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Levothyroxine is a thyroid medicine that replaces a hormone normally produced by your thyroid gland to regulate the body's energy and metabolism.
Levothyroxine is given when your thyroid does not produce enough of this hormone on its own.
Levothyroxine is used to treat hypothyroidism (low thyroid hormone). It is also used to treat or prevent goiter (enlarged thyroid gland), which can be caused by hormone imbalances, radiation treatment, surgery, or cancer.
There are many brands and forms of levothyroxine available. Not all brands are listed on this leaflet.
You may not be able to take levothyroxine if you have certain medical conditions. Tell your doctor if you have an untreated or uncontrolled adrenal gland disorder, a thyroid disorder called thyrotoxicosis, or if you have any recent or current symptoms of a heart attack.
Levothyroxine should not be used to treat obesity or weight problems. Dangerous side effects or death can occur from the misuse of this medicine, especially if you are taking any other weight-loss medications or appetite suppressants.
Levothyroxine should not be used to treat obesity or weight problems. Dangerous side effects or death can occur from the misuse of this medicine, especially if you are taking any other weight-loss medications or appetite suppressants.
Since thyroid hormone occurs naturally in the body, almost anyone can take levothyroxine. However, you may not be able to take this medicine if you have certain medical conditions. Tell your doctor if you have:
an untreated or uncontrolled adrenal gland disorder;
a thyroid disorder called thyrotoxicosis; or
symptoms of a heart attack (chest pain or heavy feeling, pain spreading to the jaw or shoulder, nausea, sweating, general ill feeling).
Tell your doctor if you have ever had:
a thyroid nodule;
heart disease, a blood clot, or a blood-clotting disorder;
diabetes (insulin or oral diabetes medication doses may need to be changed when you start taking this medicine);
kidney disease;
anemia (lack of red blood cells);
osteoporosis, or low bone mineral density;
problems with your pituitary gland; or
any food or drug allergies.
Tell your doctor if you have recently received radiation therapy with iodine (such as I-131).
If you become pregnant while taking levothyroxine, do not stop taking the medicine without your doctor's advice. Having low thyroid hormone levels during pregnancy could harm both mother and baby. Your dose needs may be different during pregnancy.
Tell your doctor if you are breast-feeding. Your dose needs may be different while you are nursing.
Do not give this medicine to a child without medical advice. Tirosint is not approved for use by anyone younger than 6 years old.
Take levothyroxine 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.
Levothyroxine oral is taken by mouth. Levothyroxine injection is given as an infusion into a vein. Levothyroxine is usually given by injection only if you are unable to take the medicine by mouth.
Levothyroxine oral 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.
Swallow the tablet>/b> or capsule whole, with a full glass (8 ounces) of water. The tablet may dissolve very quickly and could swell in your throat.
Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).
Levothyroxine doses are based on weight in children. Your child's dose needs may change if the child gains or loses 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 this medicine 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 this medicine.
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.
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.
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.
Avoid the following food products, which can make your body absorb less levothyroxine: grapefruit juice, infant soy formula, soybean flour, cotton seed meal, walnuts, and high-fiber foods.
Get emergency medical help if you have signs of an allergic reaction to levothyroxine: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
fast or irregular heartbeats;
chest pain, shortness of breath;
fever, hot flashes, sweating;
tremors, or if you feel unusually cold;
weakness, tiredness, sleep problems (insomnia);
memory problems, feeling depressed or irritable;
headache, leg cramps, muscle aches;
feeling nervous or irritable;
dryness of your skin or hair, and/or hair loss;
changes in your menstrual periods; or
vomiting, diarrhea, appetite changes, weight changes.
Certain side effects may be more likely in older adults.
Common levothyroxine side effects may include:
muscle weakness;
headache, leg cramps;
nervousness, trouble sleeping;
diarrhea; or
skin rash, partial hair loss.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Many other medicines can be affected by your thyroid hormone levels. Certain other medicines may also increase or decrease the effects of levothyroxine.
Certain medicines can make levothyroxine less effective if taken at the same time. If you use any of the following drugs, avoid taking them within 4 hours before or 4 hours after you take this medicine:
calcium carbonate (Alka-Mints, Caltrate, Os-Cal, Oyster Shell Calcium, Rolaids Soft Chew, Tums, and others);
cholestyramine, colesevelam, colestipol;
ferrous sulfate iron supplement;
sucralfate;
sodium polystyrene sulfonate (Kalexate, Kayexalate, Kionex);
stomach acid reducers--esomeprazole, lansoprazole, omeprazole, rabeprazole, Nexium, Prilosec, Prevacid, Protonix, Zegerid, and others; or
antacids that contain aluminum or magnesium--Gaviscon, Maalox, Milk of Magnesia, Mintox, Mylanta, Pepcid Complete, and others.
Many drugs can interact with levothyroxine. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any medicine you start or stop using.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Levoxyl only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/1/2020.
Source: Drugs.com Levothyroxine Sodium (www.drugs.com/levothyroxine.html).
Applies to levothyroxine: oral capsule liquid filled, oral tablet
Other dosage forms:
Oral route (Capsule; Tablet; Solution)
Thyroid hormones, including levothyroxine, should not be used either alone or with other therapeutic agents for the treatment of obesity or weight loss. In euthyroid patients, doses within the range of daily hormonal requirements are ineffective for weight reduction. Larger doses may produce serious or even life-threatening manifestations of toxicity, particularly when given in association with sympathomimetic amines such as those used for their anorectic effects.
Along with its needed effects, levothyroxine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking levothyroxine:
Less common
Rare
Get emergency help immediately if any of the following symptoms of overdose occur while taking levothyroxine:
Symptoms of overdose
Some side effects of levothyroxine may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Applies to levothyroxine: compounding powder, injectable powder for injection, intravenous powder for injection, intravenous solution, oral capsule, oral solution, oral tablet
The more commonly reported adverse events have included those of hyperthyroidism due to therapeutic overdose including arrhythmias, myocardial infarction, dyspnea, muscle spasm, headache, nervousness, irritability, insomnia, tremors, muscle weakness, increased appetite, weight loss, diarrhea, heat intolerance, menstrual irregularities, and skin rash.
Cardiac function was evaluated in 20 patients requiring TSH suppression for either thyroid goiter or following thyroidectomy and radioactive iodine therapy for thyroid cancer and in 20 age and sex-matched controls. TSH suppression was associated with an increased incidence of premature ventricular beats, an increased left ventricular mass index, and enhanced left ventricular systolic function. The clinical significance of these changes remains to be determined.
Overtreatment with this drug may cause an increase in heart rate, cardiac wall thickness, and cardiac contractility and may precipitate angina or arrhythmias, particularly in patients with cardiovascular disease and in elderly patients.
Frequency not reported: Palpitations, tachycardia, hypertension, arrhythmias, increased pulse and blood pressure, heart failure, angina, myocardial infarction, cardiac arrest
Frequency not reported: Changes in symptom presentation for diabetes and adrenal cortical insufficiency
Frequency not reported: Headache, hyperactivity, insomnia, seizures, pseudotumor cerebri (children)
Frequency not reported: Hair loss, flushing, urticaria, pruritus, skin rash, angioedema, excessive sweating
A study evaluated the effect of long-term thyroid hormone therapy on bone mineral density in 196 women (mean age, 74.4 years) compared to a control group comprised of 795 women (mean age, 72.1 years). The mean daily thyroxine dose was 1.99 mcg/kg (range, 0.3 to 6.6 mcg/kg) with a mean duration of therapy of 20.4 years (range, less than 1 to 68 years). Women taking daily doses of 1.6 mcg/kg or more had significantly lower bone mineral density levels at the ultradistal radius, midshaft radius, hip, and lumbar spine compared to controls. However, estrogen use appeared to negate the adverse effects of thyroid hormone on bone mineral density.
Higher rates of femur fractures have been found in males (p=0.008) prescribed long-term thyroid hormone therapy as compared to controls in a case-control analysis of 23,183 patients, from the United Kingdom General Practice Research Database, prescribed thyroid hormone.
Overtreatment may result in craniosynostosis in infants and premature closure of the epiphyses in children with resultant compromised adult height.
Frequency not reported: Tremors, muscle weakness, muscle cramps, increased risk of osteoporosis, slipped capital femoral epiphysis (children)
Frequency not reported: Diarrhea, vomiting, abdominal cramps
Frequency not reported: Menstrual irregularities, impaired fertility
Hypersensitivity reactions have occurred; however, it has been attributed to the inactive ingredients. These reactions have included urticaria, pruritus, skin rash, flushing, angioedema, various GI symptoms (abdominal pain, nausea, vomiting and diarrhea), fever, arthralgia, serum sickness and wheezing. Hypersensitivity to levothyroxine itself is not known to occur.
Frequency not reported: Serum sickness, hypersensitivity to inactive ingredients
Frequency not reported: Increased appetite, weight loss
Frequency not reported: Autoimmune disorders (e.g., chronic autoimmune thyroiditis)
Frequency not reported: Fatigue, heat intolerance, fever
Frequency not reported: Nervousness, anxiety, irritability, emotional lability
Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/1/2020.
Source: Drugs.com Levothyroxine Sodium (www.drugs.com/levothyroxine.html).
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