L-Thyroxin 50 Berlin Chemie table No. 50
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Active ingredient: sodium levothyroxine - 0.05 mg.
Excipients: calcium hydrogen phosphate 2-water; microcrystalline cellulose; carboxymethyl starch sodium salt, type A; dextrin: long-chain partial glycerides.
Synthetic levogyrate isomer of thyroxine. After partial conversion to triiodothyronine (in the liver and kidneys) and transition to the cells of the body, it affects the development and growth of tissues, metabolism.
In small doses, it has an anabolic effect on protein and fat metabolism. In medium doses, it stimulates growth and development, increases tissue oxygen demand, stimulates the metabolism of proteins, fats and carbohydrates, increases the functional activity of the cardiovascular system and the central nervous system.
In large doses, it inhibits the production of thyrotropin-releasing hormone of the hypothalamus and thyroid-stimulating hormone of the pituitary gland.
The therapeutic effect is observed after 7-12 days, during the same time the effect persists after the drug is discontinued. The clinical effect in hypothyroidism appears after 3-5 days. Diffuse goiter decreases or disappears within 3-6 months.
When taken orally, levothyroxine is absorbed almost exclusively in the upper small intestine. Up to 80% of the taken dose of the drug is absorbed. Food intake reduces the absorption of levothyroxine.
The maximum serum concentration is reached approximately 5-6 hours after ingestion. After absorption, more than 99% of the drug binds to serum proteins (thyroxine-binding globulin, thyroxine-binding prealbumin and albumin).
In various tissues, monodeiodination of approximately 80% of levothyroxine occurs with the formation of triiodothyronine (T 3 ) and inactive products. Thyroid hormones are metabolized primarily in the liver, kidneys, brain and muscles.
A small amount of the drug undergoes deamination and decarboxylation, as well as conjugation with sulfuric and glucuronic acids (in the liver).
Metabolites are excreted in urine and bile. The half-life of the drug is 6-7 days. With thyrotoxicosis, the half-life is shortened to 3-4 days, and with hypothyroidism it is extended to 9-10 days.
Indications for use
- euthyroid goiter;
- as replacement therapy and for the prevention of recurrent goiter after resection of the thyroid gland;
- thyroid cancer (after surgery);
- diffuse toxic goiter: after reaching the euthyroid state with thyreostatics (in the form of combination or monotherapy);
- as a diagnostic tool in a thyroid suppression test.
- Increased individual sensitivity to the drug;
- Untreated thyrotoxicosis;
- Acute myocardial infarction, acute myocarditis;
- Untreated adrenal insufficiency.
The drug should be prescribed with caution in diseases of the cardiovascular system: coronary artery disease (atherosclerosis, angina pectoris, myocardial infarction in history), arterial hypertension, arrhythmias, diabetes mellitus, severe long-term hypothyroidism, malabsorption syndrome (dose adjustment may be required).
Method of administration and dosage
The daily dose is determined individually, depending on the indications. L-Thyroxine in a daily dose is taken orally in the morning on an empty stomach, at least 30 minutes before meals, with a small amount of liquid (half a glass of water) and without chewing.
When carrying out replacement therapy for hypothyroidism in patients under 55 years of age in the absence of cardiovascular diseases, L-Thyroxin is prescribed in a daily dose of 1.6-1.8 μg / kg of body weight; in patients over 55 years of age or with cardiovascular diseases - 0.9 μg / kg of body weight. In case of significant obesity, the calculation should be based on the "ideal weight".
|Initial stage of hypothyroidism replacement therapy|
|Patients without cardiovascular disease under 55||Initial dose:
women - 75-100 mcg / day,
men - 100-150 mcg / day
|Patients with cardiovascular disease or over 55 years old||• Initial dose - 25 mcg per day
• Increase by 25 mcg with an interval of 2 months until the level of TSH in the blood normalizes.
• If cardiac symptoms appear or worsen.
correction of cardiac therapy
|Recommended doses of thyroxine for the treatment of congenital hypothyroidism|
|Dose of thyroxine, calculated
per body weight (mcg / kg)
|10-16 years old||100-200||3-4|
|& gt; 16 years old||100-200||2-3|
(L-Thyroxin 50/75/100/125/150 BH, mcg / day)
|Treatment of euthyroid goiter||75-200|
|Prevention of relapse after surgical treatment of euthyroid goiter||75-200|
|In the complex therapy of thyrotoxicosis||50-100|
|Thyroid Cancer Suppressive Therapy||150-300|
|Thyroid Suppression Test||weeks
|75 mcg / day||75 mcg / day||150-200 mcg / day||150-200 mcg / day|
For the exact dosage of the drug, use the most appropriate dosage of the drug.
For infants, the daily dose of L-Thyroxine is given in one dose 30 minutes before the first feeding. The tablet is dissolved in water to a fine suspension, which is prepared immediately before taking the drug.
In patients with severe long-term hypothyroidism, treatment should be started with extreme caution, with low doses - from 25.0 μg / day, the dose is increased to a maintenance dose at longer intervals - by 25.0 μg / day every 2 weeks and often determine the level of TSH in the blood.
In hypothyroidism, L-Thyroxine is usually taken throughout life.
In case of thyrotoxicosis, L-Thyroxin is used in complex therapy with thyreostatics after reaching the euthyroid state. In all cases, the duration of drug treatment is determined by the doctor.
When used correctly under medical supervision, side effects are not observed.
With hypersensitivity to the drug, allergic reactions may occur.
At a temperature not higher than 25 ° C.
Keep the medicinal product out of the reach of children!
- Dosage form
- 50 mcg
- Levothyroxine sodium
- INN Russian
- Левотироксин натрия
- Russian title