Treatment of Iodine deficiency and supplementation of iodine demand, in particular in the case of: inert will in adolescents, inert dilution in adults and during pregnancy, as well as prevention of goitre after iodine deficiency after streptoplasty.
Composition:
1 tabl contains 100 μg of levothyroxine sodium and 130.8 μg of potassium iodide, equivalent to 100 μg of iodine.
Action:
A combined preparation containing synthetic levothyroxine and potassium iodide being the source of iodine. Levothyroxine acts identically to thyroxine - the natural, main thyroid hormone. In peripheral tissues, it is partially transformed into liotyronine (L-triiodothyronine) and participates in the processes of development, growth and metabolic changes in the body. Levothyroxine administered orally on an empty stomach is absorbed in about 80%. It binds to plasma proteins in more than 99%. Thyroid hormones are mainly metabolized in the liver, kidneys, brain and muscles. Metabolites are excreted in urine and faeces. T0,5 the medication is an average of 7 days; in hyperthyroidism it is shorter (about 6 days) and in hypothyroidism longer (about 8 days). The action of thyroxine begins after 3-5 days after oral administration.
Contraindications:
Hypersensitivity to the components of the preparation. Symptomatic hyperthyroidism. Presence of autonomic thyroid nodules and focal or diffuse form of autonomic hyperactivity. Patients in the acute phase of myocardial infarction, with acute myocarditis or acute whole-heart inflammation.
Precautions:
Before starting treatment with the combined preparation use a preparation containing only thyroid hormone. As a rule, the additional use of iodine with thyroid hormone is indicated in younger people (under 40 years of age) with thyroid gland and an iodine deficiency in the diet. Due to the fact that usually after a treatment lasting a maximum of 1-2 years, no further reduction or regression of the will is to be expected, the use of the drug should be discontinued, unless the attending physician considers that further treatment is justified. If the proper supply of iodine in the diet can not be guaranteed, it is recommended to use iodine in the prophylactic dose after discontinuation. Before starting treatment, the following diseases should be excluded or treated: coronary insufficiency, angina pectoris, atherosclerosis, hypertension, pituitary insufficiency or adrenal cortex. In patients with coronary insufficiency, heart failure or tachyarrhythmias even small, hyperthyroidism-induced therapy should be avoided, hence frequent thyroid hormone control should be performed. In the case of secondary hypothyroidism, it should be established that there is no concomitant adrenal insufficiency; if it is, substitution treatment with Hydrocortisone should be implemented prior to the initiation of therapy. Before starting treatment, the autonomic function of the thyroid should be ruled out using special diagnostic methods. In patients with hypothyroidism in the postmenopausal period who are at increased risk of osteoporosis, thyroid function should be closely monitored in order to avoid the occurrence of physiological values of levothyroxine exceeding physiological values. The iodine saturation of the thyroid gland may prevent optimal accumulation of radioiodine during diagnostic or therapeutic intervention. It is recommended to avoid giving iodine before this type of intervention. Caution should be exercised in patients with Duhring's disease, as cases of disease development have been reported in some patients after exposure to iodine.
Pregnancy and lactation:
During pregnancy and during breastfeeding, thyroid hormone treatment should not be interrupted. There are no reports of harmful effects on the fetus. The amount of thyroid hormone penetrating into breast milk, even when using high doses of levothyroxine, is not sufficient to cause hyperthyroidism or inhibition of secretion of TSH in an infant. In areas of endemic iodine deficiency, pregnant women are recommended to supplement iodine at a dose of 150-200 μg and this dose should not be exceeded.The administration of very high doses (greater than 10-fold amount of iodine in the medicine) threatens the development of hypothyroidism in the infant.
Side effects:
In individual cases, the dose or overdose may be intolerable (especially if the dose is rapidly increased) and symptoms may appear: tachycardia, palpitation, arrhythmia, angina pectoris, headache, muscle weakness and cramps, feeling hot, fever, vomiting , menstrual disorders, alleged brain tumor, tremor, internal anxiety, insomnia, excessive sweating, weight loss, diarrhea. In such cases, the dose should be reduced or discontinued for several days. In addition, hypersensitivity reactions may occur.
Dosage:
Orally. At the beginning of treatment: 1/2 tabl. daily for 2-4 weeks, then individually depending on age and month, the dose is increased to the maintenance dose - adults and adolescents 1 tablet. per day; pregnant 1-1 1/2 tabl. per day. The drug should be taken in the morning, 30 minutes before a meal with a small amount of liquid.
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