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Indications and Usage

Levothroid (Levothyroxine) is indicated for: 

  • Hypothyroidism 
  • Thyroid cancer
  • Goiter 
  • Infertility due to thyroid issues

Dosage and Administration

Each patient’s dosage differs based on the health condition, the patient’s age, and the drug strength. Don’t change the prescription unless a physician says so.

For hypothyroidism treatment using capsule:

  • Adults & children (above twelve years with complete puberty): 1.7 microgram/ kilogram body weight daily
  • Children above twelve years with incomplete puberty: two to three mcg per kg body weight daily
  • Children six to twelve years: four to five micrograms/kilogram body weight daily

Capsule shouldn’t be administered to children below six years since they can’t swallow them.

For thyroid cancer treatment using capsules:

  • Adults: minimum of two mcg per kg body weight daily. 
  • Children: the physician will determine the doses.

For hypothyroidism treatment using solution:

  • Adults & children above twelve years (complete puberty): 1.7 microgram/ kilogram body weight daily. The physician will adjust it when necessary.
  • Children above twelve years (incomplete puberty): two to three mcg per kg body weight daily
  • Six to twelve years: four to five mcg per kg body weight daily
  • One to five years: five to six mcg per kg body weight daily
  • Six to twelve months: six to eight mcg per kg body weight daily
  • Three to six months: eight to ten mcg per kg body weight daily
  • Zero to three months: ten to fifteen mcg per kg body weight daily

For thyroid cancer treatment using solution:

  • Adults: minimum of two mcg per kg body weight daily
  • Children: the physician will determine the dose

For hypothyroidism treatment using tablet:

  • Adults & children above 12 years (complete puberty): 1.6 microgram/ kilogram body weight daily
  • Children above twelve years (incomplete puberty): two to three mcg per kg body weight daily
  • Six to twelve years: four to five mcg per kg body weight daily
  • One to five years: five to six mcg per kg body weight daily
  • Six to twelve months: six to eight mcg per kg body weight daily
  • Three to six months: eight to ten mcg per kg body weight daily
  • Zero to three months: ten to fifteen mcg per kg body weight daily

Instructions for Administration:

  • Levothroid is best administered before breakfast.
  • Don’t crush capsules; swallow them whole.
  • When administering tablets to children, dissolve them in about 5 – 10 ml of water, then administer with a dropper. Don’t store any unused mixture.
  • Levothyroxine should be administered at a specific time every day.
  • This treatment may continue all through your life. Therefore, don’t discontinue the medication without clearance from your physician.
  • If you’re consuming antacids, allow a space of four hours before ingesting levothyroxine.

Dosage Forms

Levothroid comes in capsules, tablets, and oral solutions.

Overdosage

Overdosing on Levothroid has severe consequences like the loss of consciousness and difficulty in breathing. Common overdose symptoms are:

  • Seizures
  • Confusion
  • Racing heartbeat
  • Headaches
  • Improper coordination
  • Incoherent speech
  • Racing pulse
  • Cold skin

When a dose is missed, skip it, then wait for another one, especially if it’s almost time for the next dosage. If you’ve missed two or more doses, contact a physician. 

Contraindications

Before ingesting Levothyroxine, inform the physician if you’ve experienced any of these health conditions:

  • Untreated thyrotoxicosis
  • Adrenal issues
  • Diabetes 
  • Heart failure
  • Untreated insufficient adrenal gland
  • Anemia
  • Bone problems
  • Chest pain
  • Problems in the pituitary gland
  • Arrhythmia

Warnings and Precautions

Adhere to these precautionary measures when ingesting Levothroid:

  • For a longer period of use, ensure a physician monitors your performance regularly.
  • The physician must request blood tests. This will ensure you’re not experiencing unwanted effects.
  • Don’t administer Levothroid for weight loss. Ingesting excess doses might result in severe side effects.
  • Levothyroxine must only be administered for infertility due to hypothyroidism.
  • Diabetic patients must measure their sugar and urine levels regularly. If you observe a slight change, inform a doctor.
  • Pregnant women require Levothyroxine in high doses. Inform the physician if you’re pregnant or expecting to become pregnant soon.
  • Women in their menopause age might experience bone problems. If there’s anything you’re not sure about, discuss it with a physician before ingesting Levothyroxine.
  • Don’t discontinue the medicine abruptly. The physician will gradually adjust the dosage and inform you about when to discontinue.
  • If undergoing a dental or surgical procedure, inform the specialist that you’re consuming Levothroid. The surgeon may ask you to discontinue the medication for some days prior to the procedure.
  • Avoid ingesting Levothroid with other drugs, including OTC medications and supplements unless a physician gives you clearance.

Adverse Reactions & Side Effects

The side effects below don’t need medical care. They will resolve when the patient’s body acclimatizes to Levothroid:

  • Abdominal cramps
  • Reduced or increased appetite
  • Diarrhea
  • Hair loss
  • Headache
  • Feelings of nervousness, discomfort, warmth, suspicion
  • Reduced or increased body weight
  • Mental depression
  • Weakness in the muscles
  • Mood swings
  • Infertility
  • Red patches on the skin

Contact a physician immediately, if you’re experiencing these side effects:

  • Excess fatigue
  • Fever 
  • Nausea
  • Fainting spell
  • Changes in a menstrual cycle
  • Discomfort in the thoracic region
  • Increased perspiration
  • Swollen eyes 
  • Swollen face
  • Reduction in urine level
  • Difficulty in breathing and swallowing
  • Intolerance to a hot environment
  • Itching skin
  • Painful joints
  • Tremors
  • Dilation of the veins in the neck 

These side effects are rare. Seek immediate attention if you notice them.

  • Migraine
  • Limping on one foot
  • Retarded growth in kids
  • Blurry vision
  • Discomfort inside the eye, knee, and hip
  • Seizures

Drug Interactions

These drugs will interact with Levothyroxine:

  • Iron
  • Ciprofloxacin
  • Omeprazole
  • Aluminum hydroxide
  • Mestranol
  • Rifampin
  • Calcium carbonate
  • Estramustine
  • Calcium citrate
  • Aluminum phosphate
  • Kelp
  • Magnesium oxide
  • Pantoprazole
  • Lopinavir
  • Cholestyramine

Although this isn’t a comprehensive list, when prescribed together with Levothroid, these medicines can heighten the side effects. However, the physician can alter the dosage or space the period of ingestion.

Levothroid also interacts with alcoholic drinks, soybeans, and enteral nutrition. 

Use in Specific Populations

  • Allergies: inform the physician if you’ve experienced any allergies.
  • Pediatrics: there is currently no data to prove that levothyroxine will limit a child’s usefulness.
  • Geriatric: older patients are prone to heart conditions. Therefore, their dosage should be properly adjusted and used with caution.

Lactation: risk to a breastfeeding infant is minimal.