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Synthroid (Generic)

Synthroid (levothyroxine), a synthetic thyroid hormone may be given in any of the following cases:
If your own thyroid gland is not making enough hormone;
If you have an enlarged thyroid (a goiter) or are at risk for developing a goiter;
If you have certain cancers of the thyroid;
If your thyroid production is low due to surgery, radiation, certain drugs, or disease of the pituitary gland or hypothalamus in the brain.


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Uses

Levothyroxine is approved to treat hypothyroidism and to suppress thyroid hormone release in the management of cancerous thyroid nodules and growth of goiters. In addition, levothyroxine, Levoxyl and Levothroid also are prescribed with anti-thyroid drugs, for example methimazole (Tapazole), to manage thyrotoxicosis (high thyroid hormone levels due to over-activity of the thyroid gland). Thyrotoxicosis may result in the growth of goiters and/or hypothyroidism.

How to take

Take levothyroxine as a single dose, preferably on an empty stomach, one-half to one hour before breakfast. The drug is absorbed better on an empty stomach.
If an infant or child cannot swallow whole tablets, you may crush a levothyroxine tablet and mix it into 1 or 2 teaspoonfuls of water.
While taking levothyroxine, your doctor will perform periodic blood tests to determine whether you are getting the right amount.

Side effects

Side effects from levothyroxine, other than overdose symptoms, are rare. People who are treated with levothyroxine may initially lose some hair, but this effect is usually temporary. You may have an allergic reaction such as a rash or hives. Children may have an increase in pressure within the skull. Excessive dosage or a too rapid increase in dosage may lead to overstimulation of the thyroid gland. Notify your doctor immediately if you develop any if the following symptoms.
Symptoms of overstimulation:
Abdominal cramps, anxiety, changes in appetite, change in menstrual periods, chest pain, diarrhea, emotional instability, fatigue, fever, flushing, hair loss, headache, heart attack or failure, heat intolerance, hyperactivity, increased heart rate, irregular heartbeat, irritability, muscle weakness, nausea, nervousness, palpitations, shortness of breath, sleeplessness, sweating, tremors, vomiting, weight loss

Precaution

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have overactive thyroid conditions (e.g., thyrotoxicosis), a heart attack (acute myocardial infarction), and adrenal gland problems (e.g., uncorrected adrenal insufficiency). Do not use thyroid drugs for weight control. Before using this medication, tell your doctor or pharmacist your medical history, especially of: heart problems (e.g., hypertension, congestive heart failure, arrhythmias, coronary artery disease), diabetes, male or female infertility problems, bone loss disease (e.g., osteoporosis), other hormone disorders (e.g., hypothalamic/pituitary hormone deficiencies, autoimmune polyglandular syndrome), other thyroid problems (e.g., nontoxic diffuse goiter, nodular thyroid disease), blood clotting disorders, any allergies. Notify your doctor or dentist that you are taking this medication prior to any surgery. Caution is advised when using this drug in children because overuse may reduce the child's future adult height. Consult your doctor for details. Caution is advised when using this drug in the elderly because they may be more sensitive to the effects of the drug. Current information shows that this drug may be used during pregnancy. Tell your doctor if you are pregnant because your dose will have to be adjusted. Small amounts of this drug pass into breast milk. Consult your doctor before breast-feeding.

Drug interactions


Initiation or discontinuation of therapy with levothyroxine in diabetic patients may create a need for an increase or decrease in the required dose of insulin and/or antidiabetic drug, [for example, glyburide (Micronase)].
Levothyroxine may increase the effect of blood thinners such as warfarin (Coumadin). Therefore, monitoring of blood clotting is necessary, and a decrease in the dose of warfarin may be necessary.
Intravenous administration of epinephrine to patients with coronary artery disease may lead to complications ranging from difficulty in breathing to a heart attack. These complications may occur more frequently among patients also taking levothyroxine. Therefore, careful observation is needed when intravenous epinephrine is given to patients receiving levothyroxine who also have coronary artery disease.
Converting a state of hypothyroidism (under activity) to a normal state (euthyroid state) with levothyroxine may decrease the actions of certain beta-blocking drugs, [for example, metoprolol (Lopressor) or propranolol (Inderal)]. It may be necessary, therefore, to change the dose of beta-blocker. For the same reason, the dose of digoxin (Lanoxin), a drug used to manage heart failure or an irregular heart rhythm (for example, atrial fibrillation), also may need to be changed.
Converting hypothyroidism to the euthyroid state with levothyroxine may increase the blood level of theophylline (Slo-Bid), and it may be necessary to change the dose of theophylline.
Taking levothyroxine at the same time as cholestyramine (Questran) or colestipol (Colestid), two cholesterol-lowering drugs, may decrease the effect of levothyroxine and lead to hypothyroidism. This occurs because the levothyroxine binds to the cholesterol-lowering drugs and is not absorbed. Taking the levothyroxine one hour before or four hours after cholestyramine or colestipol is necessary to prevent the binding.

Missed dose

If you miss a dose, take as soon as remembered; do not take if it is almost time for the next dose, instead, skip the missed dose and resume your usual dosing schedule. Do not "double-up" the dose to catch up.

Storage

Store at room temperature between 59 and 86 degrees F (between 15 and 30 degrees C) away from moisture and sunlight. Do not store in the bathroom. Keep away from children and pets.