Serum digitalis glycoside levels may decrease when a hypothyroid patient becomes euthyroid, necessitating an increase in the dose of digitalis glycosides. Antidepressant Therapy Concurrent use of tricyclic e. Toxic effects may include increased risk of cardiac arrhythmias and central nervous system stimulation. Synthroid may accelerate the onset of action of tricyclics. Administration of sertraline in patients stabilized on Synthroid may result in increased Synthroid requirements. Ketamine Concurrent use of ketamine and Synthroid may produce marked hypertension and tachycardia.
Closely monitor blood pressure and heart rate in these patients. Sympathomimetics Concurrent use of sympathomimetics and Synthroid may increase the effects of sympathomimetics or thyroid hormone. Thyroid hormones may increase the risk of coronary insufficiency when sympathomimetic agents are administered to patients with coronary artery disease. Tyrosine-Kinase Inhibitors Concurrent use of tyrosine-kinase inhibitors such as imatinib may cause hypothyroidism. Closely monitor TSH levels in such patients. Drug-Food Interactions Consumption of certain foods may affect Synthroid absorption thereby necessitating adjustments in dosing [see Dosage and Administration 2.
Soybean flour, cottonseed meal, walnuts, and dietary fiber may bind and decrease the absorption of Synthroid from the gastrointestinal tract. 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 concentration. 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 9000.
There are risks to the mother and fetus associated with untreated hypothyroidism in pregnancy. There are no animal studies conducted with levothyroxine during pregnancy. Synthroid should not be discontinued during pregnancy and hypothyroidism diagnosed during pregnancy should be promptly treated. The estimated background risk of major birth defects and miscarriage for the indicated population is unknown. In the U. Untreated maternal hypothyroidism may have an adverse effect on fetal neurocognitive development. Serum TSH levels should be monitored and the Synthroid dosage adjusted during pregnancy. Since postpartum TSH levels are similar to preconception values, the Synthroid dosage should return to the pre-pregnancy dose immediately after delivery [see Dosage and Administration 2.
Data Human Data Levothyroxine is approved for use as a replacement therapy for hypothyroidism. There is a long experience of levothyroxine use in pregnant women, including data from post-marketing studies that have not reported increased rates of fetal malformations, miscarriages or other adverse maternal or fetal outcomes associated with levothyroxine use in pregnant women. Lactation Risk Summary Limited published studies report that levothyroxine is present in human milk. However, there is insufficient information to determine the effects of levothyroxine on the breastfed infant and no available information on the effects of levothyroxine on milk production. Most of these problems disappear if the medicine is taken with the right amount of water or other fluids.
Do not switch brands of this medicine unless your health care professional agrees with the change. Ask questions if you are uncertain. You will need regular exams and occasional blood tests to check the response to treatment. If you are receiving this medicine for an underactive thyroid, it may be several weeks before you notice an improvement. Check with your doctor or health care professional if your symptoms do not improve. It may be necessary for you to take this medicine for the rest of your life. Do not stop using this medicine unless your doctor or health care professional advises you to.
This medicine can affect blood sugar levels. If you have diabetes, check your blood sugar as directed. You may lose some of your hair when you first start treatment. Levothyroxine doses are based on weight in children. Your dose needs may change if you gain or lose weight. It may take several weeks before your body starts to respond to levothyroxine. Keep using this medicine even if you feel well. You may need to use levothyroxine for the rest of your life. You may need frequent medical tests. Tell any doctor, dentist, or surgeon who treats you that you are using Synthroid. Store at room temperature away from moisture and heat.
Do not share this medicine with another person, even if they have the same symptoms you have. See also: Synthroid dosage information in more detail What happens if I miss a dose? Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include headache , leg cramps, tremors, feeling nervous or irritable, chest pain, shortness of breath, and fast or pounding heartbeats.
Take Synthroid exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed. Synthroid works best if you take it on an empty stomach, at least 30 to 60 minutes before breakfast. Follow your doctor's dosing instructions and try to take the medicine at the same time each day. Levothyroxine doses are based on weight in children. Your dose needs may change if you gain or lose weight. It may take several weeks before your body starts to respond to levothyroxine. Keep using this medicine even if you feel well.
You may need to use levothyroxine for the rest of your life. You may need frequent medical tests. Tell any doctor, dentist, or surgeon who treats you that you are using Synthroid. Store at room temperature away from moisture and heat. Do not share this medicine with another person, even if they have the same symptoms you have. See also: Do not stop using this medicine unless your doctor or health care professional advises you to. This medicine can affect blood sugar levels. If you have diabetes, check your blood sugar as directed.
You may lose some of your hair when you first start treatment. With time, this usually corrects itself. If you are going to have surgery, tell your doctor or health care professional that you are taking this medicine. What side effects may I notice from receiving this medicine? Side effects that you should report to your doctor or health care professional as soon as possible: Call your doctor for medical advice about side effects. Where should I keep my medicine? Keep out of the reach of children. Lactation Risk Summary Limited published studies report that levothyroxine is present in human milk.
However, there is insufficient information to determine the effects of levothyroxine on the breastfed infant and no available information on the effects of levothyroxine on milk production. Adequate levothyroxine treatment during lactation may normalize milk production in hypothyroid lactating mothers. Pediatric Use The initial dose of Synthroid varies with age and body weight. Dosing adjustments are based on an assessment of the individual patient's clinical and laboratory parameters [see Dosage and Administration 2.
In children in whom a diagnosis of permanent hypothyroidism has not been established, discontinue Synthroid administration for a trial period, but only after the child is at least 3 years of age. Obtain serum T4 and TSH levels at the end of the trial period, and use laboratory test results and clinical assessment to guide diagnosis and treatment, if warranted. Congenital Hypothyroidism[See Dosage and Administration 2. Therefore, initiate Synthroid therapy immediately upon diagnosis. Levothyroxine is generally continued for life in these patients. Closely monitor infants during the first 2 weeks of Synthroid therapy for cardiac overload, arrhythmias, and aspiration from avid suckling.
Closely monitor patients to avoid undertreatment or overtreatment. Undertreatment may have deleterious effects on intellectual development and linear growth. Overtreatment is associated with craniosynostosis in infants, may adversely affect the tempo of brain maturation, and may accelerate the bone age and result in premature epiphyseal closure and compromised adult stature. Acquired Hypothyroidism in Pediatric Patients Closely monitor patients to avoid undertreatment and overtreatment. Undertreatment may result in poor school performance due to impaired concentration and slowed mentation and in reduced adult height. Overtreatment may accelerate the bone age and result in premature epiphyseal closure and compromised adult stature.
Treated children may manifest a period of catch-up growth, which may be adequate in some cases to normalize adult height. In children with severe or prolonged hypothyroidism, catch-up growth may not be adequate to normalize adult height. Geriatric Use Because of the increased prevalence of cardiovascular disease among the elderly, initiate Synthroid at less than the full replacement dose [see Warnings and Precautions 5. Atrial arrhythmias can occur in elderly patients. Atrial fibrillation is the most common of the arrhythmias observed with levothyroxine overtreatment in the elderly. Overdosage The signs and symptoms of overdosage are those of hyperthyroidism [see Warnings and Precautions 5 and Adverse Reactions 6 ].
In addition, confusion and disorientation may occur. Cerebral embolism, shock, coma, and death have been reported. Seizures occurred in a 3-year-old child ingesting 3. Symptoms may not necessarily be evident or may not appear until several days after ingestion of levothyroxine sodium. Reduce the Synthroid dose or discontinue temporarily if signs or symptoms of overdosage occur. For current information on the management of poisoning or overdosage, contact the National Poison Control Center at 1-800-222-1222 or www.
Synthroid official prescribing information for healthcare professionals. Includes: indications, dosage, adverse reactions, pharmacology and more. Synthroid (levothyroxine) treats hypothyroidism Follow all directions on your prescription label and read all medication guides or instruction sheets. Save money when safely buying Synthroid online. PlanetDrugsDirect is a safe and secure Canadian international prescription referral service. Buy high-quality Synthroid online. Quick and safe delivery are guaranteed. Discreet packaging. The lowest prices for Synthroid.
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