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The recommended starting daily dosage of SYNTHROID in pediatric patients with primary, secondary, or tertiary hypothyroidism is based on body weight and changes with age as described in Table 2. Titrate the dosage (every 2 weeks) as needed based on serum TSH or free- T4 until the patient is euthyroid see Important Considerations For Dosing. 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. For patients at risk of atrial fibrillation or patients with underlying cardiac disease, start with a lower dosage and titrate the dosage more slowly to avoid exacerbation of cardiac symptoms. Dosage titration is based on serum TSH or free-T4 see Important Considerations For Dosing.

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Check with your physician for additional information about side effects. When prescribing SYNTHROID, protecting your script can ensure your patients receive SYNTHROID every time they refill allegra synthroid their prescription. SYNTHROID is not indicated for treatment of hypothyroidism during the recovery phase of subacute thyroiditis. They can have changes in the female hormone status, either going on or off a birth control pill, going through menopause.

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Speak to your doctor about how drug interactions should be managed. Patients need to feel comfortable to alert me of any changes in their status in terms of their symptoms. But also specific medical changes that may indicate there may be a need for a dose change or something that could have affected their thyroid hormone levels. The major pathway of thyroid hormone metabolism is through sequential deiodination. Approximately 80% of circulating T3 is derived from peripheral T4 by monodeiodination.

SYNTHROID is contraindicated in patients with uncorrected adrenal insufficiency see WARNINGS AND PRECAUTIONS. If cardiac symptoms develop or worsen, reduce the SYNTHROID dose or withhold for one week and restart at a lower dose. Seizures have been reported rarely with the institution of levothyroxine therapy. The peak therapeutic effect of a given dose of SYNTHROID may not be attained for 4 to 6 weeks.

What Drugs, Substances, or Supplements Interact with Synthroid?

The majority of the SYNTHROID dose is absorbed from the jejunum and upper ileum. The relative bioavailability of SYNTHROID tablets, compared to an equal nominal dose of oral levothyroxine sodium solution, is approximately 93%. T4 absorption is increased by fasting, and decreased in malabsorption syndromes and by certain foods such as soybeans. In addition, many drugs and foods affect T4 absorption see DRUG INTERACTIONS. In adult patients with primary hypothyroidism, monitor serum TSH levels after an interval of 6 to 8 weeks after any change in dosage. 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 manifestations of toxicity, particularly when given in association with sympathomimetic amines such as those used for their anorectic effects.

SPECIAL CONSIDERATIONS FOR HYPOTHYROID MEDICATIONS

The general aim of therapy is to normalize the serum TSH level. TSH may not normalize in some patients due to in utero hypothyroidism causing a resetting of pituitary-thyroid feedback. Assess compliance, dose of medication administered, and method of administration prior to increasing the dose of SYNTHROID see WARNINGS AND PRECAUTIONS and Use In Specific Populations. For secondary or tertiary hypothyroidism, serum TSH is not a reliable measure of SYNTHROID dosage adequacy and should not be used to monitor therapy. 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 see Recommended Dosage And Titration. So, as a reminder, SYNTHROID is indicated for the treatment of hypothyroidism.

Having low thyroid hormone levels during pregnancy could harm both mother and baby. Since thyroid hormone occurs naturally in the body, almost anyone can take levothyroxine. However, you may not be able to take this medicine if you have certain medical conditions. SYNTHROID may reduce the therapeutic effects of digitalis glycosides.

• Use of oral thyroid hormone drug products is not recommended to treat myxedema coma.
• The general aim of therapy is to normalize the serum TSH level.
• Do not administer in foods that decrease absorption of SYNTHROID, such as soybean-based infant formula see DRUG INTERACTIONS.
• Thyroid hormone increases metabolic clearance of glucocorticoids.
• A link to other websites does not constitute an endorsement of AbbVie or the linked site, its products, or services.
• Pseudotumor cerebri and slipped capital femoral epiphysis have been reported in pediatric patients receiving levothyroxine therapy.

Administer SYNTHROID at least 4 hours before or after drugs known to interfere with SYNTHROID absorption see DRUG INTERACTIONS. Our Synthroid Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication. 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.

Decreased Bone Mineral Density Associated With Thyroid Hormone Over-Replacement

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 and Use In Specific Populations. Toxic effects may include increased risk of cardiac arrhythmias and central nervous system stimulation. Administration of sertraline in patients stabilized on SYNTHROID may result in increased SYNTHROID requirements.