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Thyrox 25mcg Tablet Pot
Thyrox contains Levothyroxine Sodium, a synthetic version of the naturally occurring hormone T4, secreted by the thyroid gland. In the body, around 30% of T4 is converted to the more active form, Triiodothyronine (T3). Most T4 binds to Thyroxine-Binding Globulin (TBG), prolonging its half-life. Only a tiny fraction (~0.03%) remains unbound and active.
Elimination half-life: 6–7 days (shorter in hyperthyroidism, longer in hypothyroidism).
Metabolism: Mainly in the liver with enterohepatic recycling.
A single daily dose is typically sufficient to maintain stable T3 levels.
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✅ Description:
- Used as replacement therapy in all forms of hypothyroidism except transient cases during recovery from subacute thyroiditis.
- For TSH suppression in patients with goitre, thyroid nodules, or post-treatment of thyroid cancer.
- To counteract the goitrogenic effects of certain medications, such as lithium.
- As a diagnostic agent in thyroid suppression testing.
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✔️ Side Effects
Usually linked to overdosage, mimicking hyperthyroidism:
- General: Weight loss, fatigue, heat intolerance, sweating
- CNS: Headache, insomnia, nervousness, anxiety
- Muscle: Tremors, weakness
- Cardiac: Palpitations, tachycardia, arrhythmias, increased BP
- GI: Diarrhea, vomiting, abdominal pain
- Skin: Hair thinning, flushing
- Respiratory: Shortness of breath
✔️ Dosage & Administration
Adults:
- Initial dose: 25–50 mcg/day, gradually increasing every 6–8 weeks in 12.5–25 mcg steps until TSH normalizes.
- Severe hypothyroidism: Start with 12.5–25 mcg/day and increase every 2–4 weeks with TSH monitoring.
- Secondary or tertiary hypothyroidism: Adjust dose to normalize free T4.
- Older adults or cardiac patients: 1.7 mcg/kg/day.
Pediatric:
- Newborns: 10–15 mcg/kg/day; use a lower dose if there's a cardiac risk.
- Infants/Children: Start with 25 mcg/day for severe cases, increase every 2–4 weeks as needed.
By age group:
0–3 months: 10–15 mcg/kg/day
3–6 months: 8–10 mcg/kg/day
6–12 months: 6–8 mcg/kg/day
1–5 years: 5–6 mcg/kg/day
6–12 years: 4–5 mcg/kg/day
12 years (growth/pubertal incomplete): 2–3 mcg/kg/day
After puberty: 1.7 mcg/kg/day
Dose adjustments should be based on clinical status and lab results.
✔️ Drug Interactions
- May enhance effects and toxicity of tricyclic antidepressants, increasing risk of arrhythmias and CNS stimulation.
- Sertraline may increase levothyroxine requirements.
- Can alter insulin or antidiabetic medication needs—monitor glucose levels closely.
- Digitalis effectiveness may be reduced as thyroid function improves.
✔️ Contraindications
- Untreated thyrotoxicosis
- Acute myocardial infarction
- Uncorrected adrenal insufficiency
✔️ Use in Pregnancy & Lactation
- Pregnancy Category A: Safe when clinically indicated; dosage may need adjustment.
- Minimal transfer to breast milk, but adequate dosing is essential for lactation and infant development.
✔️ Precautions
- Adrenal insufficiency should be addressed before starting therapy to avoid adrenal crisis.
- Use caution in cardiac patients and the elderly; avoid rapid dose escalation.
- Monitor for dosage adjustments if body weight changes significantly.
- TSH and free T4 should be monitored to maintain target levels and prevent overdose.
✔️ Storage:
Store below 30°C, in a dry, light-protected area.
Keep out of reach of children.
⚠️Disclaimer:
At ePharma, we’re committed to providing accurate and accessible health information. However, all content is intended for informational purposes only and should not replace medical advice from a qualified physician. Please consult your healthcare provider for personalized guidance. We aim to support, not substitute, the doctor-patient relationship.
