Levothyroxine sodium

Chemical name

О-(4-Гидрокси-3,5-дийодф��нил)-3,5-дийиод-L-тирози н sodium

Gross

C15-H10-I4-N-Na-O4

Of drugs

Drugs, the lack of complementary hormones the thyroid gland. The metabolic effects include retseptornoe linking a genome, changes oxidative exchange muthondriah and the flow of substrates and cations from outside and inside the cell. In small doses to anabolicescoe action in the middle-stimulated growth and development has increased the need tissues of oxygen, regulates the metabolism of proteins, fats and carbohydrates, increases the functional activity of the cardiovascular system and central nervous system, in the large-oppressing a tireotropin-rilizing and tireotroponogo gormonov.80% dose absorbed in thin intestine, Time to C_max about 6 hours Linking plasma protein-more than 99%. Metabolic Cl - 1.2 litres of plasma a day T_1/2 about eight days. Biotransformation is to deyodirovania (including places to education T_3) mainly in the liver, muscles and brain, as well as with kongugirovanii glukuronatom and sulfate in Pecheni.kliniceski effect of gipotireoze evident in 3-5 days. Early diffuse giperplasticeski protein decreases or disappears within 3-6 months in the late stages of terminal large object of the thyroid gland, only 30% of the cases, but almost all patients warned of further growth.

Indications

Gipotireoidnye of different etiology (including by surgical or medicinal effects), supressus tireoidnaya simple therapy (netoksicski) goitre autoimmune tireoidita Hashimoto, mnogouzlovy goitre tireostaticescoe treat hyperthyroidism (integrated therapy after eutireoidnyi state tireotropinzawisimae высокодифференцирова нные papillarnae or follikuliarnae cell thyroid (Integrated Management), the prevention of relapse weeks after POE, the supressing scintigraficski test the thyroid gland.

Contraindications

Hypersensitivity, nelecheny thyrotoxicosis, acute myocardial infarction, stenocardia, myocarditis, tahisistolicescie rhythm, heart failure, severe hypertension, neskorrigirovannoe violation of the crust napochechnikov, advanced age (over 65 years).

Side-Effects

Tachycardia, in rhythm, pain in the sternum, tremor, anxiety, insomnia, rash, lower body mass index, diarrhoea, alopecia, a violation of napochechnikov (with or gipofizarnom gipotalamicescom gipotireoze), disorders of the kidneys in children.

Patient interaction

Reduces effects of insulin and oral protivodiabeticakih drugs, cardiac glycosides, strengthens indirect anticoagulants, tricyclic antidepressants. Holestiramin, colestipol, aluminium hydroxide reduces plasma concentration at the expense of braking technique in the gut. Phenobarbital and phenytoin accelerating metabolic Cl, without increasing the free T_3 T_4 and in the blood. Estrogens increase the concentration of tireoglobulinom fraction (less effective). Protein binding change 25.06.1997, asparaginase, klofibrat, furosemide, salicilata, tamoxifen. The synthesis, secretion, distribution and metabolism influence amiodaron, aminoglutetimid, paraaminosalicilovaya acid, ethionamide, antitireoidnye preparations beta-adrenoblokatora, carbamazepine, hloralgidrat, diazepam, levodopa, dofamin, metoclopramide, lovastatin, somatostatin and others.

Overdosing

Symptoms : tireotoksicski kriz sometimes delayed for a few days after Priema.lechenie : appointment beta-adrenoblokatorov in / with a corticosteroid, plazmaferez.

Precautions

That the time in the blood of tireotroponogo hormone, the highest levels of which points to the lack of doses. Adequacy supressivna tireoidna therapy measured by the suppression of the seizure of radioactive iodine. The existing long-term mnogouzlovom zobe before treatment should be stimulaii test with tireotropin-rilizing hormone. In most cases, the gipotireoze metabolic status should recover gradually, especially in patients with the elderly and patients with heart problems. For older patients initial dose should not exceed 50 micrograms. In applying for II and III trimestrah pregnancy dose typically increase by 25%. Be wary appointed to the long-term plight of gipofunktion thyroid gland. Prior to the start of treatment to prevent or gipofizarnogo hypothalamic hypothyroidism.

Dosing and Administration

Inside, on the morning erh, squeezed small amounts of liquid. При гипотиреозе - начальная доза 25-100 мкг в сутки, с постепенным увеличением (на 25-50 мкг каждые 2-3 нед) до поддерживающей - 125-250 мкг в сутки, после операции по поводу злокачественной опухоли щитовидной железы - до 300 мкг в сутки.Детям - начальная доза 12,5-50 мкг, supporting 100-150 g in Sutki.pri combination treatment for hyperthyroidism, 5-100 µ g Sutki.dla in supressing the test, within 14 days, 200 µ g per day or 3 mg once every 7 days before re - �цинтиграммы.Эутиреои дный families and the prevention of relapse after POE : adult-popular vehicle per day, children 12,5-150 g per day.

Directory → Hormones and their antagonists → Hormones thyroid cancer, a month and antagonists (including antitireoidnye means) → Levothyroxine sodium