Thyroid Product

Uncorrected adrenal insufficiency; hypersensitivity to glycerol; acute myocardial infarction, acute myocarditis, or acute pancarditis <2021/6/11>

Levothyroxine is the preferred treatment of maternal hypothyroidism; other agents should not be used in pregnant females.
Close monitoring of pregnant patients is recommended.

Levothyroxine is present in breast milk. Should consider risk and benefit.

Hyperthyroidism due to therapeutic overdosage: Cardiac arrhythmia, Flushing, Tachycardia, Anxiety, Skin rash, Goiter, Weight loss, Abdominal cramps, Diarrhea, Vomiting, Reduced fertility, Dyspnea, Fever, Decrease bone mineral density

Doses should be adjusted based on clinical response and laboratory parameters; on a weight basis, dosing is higher in infants and children than adults due to the higher metabolic clearance.

Hypothyroidism:
1 to 3 months: 10-15 mcg/kg/dose QD; in severe cases (serum T4 <5 mcg/dL), initiating at higher doses (12-17 mcg/kg/dose) may be necessary
>3 to 6 months: 8-10 mcg/kg/dose QD
>6 to 12 months: 6-8 mcg/kg/dose QD
1 to 5 years: 5-6 mcg/kg/dose QD
6 to 12 years: 4-5 mcg/kg/dose QD
>12 years: 2-3 mcg/kg/dose QD

TSH suppresion:
Highly individualized; doses >2 mcg/kg/day may be needed to suppress TSH to <0.1 mU/L in high-risk tumors; for intermediate-risk tumors, initial TSH suppression to 0.1-0.5 mU/L is recommended; for low-risk tumors, TSH may be maintained at 0.5-1 mU/L

No dosage adjustment necessary (expert opinion).

There are no dosage adjustments provided in the manufacturer's labeling