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Levothyroxine Sodium BP
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Thyrotab (Levothyroxine) is a synthetic form of thyroxin (thyroid hormone) which can replace natural Levothyroxine which is the principal hormone in thyroglobulin (Tg) produced by the normal thyroid gland. Thyrotab used as a hormone replacement for patients with thyroid problems.
Thyrotab: Each tablet contains 50 mcg Levothyroxine sodium BP.
Indications And Uses
Levothyroxine is indicated for the management of demonstrated thyroid hormone deficiency. Levothyroxine may be used to suppress Thyrotropin (Thyroid stimulating hormone, TSH). For the management of TSH responsive tumors of the thyroid. Levothyroxine may be used in the management of thyroiditis such as Hasimoto's disease.
Dosage And Administration
Initiation of therapy: Thyrotab (Levothyroxine) therapy should be initiated at low dosage (e.g. 25 or 50 mcg/day) and increased at intervals of not less than two weeks, by not more than 50 micrograms increments. Maintenance therapy Adults: 100-150 micrograms/day. Children: Congenital and acquired hypothyroidism. Note: The lowest dose compatible with clinical euthyroidism and satisfactory laboratory values should be used. Age Thyroxine dosage micrograms/kg/day 0-6 months Approximately 8 6-12 months Approximately 6 1-5 years Approximately 5 6-12 years Approximately 4 12 years and over Approximately 2 The elderly 75-125 micrograms/day
Pseudomotor ceribri and premature craniosynostosis have been referred as a possible complication of treatment of children. In both instances reduction of dosage and reappraisal of the maintenance needs are indicated.
Initiation of therapy: In all cases, Levothyroxine should be initiated at not more than 50 micorgrams/day and gradually increased as described under dosage and administration.
Use In Pregnancy Lactation
There is no evidence that change of dosage is required during pregnancy provided adequate replacement was established before conception. Monitoring of TSH concentrations can give guidance. Thyroxine binding globulin (TBG) increases during pregnancy and therefore total T4 and T3 may appear to be elevated. Measurement of free T4 and T3 may be more appropriate. There is contradictory evidence concerning the passage of T4 and T3 across the placenta but it is unlikely that the fetus is at risk. There is contradictory evidence concerning the secretion of T4 and T3 in human breast milk. However, T4 and T3 have been demonstrated in one case. The neonate should be carefully observed for evidence of altered thyroid function.
Levothyroxine can enhance the clinical effect of the following drugs, thus adjustment of dosage may be necessary:- coumarine anticoagulants, meperidine (petidine), phenobarbitone, methadone, morphine, catecholamines, insulin, tricyclic antidepressants and dihydrotachysterol. Levothyroxine can reduce the clinical effect of corticosteroids and degoxin, therefore adjustment of dosage may be necessary. The clinical effect of Levothyroxine can be enhanced by ketamine. The clinical effect of Levothyroxine can be reduced by cholestyramine, colesterol and soya flour, all of which interfere with its absorption from the gastrointestinal tract and by propanolol and dexamenthasone. Thyroid function tests can be modified by barbiturates and phenytoin. There are contradictory reports as to whether the clinical effect of thyroxine is reduced. Thyroid function tests can be modified, without changes in clinical effect of thyroxine, by rifampicin, salicylates, diazepam, heparin, fenclofenac, fenoprofen and flubiprofen.
Symptoms: Within 3-6 days after ingestion, any or all of the symptoms and signs may become evident. They may progress to "thyroid storm" with hyperpyrexia, coma and subsequent death.
Store below 30°C. Keep in dry place protected from light.
Known hypersensitivity to Levothyroxine, which has been described rarely, is a contraindication to the use of Levothyroxine.
Thyrotab: Each box contains 10x10's tablets in blister strip.