
Once treated with levothyroxin, in the reporting field, the dosage should be adjusted according to the patient's clinical response and the test results, in case you want to change to other drug labels.
Hypothyroidism and/or reduced control of hypothyroidism can occur when combining orlistat and levothyroxin (see the interaction item and other forms of interactions). Patients who use IEVothyroxin should consult a doctor before starting treatment with orlistate by Orlistat and Levothyroxin may need to be used at different times and levothyroxin dose may need to be adjusted. Moreover, it is recommended to monitor patients by checking serum hormones.
This drug contains lactose, so patients do not tolerate Galactose due to genetics, deficiency of Lapp Lactase or Glucose - Galactose should not use this drug.
For patients with diabetes and patients who are under coagulation treatment, see the interaction of drugs and other forms of interactions.
The effect of drugs on driving and operating machinery
No test on driving and operating machinery has been conducted. However, because levothyroxin is like a natural thyroid hormone, it does not assume that Levothyrox has any effect on the ability to drive and operate machinery.
Use drugs for women during pregnancy and lactation
pregnancy:
Treatment with levothyroxin should be guaranteed during pregnancy and lactation. The dosage needs to be increased during pregnancy.
Experience shows that there is no evidence of the likelihood of teratogenic or drug poisoning due to drugs in humans with recommended dose. Very high doses levothyroxin during pregnancy can cause adverse effects on the development of the fetus and postpartum.
Do not specify the treatment of hyperthyroidism in combination with levothyroxin and anti -thyroid drugs during pregnancy. This combination needs high doses of anti -thyroid drugs that it can pass through the placenta and cause hypothyroidism in infants.
Do not conduct a diagnosis of thyroid inhibitor during pregnancy, because the use of radioactive iodine in pregnant women is contraindicated.
breastfeeding period:
levothyroxin is excreted in breast milk during breastfeeding, but with recommended treatment dose, the concentration is not enough to cause hyperthyroidism or inhibition of TSH secretion in newborns.
Interactive drug
diabetes: levothyroxin can reduce the effect of diabetes. Therefore, it is advisable to regularly check blood sugar at the beginning of thyroid hormone treatment and must adjust the dose of diabetes if necessary.
Coumarin derivatives: The effect of anticoagulant drugs may increase due to levothyroxin releasing anticoagulant drugs from plasma proteins, thus increasing the risk of bleeding, such as gastrointestinal bleeding or central nervous system, especially older patients. Therefore, it is necessary to regularly check the coagulation index at the beginning and during the treatment process. If necessary, anticoagulant dose must be adjusted.
Protease inhibitors: Protease inhibitors (such as Ritonavir, Indinavir, Lopinavir) may affect the effect of levothyroxin. It is recommended to closely monitor thyroid hormone index. If necessary, adjust the dose of levothyroxin.
Phenytoin: Phenytoin can affect the effect of levothyroxin by releasing levothyroxin from serum protein, increasing the ratio of FT4 and FT3. On the other hand, phenytoin increases the metabolism of levothyroxin in the liver. Recommendation should closely monitor thyroid hormones.
Cholestyramine, Colestipol: Using ion exchange resins like cholestyramine and colestipol inhibits the absorption of sodium levothyroxin. So drink sodium levothyroxin 4-5 hours before using these substances.
Pills containing aluminum, iron, calcium carbonate: Aluminum -containing drugs (antacids, sucralfate) are reported in the literature as capable of reducing the effect of levothyroxin. Therefore, levothyroxin should be used for 2 hours before using aluminum.
The same applies to iron and calcium carbonate drugs.
salicylate, dicumarol, Furosemid, Clofibrate: salicylate, dicumarol, high -dose Furosemid (250mg), clofibone and other substances can release sodium levothyroxin from plasma proteins, increasing the ratio of FT4.
Orlistate: Hypertmania and/or reduced control of hypothyroidism may occur when orlistat and levothyroxin are used at the same time. This may be due to reduction in iodized salt absorption and/or levothyroxin.
Sevelamer: SEVELAMER can reduce the absorption of levothyroxin. Therefore, it is recommended that patients monitor thyroid function when starting and ending combined treatment. If necessary, adjust the dose of levothyroxin.
Tyrosine Kinase inhibitors: Tyrosine Kinase inhibitors (such as imatinib, Sunitinib) can reduce the effect of levothyroxin. Therefore, it is recommended that patients monitor thyroid function when starting and ending combined treatment. If necessary, adjust the dose of levothyroxin.
propylthiouracil, glucocorticoid, sympathetic neurotransmitter, amiodarone and contrast containing iodine
These substances inhibit peripheral metabolism from T4 to T3.
Because of high iodine, Amiodaron may start hyperthyroidism as well as hypothyroidism. It should be noted especially in the case of thyroid thyroid but may not be identified as a self -control thyroid disease.
Sertraline, Chloroquin/Proguanil: These substances reduce the effectiveness of levothyroxin and increase serum levels.
Enzyme induction drugs: Enzyme -induced drugs such as barbiturat, carbamazepin may increase liver clearance of levothyroxin.
estrogen: Women who use birth control pills containing estrogen or menopausal women are treating hormones instead can increase the demand for levothyroxin.
Soy -containing substances: Soy -containing substances can reduce the absorption of levothyroxin in the intestine. Therefore, the Levothyrox dose may be needed, especially when starting or stopping using soy -containing supplements.
Storage
Leave a cool place, avoid light, temperature below 30⁰C.
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