Levothyrox 75µg Merck pengobatan gondok piyambak (2 blister x 15 tablet)

Bentuk sediaan Kothak 2 blister x 15 tablet
Spesifikasi Natrium Levothyroxine

Komposisi

Informasi komposisi	Isi
Natrium Levothyroxine	75mcg

Migunakake

indikasi

obat levothyrox 75µg dituduhake ing kasus ing ngisor iki:

Pengobatan gondok jinak. Sinau

klompok farmakologis: hormon tiroid.

Kode ATC: H03A A01.

Levothyroxin sintetik ing levothyrox nduweni efek sing padha karo hormon alami sing utamane diekskresikan dening tiroid. Iki diowahi dadi T3 ing agensi periferal lan minangka hormon, ningkatake efek spesifik ing reseptor T3. Awak ora bisa mbedakake levothyroxin eksternal lan endogen.

Farmakokinetik dinamis

Digunakake kanthi lisan, levothyroxin diserap meh kabeh ing bagean ndhuwur usus cilik. Gumantung ing rumus jumlah panyerepan, nganti 80%. Tmax udakara 5 nganti 6 jam.

Sawise nggunakake lisan, efek wiwitan katon sawise 3-5 dina. Levothyroxin nuduhake tingkat kohesi sing dhuwur banget karo protein pengiriman khusus babagan 99,97%. Koneksi hormon protein iki ora homoseksual saengga hormon kasebut disambungake ing plasma kanthi cepet lan terus-terusan tukar karo hormon bebas.

Amarga kohesi protein sing dhuwur, levothyroxin ora kena pengaruh hemolisis utawa dialisis.

Umur setengah IEVothyroxin yaiku 7 dina. Ing hipertiroidisme, wektu iki luwih cendhek (3-4 dina) lan luwih suwe ing hipotiroidisme (kira-kira 9-10 dina). Volume distribusi kira-kira 10 - 12L. Ati ngandhut 1/3 saka total levothyroxin ing njaba kelenjar toroida sing cepet ngomong karo levothyroxin ing serum. Hormon tiroid dimetabolisme utamane ing ati, ginjel, otak lan otot. Metabolit dibuwang liwat urin lan feces. Reresik metabolik umum levothyroxin yaiku 1.2L plasma / dina.

Sadurunge njupuk Levothyrox 75µg Merck pengobatan gondok piyambak (2 blister x 15 tablet)

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. Dosage Sodium 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. Indications Daily dose recommended (McG levothyroxin sodium/day) Treatment of benign goiter 75 - 200 Renable recurrence after a simple goiter surgery Starting dose: Maintenance dose: 25 - 50 100 - 200 Starting dose: Maintenance dose: 12.5 - 50 100 - 150 mcg/m2 body surface 300 in collaboration with anti -thyroid drugs in the treatment of hyperthyroidism 150 - 300 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 do do when overdose? After overdose, symptoms of metabolic increase significantly appear. Depending on the level of overdose, the recommendation to stop treatment and conduct tests. Symptoms include increased effects similar to sympathetic beta such as fast heartbeat, anxiety, anxiety and increased exercise and these symptoms can be reduced by beta blockers. Treatment with plasma purification may have a very high overdose. In some patients at risk, there are several cases of epilepsy reported when using an individual's tolerance limit. Levothyroxin overdose can lead to hyperthyroidism and can lead to symptoms of 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 you forget 1 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.

Efek sisih

Nalika ngluwihi wates toleransi pribadi kanggo sodium levothyroxin utawa overdosis, gejala klinis khas hipertiroidisme bisa kedadeyan, utamane ing kasus nambah dosis kanthi cepet banget nalika miwiti perawatan kayata aritmia (kayata fibrilasi atrium lan jantung ekstra), tachycardia, nyeri dada, nyeri dada, kelemahan otot, abang, iritasi, gemeter, tremor, kringet.

Ing kasus iki, dosis saben dina kudu dikurangi utawa mandheg nggunakake obat nganti pirang-pirang dina. Bisa miwiti perawatan nalika reaksi salabetipun ilang.

Yen sensitivitas kanggo komponen apa wae saka Levothyrox, reaksi alergi bisa kedadeyan ing kulit lan saluran pernapasan. Ana laporan babagan sawetara kasus sirkuit.

Pènget

Sadurunge nggunakake obat kasebut, sampeyan kudu maca instruksi kasebut kanthi teliti lan deleng informasi ing ngisor iki.

Kontraindikasi

Obat Levothyrox 75µg kontraindikasi ing kasus ing ngisor iki:

Hipersensitivitas kanggo bahan aktif utawa bahan bantu obat kasebut. levothyroxin lan agen tahan tiroid kanggo hipertiroidisme nalika meteng.

Ati-ati nalika digunakake

Sadurunge miwiti perawatan hormon tiroid utawa sadurunge nganakake tes nyegah tiroid, ngilangi utawa nambani penyakit lan kondisi ing ngisor iki: insension koroner, angina, arteriosclerosis, tekanan darah tinggi, kelenjar pelana, gangguan adrenal. Penyakit tiroid otonom uga kudu diilangi utawa diobati sadurunge miwiti perawatan karo hormon tiroid.

Nalika miwiti ngobati levothyroxin ing pasien kanthi risiko gangguan mental, dianjurake kanggo miwiti kanthi dosis IEVothyroxin sing kurang lan nambah dosis saka wiwitan perawatan. Perlu ngawasi pasien. Yen ana pratandha saka kelainan mental, pangaturan levothyroxin kudu dianggep.

Hipertus amarga obat sing entheng uga kudu dihindari ing pasien kanthi gagal jantung koroner, gagal jantung, tachycardia. Mula, perlu rutin mriksa indikator hormon tiroid ing kasus kasebut.

Ing kasus hipotiroidisme sekunder, perlu kanggo nemtokake sababe sadurunge perawatan panggantos lan yen perlu kanggo miwiti panggantos gagal ginjal adrenal.

Yen dicurigai duwe penyakit tiroid otonom, disaranake kanggo nganakake tes utawa kedhip saka inhibitor sadurunge perawatan.

Ngindhari serum levothyroxin ing kasus tingkat fisiologis ing kasus hipotiroidisme ing wanita menopause lan nambah risiko osteoporosis, lan kanthi mangkono, priksa fungsi tiroid sing ketat.

Aja nggunakake levothyroxin ing hipertiroidisme, kajaba digunakake karo obat anti-tiroid nalika ngobati hipertiroidisme.

hormon tiroid ora digunakake kanggo ngilangi bobot. Ing pasien sing nganggo armor, perawatan karo levothyroxin ora nyebabake bobot awak. Dosis dhuwur bisa nyebabake reaksi serius utawa malah ngancam nyawa. Aja koordinasi dosis dhuwur saka levothyrox karo sawetara obat kanggo mundhut bobot, kayata obat simpatik.

Sawise diobati karo levothyroxin, yen ana rekomendasi kanggo nyetel dosis miturut respon klinis pasien lan asil tes, yen pengin ngganti label obat liyane.

Hypothyroidism lan/utawa nyuda kontrol hipotiroidisme bisa kedadeyan nalika nggabungake orlistat lan levothyroxin (deleng item interaksi lan bentuk interaksi liyane). Pasien sing nggunakake IEVothyroxin kudu takon dhokter sadurunge miwiti perawatan karo orlistate dening Orlistat lan Levothyroxin bisa uga kudu digunakake ing wektu sing beda lan dosis levothyroxin bisa uga kudu diatur. Kajaba iku, dianjurake kanggo ngawasi pasien kanthi mriksa hormon serum.

Obat iki ngandhut laktosa, mula pasien ora ngidinke Galaktosa amarga genetik, kekurangan Lapp Lactase utawa Glukosa - Galaktosa ora kudu nggunakake obat iki.

Kanggo pasien diabetes lan pasien sing lagi diobati kanthi koagulasi, deleng interaksi obat lan bentuk interaksi liyane.

Efek obat kanggo nyopir lan ngoperasikake mesin

Ora ana tes kanggo nyopir lan mesin sing digunakake. Nanging, amarga levothyroxin kaya hormon tiroid alami, ora nganggep yen Levothyrox duweni pengaruh marang kemampuan nyopir lan ngoperasikake mesin.

Gunakake obat kanggo wanita nalika ngandhut lan laktasi

meteng:

Perawatan karo levothyroxin kudu dijamin nalika meteng lan lactation. Dosis kudu ditambah nalika meteng.

Pengalaman nuduhake yen ora ana bukti kemungkinan teratogenik utawa keracunan obat amarga obat ing manungsa kanthi dosis sing disaranake. Dosis levothyroxin sing dhuwur banget nalika meteng bisa nyebabake efek sing ora becik kanggo perkembangan janin lan postpartum.

Aja nemtokake perawatan hipertiroidisme kanthi kombinasi karo levothyroxin lan obat anti-tiroid nalika meteng. Kombinasi iki mbutuhake obat anti-tiroid dosis dhuwur sing bisa ngliwati plasenta lan nyebabake hipotiroidisme ing bayi.

Aja nindakake diagnosis inhibitor tiroid nalika meteng, amarga panggunaan yodium radioaktif ing wanita ngandhut wis kontraindikasi.

wektu nyusoni:

levothyroxin diekskripsikake ing susu nalika nyusoni, nanging kanthi dosis perawatan sing disaranake, konsentrasi kasebut ora cukup kanggo nyebabake hipertiroidisme utawa inhibisi sekresi TSH ing bayi anyar.

Obat interaktif

diabetes: levothyroxin bisa nyuda efek diabetes. Mula, luwih becik mriksa gula getih kanthi rutin ing wiwitan perawatan hormon tiroid lan kudu nyetel dosis diabetes yen perlu.

Turunan kumarin: Efek obat antikoagulan bisa saya tambah amarga levothyroxin ngeculake obat antikoagulan saka protein plasma, saéngga nambah risiko pendarahan, kayata pendarahan gastrointestinal utawa sistem saraf pusat, utamane pasien tuwa. Mulane, perlu mriksa indeks koagulasi kanthi rutin ing wiwitan lan sajrone proses perawatan. Yen perlu, dosis antikoagulan kudu diatur.

Inhibitor protease: Inhibitor protease (kayata Ritonavir, Indinavir, Lopinavir) bisa mengaruhi efek levothyroxin. Dianjurake kanggo ngawasi kanthi teliti indeks hormon tiroid. Yen perlu, atur dosis levothyroxin.

Phenytoin: Phenytoin bisa mengaruhi efek levothyroxin kanthi ngeculake levothyroxin saka protein serum, nambah rasio FT4 lan FT3. Ing sisih liya, phenytoin nambah metabolisme levothyroxin ing ati. Rekomendasi kudu ngawasi kanthi teliti hormon tiroid.

Cholestyramine, Colestipol: Nggunakake resin penukar ion kaya cholestyramine lan colestipol nyegah panyerepan sodium levothyroxin. Dadi ngombe sodium levothyroxin 4-5 jam sadurunge nggunakake zat kasebut.

Pil sing ngemot aluminium, wesi, kalsium karbonat: Obat-obatan sing ngemot aluminium (antasida, sucralfate) dilaporake ing literatur bisa nyuda efek levothyroxin. Mula, levothyroxin kudu digunakake sajrone 2 jam sadurunge nggunakake aluminium.

Semono uga kanggo obat wesi lan kalsium karbonat.

salisilat, dicumarol, Furosemid, Clofibrate: salisilat, dicumarol, Furosemid dosis dhuwur (250mg), clofibone lan zat liyane bisa ngeculake sodium levothyroxin saka protein plasma, nambah rasio FT4.

Orlistate: Hipertmania lan/utawa nyuda kontrol hipotiroidisme bisa kedadeyan nalika orlistat lan levothyroxin digunakake bebarengan. Iki bisa uga amarga nyuda penyerapan uyah yodium lan/utawa levothyroxin.

Sevelamer: SEVELAMER bisa nyuda penyerapan levothyroxin. Mulane, dianjurake supaya pasien ngawasi fungsi tiroid nalika miwiti lan mungkasi perawatan gabungan. Yen perlu, atur dosis levothyroxin.

Inhibitor tirosin kinase: Inhibitor tirosin kinase (kayata imatinib, Sunitinib) bisa nyuda efek levothyroxin. Mulane, dianjurake supaya pasien ngawasi fungsi tiroid nalika miwiti lan mungkasi perawatan gabungan. Yen perlu, atur dosis levothyroxin.

propylthiouracil, glukokortikoid, neurotransmiter simpatik, amiodaron lan kontras sing ngandhut yodium

Zat iki nyegah metabolisme perifer saka T4 dadi T3.

Amarga jumlah yodium sing dhuwur, Amiodaron bisa miwiti hipertiroidisme uga hipotiroidisme. Iki kudu dicathet utamane ing kasus tiroid tiroid nanging ora bisa diidentifikasi minangka penyakit tiroid sing bisa ngontrol diri.

Sertraline, Chloroquin/Proguanil: Zat-zat iki nyuda efektifitas levothyroxin lan nambah tingkat serum.

Obat-obatan induksi enzim: Obat-obatan sing diinduksi enzim kayata barbiturat, carbamazepin bisa nambah reresik ati saka levothyroxin.

estrogen: Wanita sing nggunakake pil KB sing ngandhut estrogen utawa wanita menopause sing nambani hormon malah bisa nambah panjaluk levothyroxin.

Zat sing ngandhut kedhele: Zat sing ngandhut kedhele bisa nyuda penyerapan levothyroxin ing usus. Mula, dosis Levothyrox bisa uga dibutuhake, utamane nalika miwiti utawa mandheg nggunakake suplemen sing ngemot soya.

Panyimpenan

Ninggalake papan sing adhem, aja nganti cahya, suhu ngisor 30⁰C.

Obat liyane

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