L-thyroxine

Active substance

Levothyroxine sodium* (Levothyroxine sodium*)

ATH

H03AA01 Levothyroxine sodium

Pharmacological group

 

  • Thyroid hormones, their analogs and antagonists (including antithyroid drugs)

 

Indications

Hypothyroid states of various etiologies (including those caused by surgical or drug exposure), prevention of recurrence of nodular goiter after thyroid resection, diffuse euthyroid goiter; diffuse toxic goiter – after the creation of a euthyroid state with thyreostatics (in the form of combined or monotherapy); thyroid cancer after surgical treatment (to suppress tumor recurrence and as replacement therapy), as a diagnostic tool during the thyroid suppression test. As part of complex therapy: Graves’ disease, autoimmune thyroiditis.

Contraindications

Hypersensitivity, untreated thyrotoxicosis, acute myocardial infarction, acute myocarditis, untreated adrenal insufficiency (should be compensated before starting therapy).

Use during pregnancy and lactation

During pregnancy and breastfeeding, therapy with levothyroxine sodium, prescribed for hypothyroidism, should continue. During pregnancy, an increase in the dosage of the drug is required due to an increase in the level of thyroxin-binding globulin. The amount of thyroid hormone secreted in breast milk (even when treated with high doses of the drug) is not enough to cause any problems in the child during breastfeeding. Use during pregnancy in combination with thyreostatics is contraindicated, because. taking levothyroxine sodium may require an increase in doses of thyreostatics. Since thyreostatics, unlike levothyroxine sodium, can cross the placenta, the fetus may develop hypothyroidism.

FDA Fetal Action Category — A.

During breastfeeding, the drug should be taken with caution, strictly in the recommended doses, under the supervision of a physician.

Side effects

Tachycardia, cardiac arrhythmia, chest pain, tremor, anxiety, insomnia, hyperhidrosis, weight loss, diarrhea, alopecia, adrenal dysfunction (with pituitary or hypothalamic hypothyroidism), kidney dysfunction in children, allergic reactions (skin rash, itching skin).

Precautionary measures

It is proposed to periodically determine the content of thyroid-stimulating hormone in the blood, an increased level of which indicates an insufficient dosage. The adequacy of thyroid suppressive therapy is also assessed by the suppression of radioactive iodine uptake. With a long-term multinodular goiter, a stimulation test with thyrotropin-releasing hormone should be performed before starting treatment. In most cases of hypothyroidism, the metabolic status should be restored gradually, especially in elderly patients and patients with cardiovascular pathology. For elderly patients, the initial dosage should not exceed 50 micrograms. When used in the II and III trimesters of pregnancy, the dose is often increased by 25%. Prescribed with caution in severe long-term hypothyroidism.

Storage conditions of the preparation

In a dry, dark place, at a temperature not exceeding 25 °C.

Keep out of the reach of children.

 

Expiry date of the drug

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