Index of drugs

Tablets 25-200 μg: treatment of the inert goat; prevention of recurrence after willpine resection after resection depending on the degree of thyroid function remaining after surgery; substitution therapy in hypothyroidism; suppressive therapy in thyroid cancer. 25-100 μg tablets: supplementation associated with the use of antithyroid drugs during treatment of hyperthyroidism. Tablets 100 μg / 150 μg / 200 μg: thyroid function test.

1 tabl contains 25 μg, 50 μg, 75 μg, 88 μg, 100 μg, 112 μg, 125 μg, 137 μg, 150 μg, 175 μg or 200 μg levothyroxine sodium salt. Table. contain lactose.

Synthetic levothyroxine, acting identically to thyroxine - the natural, main thyroid hormone. In peripheral tissues it is converted to T₃ and just as the endogenous hormone exerts a specific effect on T-receptors₃. The oral levothyroxine is absorbed in approx. 80% mainly in the small intestine. Absorption depends on the galenical form of the preparation. It reaches the maximum concentration in the blood after 5-6 h after administration. The onset of action is observed 3-5 days after oral administration. Levothyroxine binds 99% of plasma proteins. Thyroid hormones are mainly metabolized in the liver, kidneys, brain and muscles. Metabolites are excreted in urine and faeces. T_0,5 the medication is an average of 7 days; in hyperthyroidism it is shorter (3-4 days) and in hypothyroidism longer (9-10 days).

Hypersensitivity to the components of the preparation. Untreated adrenal insufficiency, untreated hypopituitarism or untreated hyperthyroidism; Do not start treatment with the product in recent myocardial infarction, myocarditis and acute inflammation of all heart layers.

Before the use of thyroid hormones, the following diseases should be excluded or initiated: coronary insufficiency, angina pectoris, atherosclerosis, hypertension, hypopituitarism or adrenal cortex, autonomous thyroid function. In the case of coronary insufficiency, heart failure or arrhythmias with tachycardia even small drug-induced thyroid hyperthyroidism should be avoided (in these cases thyroid hormone levels should be frequently monitored. In the case of secondary hypothyroidism, it is necessary to determine its cause and if need to implement substitution treatment for compensated adrenal insufficiency If thyroid autonomy is suspected, a TRH test or suppressor scintigraphy should be performed Levothyroxine should not be administered in hyperthyroidism, with the exception of concomitant use with antithyroid drugs.The preparation contains lactose - should not be used in patients with rare Hereditary galactose intolerance, Lapp lactase deficiency or malabsorption of glucose-galactose.

During pregnancy and breastfeeding, treatment with thyroid hormones should be carried out continuously. During pregnancy, it may be necessary to increase the dosage. There is currently no information indicating the teratogenic and / or toxic effects of levothyroxine on the fetus used at the recommended therapeutic doses. Too high doses may have a negative effect on fetal development. The amount of thyroid hormone penetrating into breast milk is not sufficient to cause hyperthyroidism or suppression of TSH secretion in an infant. Levothyroxine should not be used in combination with antityrtic drugs in pregnancy - when treating hyperthyroidism during pregnancy, monotherapy with low-dose antithyroid drugs should be used. During pregnancy, diagnostic tests should not be carried out using radioactive substances.

During the proper administration of levothyroxine, undesirable effects should not occur under both clinical and laboratory control. In the case of intolerance or overdose of levothyroxine, especially if the dose is increased too rapidly at the beginning of treatment, typical symptoms of hyperthyroidism may occur, such as: tachycardia, arrhythmia, angina, headache, muscle weakness and spasms, hot flushes, fever, vomiting , menstrual disorders, alleged brain tumor, tremors, restlessness, insomnia, excessive sweating, weight loss, diarrhea. In this case, reduce the daily dose or discontinue the preparation for several days. After the disappearance of side effects, treatment can be resumed with caution.Hypersensitivity reactions may occur in case of hypersensitivity.

Dosage is determined individually, depending on the indications. The daily dose is determined based on laboratory tests (TSH levels) and a clinical trial. With the exception of newborns in whom a rapid onset of substitution treatment is very important, thyroid hormone therapy should be started at a low dose and increased gradually every 2-4 weeks to reach the full substitution dose. In elderly patients, patients with ischemic heart disease and severe or long-lasting hypothyroidism, a small starting dose (eg 12.5 μg / day) should be used, and then it should be increased gradually at longer intervals, depending on the results of the concentration tests. thyroid hormone. In these patients, it may be necessary to use a dose less than the full substitution dose. Practice shows that patients with low b. and large doses of the drug are sufficient for high-volume tuberosity.
I prefer indifferent75-200 μg / day.Prevention of relapse (after resection)75-200 μg / day.Hypothyroidism in adults: starting dose - 25-50 μg / day; maintenance dose - 100-200 μg / day.Hypothyroidism in children: starting dose of 12.5-50 μg / day; maintenance dose - 100-150 μg / m2 / day.Therapy associated with the use of thyrostatic agents in the treatment of hyperthyroidism50-100 μg / day.Suppressive therapy in thyroid cancer150-300 μg / day. Thyroid function test: 2 weeks and a week before the test - 200 μg / day (1 Euthyrox N 200 or 2 Euthyrox N 100) or alternatively 4th and 3rd week before the test - 75 μg / day (1/2 plate Euthyrox N 150) and the second week and week before the test - 150 μg / day (1 table Euthyrox N 150).
The daily dose should be taken once in the morning, on an empty stomach, at least 1/2 hour before breakfast, with a small amount of liquid. Table. can be divided into halves. Infants should be given a daily dose once, at least 1/2 hour before the first meal; the tablet should be dissolved in a small amount of water and the resulting suspension (always prepared immediately before administration) is given with a small amount of liquid.
In the case of hypothyroidism, after-resection of the goitre or thyroid and prophylaxis of recurrences after removal of the inert goat, the treatment is usually carried out throughout life. Adjunctive therapy of hyperthyroidism after euthyreosis is indicated during the period of administration of the antithyroid drug. In mild indifferent go treatment is necessary from 6 months to 2 years; after achieving a reduction, it is recommended to prophylaxis with low doses of Iodine (100-200 μg / day) to prevent goitosis; if pharmacological treatment turns out to be ineffective at the time, surgical treatment or radioactive iodine treatment should be considered.