Used for thyroid replacement therapy in hypothyroid patients
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Prototype Med
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Levothyroxine (Synthroid)
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Other Meds
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liothyroxine (Cytomel)
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liotrix (Thyrolar)
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Thyroid USP
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Hypothyroidism
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Thyrotoxicosis, Hyperthyroidism (from excessive doses)
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Headache, irritability, insomnia
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Abdominal cramping, diarrhea
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Tachycardia, arrhythmia
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Heat intolerance, diaphoresis
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Menstrual irregularities
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Monitor thyroid function
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Monitor for indications of hyperthyroidism (anxiety, tachycardia, palpi- tations, tremors, altered appetite, heat intolerance, fever, diaphoresis, weight loss)
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Watch for and report nervousness, rapid heart rate, palpitations, trem- ors, altered appetite, heat intolerance, fever, sweating, weight loss, and chest pain.
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Thyrotoxicosis
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Recent myocardial infarction
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Cardiovascular disorders (hypertension, angina pectoris, ischemic heart disease)
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Renal impairment
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Diabetes mellitus
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Older adults
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Give orally to treat hypothyroidism and IV to treat myxedema coma.
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Give daily on an empty stomach (at least 30–60 min before breakfast with full glass of water).
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Measure baseline vital signs, weight, and height, and monitor periodical- ly thereafter.
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Monitor for cardiac excitability (angina, chest pain, palpitations, dys- rhythmias).
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Monitor T4 and TSH levels.
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Be aware that the various formulations of thyroxine are not inter- changeable; instruct clients to notify the provider if a pharmacy dispens- es a different levothyroxine product.
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Expect lifelong replacement therapy.
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Cholestyramine (Questran), antacids, iron and calcium supplements, and sucralfate (Carafate) reduce absorption, so clients should not take levothyroxine within 4 hr of these drugs
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Food reduces absorption
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Many antiseizure and antidepressant drugs, including carbamazepine (Tegretol), phenytoin (Dilantin), phenobarbital, and sertraline (Zoloft), decrease levels.
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Anticoagulant effects of warfarin (Coumadin) increase.
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Cardiac response to catecholamines (such as epinephrine) increases.
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