Synthroid Levothyroxine Sodium: Side Effects, Uses, Dosage, Interactions, Warnings

Grapefruit juice may delay the absorption of levothyroxine and reduce its bioavailability. Patients The SYNTHROID dosage is based on the target level of TSH suppression for the stage and clinical status of thyroid cancer. Inquire whether patients are taking biotin or biotin-containing supplements. If so, advise them to stop biotin supplementation at least 2 days before assessing TSH and/or T4 levels see DOSAGE AND ADMINISTRATION synthroid pancreas and DRUG INTERACTIONS.

Drug-Food Interactions

• Pseudotumor cerebri and slipped capital femoral epiphysis have been reported in pediatric patients receiving levothyroxine therapy.
• Start at a lower starting dosage and increase the dosage every 4 to 6 weeks as needed based on clinical and laboratory response.
• Many drugs can inhibit Synthroid’s adsorption by the body; other medications may increase or decrease its effectiveness once it is adsorbed.
• Certain other medicines may also increase or decrease the effects of Synthroid.

34-week prescription audit of 441 pharmacies (average 41 prescriptions per state) totaling 1908 new and renewed SYNTHROID prescriptions between August 1, 2020 and March 23, 2021. In addition to testing TSH, sometimes it may be important to run other labs such as a free T4, in addition to the TSH, to ensure you have accurate dosing in the medication. Long-term carcinogenicity studies in animals to evaluate the carcinogenic potential of levothyroxine have not been performed.

The results were supplemented by a manual search of the bibliographies of the shortlisted review and original study articles. In addition, a number of field experts were approached in order to identify additional viable studies from the gray literature. Two independent investigators (YGP and OS) separately screened the titles and abstracts for eligible studies published up to September 1, 2019. Levothroid is used for hashimoto’s disease, hypothyroidism, after thyroid removal, myxedema coma … Eltroxin is used for hashimoto’s disease, hypothyroidism, after thyroid removal, myxedema coma … Unithroid is used for hashimoto’s disease, hypothyroidism, after thyroid removal, myxedema coma …

Absorption

And, as a practicing thyroid specialist, I have extensive clinical experience with using this medication. So, getting the patients on the right dose, but maintaining them on the right dose, is also very important. Primary hypothyroidism is basically diagnosed off of a screening TSH, or thyroid stimulating hormone. A portion of the conjugated hormone reaches the colon unchanged and is eliminated in the feces. SYNTHROID is contraindicated in patients with uncorrected adrenal insufficiency see WARNINGS AND PRECAUTIONS.

Add your drug list to My Med List to view medical information in a simple, easy-to-read, personalized format. Automatically receive FDA alerts, drug interaction warnings, plus data on food, allergy & condition interactions. DAW codes are codes a pharmacy uses when filling your patient’s prescription. DAW-1 indicates that substitution is not allowed, based on the prescriber’s preference, and ensures your patient will receive the treatment you prescribe.

• Do not administer in foods that decrease absorption of SYNTHROID, such as soybean-based infant formula see DRUG INTERACTIONS.
• The aim of this study was to assess the effect of concomitant use of levothyroxine (LT4) and proton pump inhibitors (PPIs) on thyroid-stimulating hormone (TSH) levels in patients with primary hypothyroidism.
• After joining, patients will receive exclusive benefits including savings, tips, and tools to help your patients make the most of their SYNTHROID treatment.

After joining, patients will receive exclusive benefits including savings, tips, and tools to help your patients make the most of their SYNTHROID treatment. The concomitant use of LT4 and PPI showed a significant increase in TSH concentration. However, given the small number of studies, further research is needed to clarify the interfering role of PPI on LT4 intestinal absorption. Levoxyl treats hypothyroidism (low thyroid hormone) and treats or prevents goiter. Do not store the crushed tablet/water mixture and do not administer it mixed with foods that decrease absorption of levothyroxine, such as soybean-based infant formula. Follow all directions on your prescription label and read all medication guides or instruction sheets.

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. For secondary or tertiary hypothyroidism, serum TSH is not a reliable measure of SYNTHROID dosage adequacy and should not be used to monitor therapy.

• 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.
• Biotin supplementation is known to interfere with thyroid hormone immunoassays that are based on a biotin and streptavidin interaction, which may result in erroneous thyroid hormone test results.
• Careful titration of medication and monitoring is required in that setting.
• So, as a reminder, SYNTHROID is indicated for the treatment of hypothyroidism.
• Overtreatment or undertreatment with levothyroxine may have negative effects on different systems throughout the human body.

Cardiac Adverse Reactions In The Elderly And In Patients With Underlying Cardiovascular Disease

The physiological actions of thyroid hormones are produced predominantly by T3, the majority of which (approximately 80%) is derived from T4 by deiodination in peripheral tissues. Serum TSH levels should be monitored and the SYNTHROID dosage adjusted during pregnancy. Since postpartum TSH levels are similar to preconception values, the SYNTHROID dosage should return to the pre-pregnancy dose immediately after delivery see DOSAGE AND ADMINISTRATION. The recommended daily dosage of SYNTHROID in pregnant patients is described in Table 3. Each of the included studies showed an increase in TSH levels following LT4 and PPI consumption and in the majority of these, the increase was statistically significant.

Important Administration Instructions

This effect could be much evident in subjects in whom LT4 absorption is already impaired for other reasons. However, this finding should be interpreted with caution due to the limited number of studies with relatively short follow-up period and lack of robust statistical evidence. Well-designed large studies are needed in order to further better clarify the interfering role of PPI on LT4 intestinal absorption. Regarding the quality assessment, six out of seven studies were considered at low risk of bias,25–28,31,38 while one37 was considered at moderate risk because of measurement of outcomes. A detailed assessment of the systematic error risk of all included studies is presented in Supplementary Tables S2 and S3, and Supplementary Figures S1 and S2.

Our Synthroid Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication. This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects. In the preliminary search, 5012 studies were identified through the literature search, and 2004 remained after the duplicates were removed. A title and abstract review was performed on the remaining 2004 studies, with 1983 excluded at this first stage for not meeting the PICOS criteria. A PRISMA flow diagram of the screening and selection process can be found in Figure 1.