Why prescribe levoxyl

If you are giving levothyroxine to an infant, child, or adult who cannot swallow the tablet, crush and mix it in 1 to 2 teaspoons 5 to 10 mL of water. Only mix the crushed tablets with water; do not mix it with food or soybean infant formula. Give this mixture by spoon or dropper right away. Do not store it for later use. Your doctor will probably start you on a low dose of levothyroxine and gradually increase your dose.

Levothyroxine controls hypothyroidism but does not cure it. It may take several weeks before you notice a change in your symptoms. Continue to take levothyroxine even if you feel well. Do not stop taking levothyroxine without talking to your doctor. This medication may be prescribed for other uses; ask your doctor or pharmacist for more information. Some foods and beverages, particularly those that contain soybeans, walnuts, and dietary fiber, may affect how levothyroxine works for you.

Talk to your doctor before eating or drinking these foods. Talk to your doctor about eating grapefruit and drinking grapefruit juice while taking this medication. Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule.

Do not take a double dose to make up for a missed one. Keep this medication in the container it came in, tightly closed, and out of reach of children.

Store it at room temperature and away from excess heat and moisture not in the bathroom. It is important to keep all medication out of sight and reach of children as many containers such as weekly pill minders and those for eye drops, creams, patches, and inhalers are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location — one that is up and away and out of their sight and reach.

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program.

In case of overdose, call the poison control helpline at If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at Levothyroxine oral tablet is used to treat hypothyroidism. This is a condition when your thyroid gland produces too little thyroid hormone. Levothyroxine also can be used to treat goiter, which is an enlarged thyroid gland.

It also treats certain types of thyroid cancer. Levothyroxine belongs to a class of drugs called hormones. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions. Levothyroxine works by providing the thyroid hormone that your thyroid gland would produce if it were working normally. If these effects are mild, they may go away within a few days or a couple of weeks.

Call your doctor right away if you have serious side effects. Serious side effects and their symptoms can include the following:. Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

Levothyroxine oral tablet can interact with other medications, vitamins , or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well. To help avoid interactions, your doctor should manage all of your medications carefully. Taking levothyroxine with certain drugs may result in an increase in adverse effects. Examples of these drugs include:. When levothyroxine is less effective: When you take levothyroxine with certain drugs, it may not work as well to treat your condition.

This is because the amount of levothyroxine in your body may be decreased. When other drugs are less effective: When certain drugs are used with levothyroxine, they may not work as well. This is because the amount of these drugs in your body may be decreased. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:. Your dosage is based on your needs and thyroid hormone levels.

Your doctor will determine the right dosage for you and adjust it based on your current level of thyroid hormone. For people with heart disease :.

However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. Always speak with your doctor or pharmacist about dosages that are right for you.

Taking iron and calcium supplements or antacids can decrease the amount of levothyroxine your body absorbs. Do not take levothyroxine within 4 hours of taking these supplements or antacids.

Taking it again could be fatal cause death. Certain foods, such as soybean flour, cotton seed meal, walnuts, and other dietary fibers, may affect how well your body absorbs levothyroxine.

For people with heart problems: Levothyroxine can increase your risk of serious heart problems, such as heart attack , abnormal heart rhythm, and heart failure. Tell your doctor if you have heart problems or a history of heart problems. LEVOXYL is indicated in pediatric and adult patients as a replacement therapy in primary thyroidal , secondary pituitary , and tertiary hypothalamic congenital or acquired hypothyroidism.

LEVOXYL is indicated in pediatric and adult patients as an adjunct to surgery and radioiodine therapy in the management of well-differentiated thyroid cancer. Administer LEVOXYL tablets orally as a single daily dose, on an empty stomach, one-half to one hour before breakfast with a full glass of water to avoid choking or gagging [see Adverse Reactions 6 ]. Administer LEVOXYL to infants and children who cannot swallow intact tablets by crushing the tablet, suspending the freshly crushed tablet in a small amount 5 mL to 10 mL or 1 teaspoon to 2 teaspoons of water and immediately administering the suspension by spoon or dropper.

Do not store the suspension. The dose of LEVOXYL for hypothyroidism or pituitary TSH suppression depends on a variety of factors including: the patient's age, body weight, cardiovascular status, concomitant medical conditions including pregnancy , concomitant medications, co-administered food and the specific nature of the condition being treated [see Dosage and Administration 2.

Dosing must be individualized to account for these factors and dose adjustments made based on periodic assessment of the patient's clinical response and laboratory parameters [see Dosage and Administration 2. Start LEVOXYL at the full replacement dose in otherwise healthy, non-elderly individuals who have been hypothyroid for only a short time such as a few months. Adjust the dose by Doses greater than mcg per day are seldom required. An inadequate response to daily doses of greater than mcg per day is rare and may indicate poor compliance, malabsorption, drug interactions, or a combination of these factors.

For elderly patients or patients with underlying cardiac disease, start with a dose of Increase the dose every 6 to 8 weeks, as needed until the patient is clinically euthyroid and the serum TSH returns to normal. In patients with severe longstanding hypothyroidism, start with a dose of Adjust the dose in Start with a lower dose in elderly patients, patients with underlying cardiovascular disease or patients with severe longstanding hypothyroidism as described above.

Use the serum free-T4 level to monitor adequacy of therapy in this patient population. Titrate LEVOXYL dosing per above instructions until the patient is clinically euthyroid and the serum free-T4 level is restored to the upper half of the normal range. Pediatric Dosage - Congenital or Acquired Hypothyroidism. Start at a lower starting dose in newborns 0 to 3 months at risk for cardiac failure and in children at risk for hyperactivity see below.

Monitor for clinical and laboratory response [see Dosage and Administration 2. Consider a lower starting dose in newborns at risk for cardiac failure. Increase the dose every 4 to 6 weeks as needed based on clinical and laboratory response. To minimize the risk of hyperactivity in pediatric patients, start at one-fourth the recommended full replacement dose, and increase on a weekly basis by one-fourth the full recommended replacement dose until the full recommended replacement dose is reached.

Measure serum TSH and free-T4 as soon as pregnancy is confirmed and, at minimum, during each trimester of pregnancy. In patients with primary hypothyroidism, maintain serum TSH in the trimester-specific reference range.

New Onset Hypothyroidism: Normalize thyroid function as rapidly as possible. Assess the adequacy of therapy by periodic assessment of laboratory tests and clinical evaluation. Persistent clinical and laboratory evidence of hypothyroidism despite an apparent adequate replacement dose of LEVOXYL may be evidence of inadequate absorption, poor compliance, drug interactions, or a combination of these factors.

In adult patients with primary hypothyroidism, monitor serum TSH levels after an interval of 6 to 8 weeks after any change in dose. In patients on a stable and appropriate replacement dose, evaluate clinical and biochemical response every 6 to 12 months and whenever there is a change in the patient's clinical status.

In patients with congenital hypothyroidism, assess the adequacy of replacement therapy by measuring both serum TSH and total or free-T4. Monitor TSH and total or free-T4 in children as follows: 2 and 4 weeks after the initiation of treatment, 2 weeks after any change in dosage, and then every 3 to 12 months thereafter following dose stabilization until growth is completed. Poor compliance or abnormal values may necessitate more frequent monitoring.

Perform routine clinical examination, including assessment of development, mental and physical growth, and bone maturation, at regular intervals. While the general aim of therapy is to normalize the serum TSH level, TSH may not normalize in some patients due to in utero hypothyroidism causing a resetting of pituitary-thyroid feedback. Monitor serum free-T4 levels and maintain in the upper half of the normal range in these patients. Levothyroxine is contraindicated in patients with uncorrected adrenal insufficiency [see Warnings and Precautions 5.

Overtreatment 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 LEVOXYL therapy in this population at lower doses than those recommended in younger individuals or in patients without cardiac disease [see Dosage and Administration 2.

Monitor for cardiac arrhythmias during surgical procedures in patients with coronary artery disease receiving suppressive LEVOXYL therapy. Myxedema coma is a life-threatening emergency characterized by poor circulation and hypometabolism, and may result in unpredictable absorption of levothyroxine sodium from the gastrointestinal tract.

Use of oral thyroid hormone drug products is not recommended to treat myxedema coma. Administer thyroid hormone products formulated for intravenous administration to treat myxedema coma. Thyroid hormone increases metabolic clearance of glucocorticoids.

Initiation of thyroid hormone therapy prior to initiating glucocorticoid therapy may precipitate an acute adrenal crisis in patients with adrenal insufficiency. Over- or undertreatment with LEVOXYL may have negative effects on growth and development, cardiovascular function, bone metabolism, reproductive function, cognitive function, emotional state, gastrointestinal function, and on glucose and lipid metabolism.

Addition of levothyroxine therapy in patients with diabetes mellitus may worsen glycemic control and result in increased antidiabetic agent or insulin requirements. Increased bone resorption and decreased bone mineral density may occur as a result of levothyroxine over-replacement, particularly in post-menopausal women.

The increased bone resorption may be associated with increased serum levels and urinary excretion of calcium and phosphorous, elevations in bone alkaline phosphatase, and suppressed serum parathyroid hormone levels.

They include the following:. General : fatigue, increased appetite, weight loss, heat intolerance, fever, excessive sweating. Central nervous system : headache, hyperactivity, nervousness, anxiety, irritability, emotional lability, insomnia. Cardiovascular : palpitations, tachycardia, arrhythmias, increased pulse and blood pressure, heart failure, angina, myocardial infarction, cardiac arrest.

Gastrointestinal : diarrhea, vomiting, abdominal cramps, elevations in liver function tests. Pseudotumor cerebri and slipped capital femoral epiphysis have been reported in pediatric patients receiving levothyroxine therapy. Overtreatment may result in craniosynostosis in infants and premature closure of the epiphysis in pediatric patients with resultant compromised adult height. Hypersensitivity reactions to inactive ingredients have occurred in patients treated with thyroid hormone products.

These include urticaria, pruritus, skin rash, flushing, angioedema, various gastrointestinal symptoms abdominal pain, nausea, vomiting, and diarrhea , fever, arthralgia, serum sickness and wheezing. Hypersensitivity to levothyroxine itself is not known to occur. Many drugs can exert effects on thyroid hormone pharmacokinetics e. Addition of LEVOXYL therapy in patients with diabetes mellitus may worsen glycemic control and result in increased antidiabetic agent or insulin requirements.

Therefore, a decrease in the dose of anticoagulant may be warranted with correction of the hypothyroid state or when the LEVOXYL dose is increased.

Closely monitor coagulation tests to permit appropriate and timely dosage adjustments. Serum digitalis glycoside levels may be decreased when a hypothyroid patient becomes euthyroid, necessitating an increase in the dose of digitalis glycosides.

Concurrent use of tricyclic e. Toxic effects may include increased risk of cardiac arrhythmias and central nervous system stimulation. Closely monitor blood pressure and heart rate in these patients. Thyroid hormones may increase the risk of coronary insufficiency when sympathomimetic agents are administered to patients with coronary artery disease. Concurrent use of tyrosine-kinase inhibitors such as imatinib may cause hypothyroidism.

Closely monitor TSH levels in such patients. Grapefruit juice may delay the absorption of levothyroxine and reduce its bioavailability. Pregnancy, infectious hepatitis, estrogens, estrogen-containing oral contraceptives, and acute intermittent porphyria increase TBG concentrations.

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 Experience with levothyroxine use in pregnant women, including data from post-marketing studies, have not reported increased rates of major birth defects or miscarriages see Data. There are risks to the mother and fetus associated with untreated hypothyroidism in pregnancy.

There are no animal studies conducted with levothyroxine during pregnancy.