Levothyrox 50µg Merck treatment of goiter, hypothyroidism, cancer (3 blisters x 10 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications Levothyroxine

Ingredient

Composition information	Content
Levothyroxine	50mcg

Uses

Indications

Levothyrox 50µg pills are indicated in the following cases:

Treatment of benign goiter.

Pharmacokology

Levothyroxin synthetic in levothyrox has the same effect as natural hormones, 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.

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 can be 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 the average levothyroxin 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 1.21 plasma/day.

Before taking Levothyrox 50µg Merck treatment of goiter, hypothyroidism, cancer (3 blisters x 10 tablets)

How to use

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 period is not enough, it is advisable to consider surgery or iodine radiation.

Dosage

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 average concentration of serum thyroid hormones is more reliable for the treatment process.

thyroid hormone treatment should start with low doses and gradually increase for every 2 to 4 weeks until a full replacement dose.

For babies and young children with congenital hypothyroidism: When fast replacement therapy is important, the recommended starting dose is 10 to 15mcg/kg body weight per day for the first 3 months. After that, the dose should be adjusted for each individual based on clinical signs and thyroid hormones 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 low doses, then increase the dose slowly and the distance is long and regularly monitor thyroid hormones.

lower dose than the optimal dose needed for complete replacement treatment, will lead to non -complete TSH adjustment, so it is necessary to consider.

Experience shows that lower dose is enough for mild weight patients and large goiter patients.

indicated

Daily recommendations

(mcg sodium levothyroxin/day)

75 - 200

Maintenance dose

100 - 200

Maintenance dose

100 - 150 mcg/m2 of body surface

150 - 300

50 - 100

Used in diagnosis for thyroid inhibition tests

week 2 and 1 before testing

200

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.

What to do when overdose? After overdose, symptoms of metabolic increase significantly appear (see the unwanted effect).

Depending on the level of overdose, recommendations to stop treatment and conduct tests.

Symptoms include increased effects like sympathetic beta such as fast heartbeat, anxiety, anxiety and increased movement and these symptoms can be reduced by beta blockers. Treatment with plasma refined can be effective in case of overdose very high. In some patients at risk, there are some cases of epilepsy reported when using an individual's tolerance limit.

Overdose of levothyroxin can lead to hyperthyroidism and can lead to acute mental disorders, especially in patients at risk of mental disorders. Many cases of sudden death are reported in patients with abuse of levothyroxin for many years.

In an emergency, call the 115 emergency center immediately or go to the nearest local health station.

What to do when forgetting a dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double dose to compensate for missed dose.

Side Effects

When using levothyrox 50µg , you may experience unwanted effects (ADR).

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 -mindedness), tachycardia, chest pain, chest pain, headache, muscle weakness and rats, fake, nervousness, tremor, tremor, tremor, tremor, restraint, tremor, restraint, nervousness 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.

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

Levothyrox 50µg drug is contraindicated in the following cases:

Hypersensitivity to the active ingredient or any excipients of the drug. levothyroxin and anti -thyroid agent for hyperthyroidism during pregnancy (see the part of pregnant and nursing women).

Caution when using

Before starting treatment with thyroid hormone or before conducting thyroid inhibiting tests, excluding or treating diseases & the following condition: coronary failure, angina, arteriosclerosis, high blood pressure, saddle gland, adrenal insufficiency. 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 levothyroxin and increase the dose from the beginning of treatment. Recommendations 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 suitable for weight loss. Physiological dose does not cause weight loss in patients with armor. The dose on the physiological level can cause serious undesirable reactions or life -threatening (see overdose).

Once treatment with levothyroxin, recommends adjusting the dose according to the patient's clinical response and test results, in case of wanting to change to other drug labels.

Hypothyroidism and/or reduced control of hypothyroidism may occur when combining orlistat and levothyroxin (see interactive section). Patients who use levothyroxin should consult a doctor before starting treatment with orlistat by Orlistat and levothyroxin may need to be used at different times and the dose of levothyroxin 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.

The ability to drive and operate machinery

No test on the ability to drive and operate 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.

Pregnancy and lactation

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 inhibition during pregnancy, because the use of radioactive iodine in pregnant women is contraindicated.

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.

Medicinal interaction

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 salts/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 you need to adjust the dose 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 you need to adjust the dose levothyroxin.

propylthiouracil, glucocorticoid, sympathetic neurological inhibitors, 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 -induced drugs: enzyme -induced drugs such as barbiturat, carbamazepine may increase liver clearance of levothyroxin.

estrogen: Women using 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, it may be necessary to adjust the dose of Levothyrox, especially when starting or stopping using supplements containing soybeans.

Storage

Leave a cool place, avoid light, temperature below 30⁰C.

To be out of reach of children.

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