Synthroid Patient Tips: 7 things you should know

Doctors often may have to slowly increase the dose; patients should not increase or decrease this medication themselves. Because some preparations of the drug may contain iodine or lactose, patients should tell their doctors about such allergies or reactions to these components. Administration of thyroid hormone in doses higher than those produced physiologically by the gland results in suppression of the production of endogenous hormone.

6 Decreased Bone Mineral Density Associated with Thyroid Hormone Over-Replacement

Treat patients with adrenal insufficiency with replacement glucocorticoids prior to initiating treatment with SYNTHROID see Contraindications (4). Titrate the dose of SYNTHROID carefully and monitor response synthroid tablet to titration to avoid these effects see Dosage and Administration (2.4). Consider the potential for food or drug interactions and adjust the administration or dosage of SYNTHROID as needed see Dosage and Administration (2.1), Drug Interactions (7.1), and Clinical Pharmacology (12.3). Stop biotin and biotin-containing supplements for at least 2 days before assessing TSH and/or T4 levels see Drug Interactions (7.10). ​Biotin supplementation may interfere with immunoassays for TSH, T4, and T3, resulting in erroneous thyroid hormone test results.

This initial dose is followed by daily supplements of 100 to 200 mcg given IV. Normal T4 levels are achieved in 24 hours followed in 3 days by threefold elevation of T3. Oral therapy with thyroid hormone would be resumed as soon as the clinical situation has been stabilized and the patient is able to take oral medication. In adult patients with primary hypothyroidism, monitor serum TSH levels after an interval of 6 to 8 weeks after any change in dosage. In patients on a stable and appropriate replacement dosage, evaluate clinical and biochemical response every 6 to 12 months and whenever there is a change in the patient’s clinical status.

The usual starting dose is 30 mg RenThyroid (Thyroid Tablets, USP), with increments of 15 mg every 2 to 3 weeks. A lower starting dosage, 15 mg/day, is recommended in patients with long-standing myxedema, particularly if cardiovascular impairment is suspected, in which case extreme caution is recommended. The appearance of angina is an indication for a reduction in dosage. Start at a lower starting dosage and increase the dosage every 4 to 6 weeks as needed based on clinical and laboratory response. 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. Failure to respond to doses of 180 mg suggests lack of compliance or malabsorption.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use levothyroxine only for the indication prescribed.
• Synthroid is prescribed in tablets that range from 25 to 300 mcg in strength and is usually taken once a day with a full glass of water (about 8 ounces) 30 to 60 minutes before breakfast for best adsorption into the body.
• The dose of this medicine will be different for different patients.
• Unithroid is used for hashimoto’s disease, hypothyroidism, after thyroid removal, myxedema coma …
• Administration of sertraline in patients stabilized on SYNTHROID may result in increased SYNTHROID requirements.

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• ​Biotin supplementation may interfere with immunoassays for TSH, T4, and T3, resulting in erroneous thyroid hormone test results.
• Administer SYNTHROID as a single daily dose, on an empty stomach, one-half to one hour before breakfast.
• Taking more than your recommended dose will not make this medicine more effective, and may cause serious side effects.
• Concurrent use of ketamine and SYNTHROID may produce marked hypertension and tachycardia.

The recommended starting daily dosage of SYNTHROID in adults with primary, secondary, or tertiary hypothyroidism is based on age and comorbid cardiac conditions, as described in Table 1. For patients at risk of atrial fibrillation or patients with underlying cardiac disease, start with a lower dosage and titrate the dosage more slowly to avoid exacerbation of cardiac symptoms. Dosage titration is based on serum TSH or free-T4 see Dosage and Administration (2.2). Dosage titration is based on serum TSH or free-T4 see Important Considerations For Dosing.

The signs and symptoms of overdosage are those of hyperthyroidism see Warnings and Precautions (5) and Adverse Reactions (6). Seizures occurred in a 3-year-old child ingesting 3.6 mg of levothyroxine. Symptoms may not necessarily be evident or may not appear until several days after ingestion of levothyroxine sodium. 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.

Related treatment guides

In pregnant patients with primary hypothyroidism, maintain serum TSH in the trimester-specific reference range. Do not administer in foods that decrease absorption of SYNTHROID, such as soybean-based infant formula see DRUG INTERACTIONS. Sometimes it is not safe to use certain medicines at the same time. Some drugs can affect your thyroid hormone levels and also make levothyroxine less effective. The dosage of thyroid hormones is determined by the indication and must in every case be individualized according to patient response and laboratory findings.

Drug Summary

Absorption of orally administered T4 from the gastrointestinal tract ranges from 40% to 80%. The majority of the SYNTHROID dose is absorbed from the jejunum and upper ileum. The relative bioavailability of SYNTHROID tablets, compared to an equal nominal dose of oral levothyroxine sodium solution, is approximately 93%. T4 absorption is increased by fasting, and decreased in malabsorption syndromes and by certain foods such as soybeans. In addition, many drugs and foods affect T4 absorption see Drug Interactions (7).

Hypothyroidism

Evaluate the need for dosage adjustments when regularly administering within one hour of certain foods that may affect SYNTHROID absorption. The dose of this medicine will be different for different patients. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so. This medicine will need to be taken for the rest of your life or your child’s life.

Maintenance dosages 60 to 120 mg/day usually result in normal serum T4 and T3 levels. 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. Stop biotin and biotin-containing supplements for at least 2 days prior to thyroid testing. If so, advise them to stop biotin supplementation at least 2 days before assessing TSH and/or T4 levels see Dosage and Administration (2.4) and Drug Interactions (7.10). The major pathway of thyroid hormone metabolism is through sequential deiodination.