Taking with a full glass of water reduces the risk for this problem in most patients. Levothyroxine tablets may rapidly disintegrate reports exist of choking, gagging, dysphagia, and tablets being stuck in the throat. Reports exist of choking, gagging, dysphagia, and tablets getting stuck in the throat. Instruct patients to take tablets with a full glass of water. The capsules cannot be dissolved in water.Īdminister the capsule with a full glass of water to ease swallowing. The patient must swallow the capsules whole. Do not administer capsules to patients that cannot swallow the intact capsule. Conversely, if a patient is stabilized on IV or IM dosage, when it is time to convert back to oral dosage, many clinicians use an initial 20% to 25% increase in the IV or IM dosage to convert to an initial oral dosage, with subsequent dosage titration based on clinical and laboratory status to individualize dose and achieve euthyroidism.Īdminister whole. Differences in absorption characteristics of patients and how they take their oral medication necessitate the use of TSH measurements a few weeks after initiating therapy to ensure proper dose adjustments. Based on medical practice, the relative bioavailability between oral and IV administration is estimated to be 48% to 74%. Some patients may need titration after this initial dosage selection to maintain euthyroid status. Īccording to guidelines for the treatment of hypothyroidism, the equivalent IV dose is approximately 75% of the previously established oral dosage, assuming the enteral levothyroxine dose had achieved euthyroidism. Inadequate response to more than 300 mcg/day may indicate poor compliance, malabsorption, drug interactions, or a combination of these factors. Rare patients may require up to 300 mcg/day PO. Adult Max: Greater than 200 mcg/day PO is rarely required. For mild hypothyroidism (TSH less than 10 mIU/L), initiate at 1 mcg/kg/day PO. PREGNANT WOMEN WITH NEW-ONSET HYPOTHYROIDISM: For moderate to severe signs and symptoms, initiate at full replacement dosage of roughly 1.6 mcg/kg/day PO. PATIENTS WITH SEVERE LONGSTANDING HYPOTHYROIDISM: Initially, 12.5 to 25 mcg/day PO with increases of 12.5 to 25 mcg/day every 2 to 4 weeks until at effective target dose. The full replacement dose may be less than 1 mcg/kg/day PO in geriatric patients. GERIATRIC PATIENTS OR IF CARDIAC DISEASE PRESENT: Initiate with 12.5 to 25 mcg PO once daily with gradual (12.5 to 25 mcg) increments at 6 to 8-week intervals as needed. Adjust the dose by 12.5 mcg to 25 mcg increments every 4 to 6 weeks until desired response. IF OTHERWISE HEALTHY: May initiate at full replacement dosage of roughly 1.6 mcg/kg/day PO.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |