Dosing & Administration

Consider changes in TBG concentration when interpreting T4 and T3 values. Measure and evaluate unbound (free) hormone and/or determine the free-T4 index (FT4I) in this circumstance. Pregnancy, infectious hepatitis, estrogens, estrogen-containing oral contraceptives, and acute intermittent porphyria increase TBG concentration. Nephrosis, severe hypoproteinemia, severe liver disease, acromegaly, androgens, and corticosteroids decrease TBG concentration. Familial hyper- or hypo-thyroxine binding globulinemias have been described, with the incidence of TBG deficiency approximating 1 in 9000.

Serious Risks Related To Overtreatment Or Undertreatment With SYNTHROID

Closely monitor infants during the first 2 weeks of SYNTHROID therapy for cardiac overload and arrhythmias. Biotin supplementation is known tointerfere with thyroid hormone immunoassays that are based on a biotin and streptavidin interaction, which may result in erroneous thyroid hormone test results. Stop biotin and biotin-containing supplements for at least 2 days prior to thyroid testing. Oral levothyroxine is taken by mouth and is available as tablets, capsules, and an oral solution.

The benefit of treating hypothyroidism may outweigh any risks to the baby. Levothyroxine should not be used to treat obesity or weight problems. Dangerous side effects or death can occur from the misuse of this medicine, especially if you are taking any other weight-loss medications or appetite suppressants. I go over with the patient there are treatment goals that are very important in the process. And the other is to improve the clinical symptoms that they’ve been experiencing.

• The signs and symptoms of overdosage are those of hyperthyroidism see WARNINGS AND PRECAUTIONS and Adverse Reactions.
• I also review the safety and risks of taking thyroid medication.
• In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively.
• Assess compliance, dose of medication administered, and method of administration prior to increasing the dose of SYNTHROID see Warnings and Precautions (5.1) and Use in Specific Populations (8.4).

Therapeutic Class

In pregnant patients with primary hypothyroidism, maintain serum TSH in the trimester-specific reference range. Sometimes it is not safe to use certain medicines at the same time. Some drugs can affect your thyroid hormone levels and also make levothyroxine less effective. Once the patient and I have decided that thyroid hormone replacement is necessary, we go over the specific reasons for choosing and writing Synthroid as that replacement therapy.

The “optimal dose” was determined for each patient as that dosage of thyroxine being taken when the thyrotropin-releasing hormone (TRH) response was normal (ie, an increase in TSH of between 4.7 and 25 mIU/L). Synthroid should not be used to treat obesity or weight problems. Dangerous side effects or death can occur from the misuse of levothyroxine, especially if you are taking any other weight-loss medications or appetite suppressants. Synthroid is a prescription medicine used to treat hypothyroidism (low thyroid hormone). Levothyroxine is given when your thyroid does not produce enough of this hormone on its own. Synthroid is a thyroid medicine that replaces a hormone normally produced by your thyroid gland to regulate the carafate synthroid body’s energy and metabolism.

• Seizures occurred in a 3-yearold child ingesting 3.6 mg of levothyroxine.
• Administer SYNTHROID at least 4 hours before or after drugs known to interfere with SYNTHROID absorption see DRUG INTERACTIONS.
• You may not be able to take Synthroid if you have certain medical conditions.
• Consumption of certain foods may affect SYNTHROID absorption thereby necessitating adjustments in dosing see Dosage and Administration (2.1).
• Therefore, initiate SYNTHROID therapy immediately upon diagnosis.
• Check with your physician for additional information about side effects.

Concurrent use of ketamine and SYNTHROID may produce marked hypertension and tachycardia. Closely monitor blood pressure and heart rate in these patients. Seizures have been reported rarely with the institution of levothyroxine therapy.

Drugs That May Alter T4 and Triiodothyronine (T Serum Transport

Your child’s dose needs may change if the child gains or loses weight. You may not be able to take Synthroid if you have certain medical conditions. Tell your doctor if you have an untreated or uncontrolled adrenal gland disorder, a thyroid disorder called thyrotoxicosis, or if you have any recent or current symptoms of a heart attack. You are encouraged to report negative side effects of prescription drugs to the FDA.

The recommended daily dosage of SYNTHROID in pregnant patients is described in Table 3. This list is not complete and many other drugs may interact with levothyroxine. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor if you are pregnant or plan to become pregnant. Having hypothyroidism during pregnancy may increase the risk of premature birth or other complications.

levothyroxine sodium (L-thyroxine, T Nursing Considerations & Management

Foods containing soy and cottonseed meal can make Synthroid less effective. Walnuts, grapefruit juice, and dietary fiber can also make Synthroid less effective. If you eat any of these on a regular basis, check with your doctor. This website is intended solely for educational purposes, such as to assist nursing students in developing care plans. The content provided here should not be considered medical advice. We do not diagnose, treat, or prescribe for any medical conditions.

Rapid restoration of normal serum T4 concentrations is essential for preventing the adverse effects of congenital hypothyroidism on cognitive development as well as on overall physical growth and maturation. Therefore, initiate SYNTHROID therapy immediately upon diagnosis. Levothyroxine is generally continued for life in these patients see Warnings and Precautions (5.1). Addition of levothyroxine therapy in patients with diabetes mellitus may worsen glycemic control and result in increased antidiabetic agent or insulin requirements.