L-Thyroxin (Levothyroxine), a thyroid hormone, is used to treat hypothyroidism, a condition where the thyroid gland does not produce enough thyroid hormone.
50 tablets 100 mkg
Mode of action:
Levothyroxine, a part of the preparation, by the action of endogenous thyroid hormone similar to humans. In the body metabolizes to levothyroxine liothyronine that getting into the cells and tissues, is able to regulate the development and growth of cells, influence the metabolism. In particular, the drug can affect the oxidative metabolism in mitochondria and selectively regulate the flow of cations within and outside the cell. Furthermore, the action depends on the levothyroxine dosage so in small doses, it can exert an anabolic effect in the medium influences mainly on cells and tissues. The preparation increases the need for oxygen in tissues, stimulates the oxidation reaction and accelerates the breakdown of metabolism of proteins, fats and carbohydrates, activates the function of the cardiovascular system, has a stimulating effect on the central nervous system.
In large doses, the drug inhibits the production of hypothalamic thyrotropin - releasing hormone, thereby reducing the production of thyroid hormone by the pituitary gland.
The clinical manifestation of the drug in hypothyroidism has been observed for 3-5 days after initiation of therapy. For 3-6 months, subject to continuous therapy with levothyroxine is reduced or disappears completely diffuse goiter.
Following oral administration of adsorption from the gastrointestinal tract of up to 80%, the maximum plasma concentration is reached within 6 hours. The half-life depends on the amount of levothyroxine thyroid hormones in blood, when hypothyroid states half-life is 10 days. When euthyroid states 6-7 days, and when hyperthyroid states to 4 days. Upon receiving the active levothyroxine to liothyronine metabolized in the liver and kidneys. Levothyroxine is displayed in the bile.
Indications for use:
The drug is used for replacement therapy in hypothyroidism of various etiologies, including primary and secondary hypothyroidism after surgery of the thyroid gland, and after a course of treatment with radioactive iodine.
As replacement therapy in congenital and acquired hypothyroidism. With myxedema, cretinism, obesity manifestations of hypothyroidism. When cerebrohypophyseal diseases.
For prevention in patients with recurrent nodular goiter after resections in an undisturbed functioning of the thyroid gland.
In monotherapy diffuse euthyroid goiter. When euthyroid hyperplasia of the thyroid gland. In the combined treatment of diffuse toxic goiter after payments thyrotoxicosis thyreostatics.
In the complex treatment of Graves' disease and Hashimoto's autoimmune thyroiditis.
For the treatment of hormone-dependent highly differentiated thyroid tumors, including follicular and papillary carcinomas.
The drug is also used for substitution and suppressive therapy of malignant tumors of the thyroid gland, including after surgery for cancer of the thyroid gland.
As a diagnostic tool to test thyroid suppression.
How to use:
Take the entire dose at a time, preferably in the morning on an empty stomach 30 minutes before eating, drinking plenty of water. Babies tablet crushed and dissolved in a small amount of water, the resulting slurry was given 30 minutes before the first morning feeding, prepare a suspension is necessary immediately before administration.
Dose selected individually, taking into account weight, age, severity and nature of the disease, laboratory indicators of the functional state of the thyroid gland.
Typically, the initial dose for adults with euthyroid goitre and hypothyroidism 25 - 100mcg a day, then gradually increase the dose every 2-3 weeks for a 25- 50mkg until a maintenance dose. For children, the initial dose of 12.5 50mkg night, reaching a maintenance dose in the same way as for adults.
In severe hypothyroidism, or in the case of hypothyroidism, which has long existed, the initial dose is reduced and the dose increase is slow.
In malignant tumors of the thyroid gland after surgery appoint 300mcgs 150 per day.
In hypothyroidism, caused by the removal of part or all of the thyroid gland, taking levothyroxine for life.
For diagnostic method supressionnoy scintigram prescribe a dose of levothyroxine 200mkg a day for 14 days, or 3 mg for 1 day a week before re- test.
Under recommended dosage drug side effects are very rare, but possible their manifestations such as weight gain due to increased appetite by the action of the drug, it is furthermore possible hair loss, impaired kidney function. In children with epilepsy or are prone to seizures, there may be a worsening of these diseases.
When you receive excessive doses or too rapid increase in the dose of therapy possible manifestations of hyperthyroidism. In particular may develop tachycardia, arrhythmias, disturbances of sleep and wakefulness, tremor of limbs, the emergence of causeless anxiety and feelings of anxiety. In addition, the possible attacks of angina pectoris, rash, diarrhea, vomiting, weight loss.
Very rarely may develop an allergic dermatitis.
In case of adverse effects it is necessary to reduce the therapeutic dose or stop taking the drug before their disappearance, and resume treatment with a single dose of a lesser drug.
Individual hypersensitivity to the drug.
Thyrotoxicosis of various etiologies, which has not been cured.
Coronary heart disease, angina, coronary insufficiency of blood circulation, atherosclerosis, acute myocardial infarction.
Organic heart disease, including myocarditis, pericarditis.
Severe forms of hypertension and heart failure.
Adrenal insufficiency, Addison's disease.
Age older than 65 years.
These applications relate to preparation contraindications for suppressive mono- and combination therapy of diseases and do not relate to replacement therapy.
For replacement therapy is a contraindication to the use of only the individual sensitivity, in other cases, after consultation with the doctor drug can be used.
The preparation is lactose, which should be considered in the appointment of L- thyroxine in patients with lactase deficiency.
The drug has no embryotoxic, teratogenic and mutagenic action. Poor crosses the placental barrier. In small doses into breast milk even during therapy with high doses. In the second and third trimester of pregnancy, the need for thyroid hormones increases, so should be reported to your doctor about the pregnancy for a possible correction doses.
Use of the drug in combination with tireostaticheskimi agents during pregnancy and lactation is not recommended, as a consequence, a child may develop hypothyroidism with levothyroxine monotherapy is indicated only.
Interactions with other drugs:
Drug reduces the effect of insulin and oral antidiabetics, when assigning levothyroxine patients with diabetes need to control blood sugar levels and, if necessary to adjust the dose of insulin or oral antidiabetic agents.
At the same time taking the drug reduces the effect of cardiac glycosides.
The drug increases the pharmacological effect of antidepressants.
Levothyroxine can increase the prothrombin time when co-administered with anticoagulants, particularly strongly expressed in these interactions with coumarin derivatives.
Estrogens reduce the effectiveness of levothyroxine.
Enveloping means, in particular aluminum hydroxide and magnesium hydroxide, and calcium carbonate, colestipol, cholestyramine, sucralfate and reduce absorption of levothyroxine from the gastrointestinal tract, so while appointing levothyroxine these tools need to make the interval between doses of 4-5 hours.
Clofibrate, dicumarol, salicylic acid derivatives, higher doses increase the content of levothyroxine of furosemide in the blood increases the risk of arrhythmia.
Anabolic hormones can alter the degree of binding to plasma proteins levothyroxine. The same effect has the simultaneous use of asparaginase and tamoxifen with levothyroxine.
Chloroquine increases the rate of transformation of levothyroxine in the liver.
L-dopa, dopamine, diazepam, carbamazepine, aminosalicylic acid, amiodarone, aminoglutethimide, metoclopramide, somatostatin, lovastatin and antithyroid drugs alter the level of thyroid hormones in the body, their influence extends to the endogenous hormones and hormone entered the body in the form of preparations.
Sertraline reduces efficiency levothyroxine patients with hypothyroidism.
When receiving ritonavir increases the body's need levothyroxine.
The manifestations of overdose may appear immediately or after taking a few days later. If overdose, symptoms of hyperthyroidism, in severe cases up to thyrotoxic crisis. Characterized by a sense of palpitations, diarrhea, epigastric pain, palpitations, chest pain. Also characteristic manifestations of heart failure, tremors, disturbances of sleep and wakefulness, fever, heat intolerance, sweating, irritability. Increased laboratory values of free thyroxin index, and serum T3 and T4. May be a reduction in body weight.
The treatment is to remove the drug. In acute overdose shown intramuscular corticosteroids (prednisone, hydrocortisone, dexamethasone) or the appointment of B- blockers. In extreme cases, the poisoning of levothyroxine shown plasmapheresis.
Tablets 100mcg 50 tablets in a blister in a carton.
The drug should be stored in a cool dry place at a temperature of 15-25 degrees Celsius.
Shelf life - 3 years.
Levothyroxine sodium Eutiroks, Eferoks, Bagotiroks.
1 tablet contains :
Levothyroxine sodium - 25, 50 or 100mcg ;
Excipients including lactose.