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Levoxyl (levothyroxine sodium)

Indications

• Hypothyroidism: Levoxyl is prescribed to treat an underactive thyroid (hypothyroidism) by supplementing the deficient thyroid hormone.
• Thyroid Hormone Replacement: Used as a replacement therapy in patients with thyroid hormone deficiency, such as after thyroid surgery or radiation treatment.
• Goiter: Helps reduce the size of an enlarged thyroid gland (goiter).
• Thyroid Cancer: Used as part of the treatment to suppress thyroid-stimulating hormone (TSH) in patients with thyroid cancer.

Dosage and Administration

• Take Levoxyl exactly as prescribed by your doctor.
• Take the tablet once daily, preferably in the morning on an empty stomach, at least 30 to 60 minutes before breakfast.
• Swallow the tablet whole with a full glass of water.
• Stick to a regular schedule for taking the medication to maintain consistent thyroid hormone levels.
• Have regular blood tests to monitor thyroid hormone levels and adjust the dosage as necessary.
• Do not switch brands or generic forms of levothyroxine without consulting your doctor, as different brands may not be equivalent.
• Avoid taking antacids, calcium, or iron supplements within 4 hours of taking Levoxyl, as they can interfere with its absorption.
• Do not abruptly stop taking Levoxyl without consulting your doctor, as this can worsen your condition.
• Avoid consuming grapefruit or grapefruit juice, which can affect the medication’s absorption.

Mechanism of Action

Levoxyl is a synthetic form of the thyroid hormone thyroxine (T4). It works by replacing the thyroid hormone that your body is unable to produce in sufficient quantities. Levothyroxine is converted to its active form, triiodothyronine (T3), in the body. T3 then binds to thyroid receptor proteins in the cell nucleus and regulates gene expression involved in controlling metabolism and energy production, thereby restoring normal thyroid hormone levels and improving symptoms of hypothyroidism.

Contraindications

• Allergy to Levothyroxine: Do not use if you have had an allergic reaction to levothyroxine or any other ingredients in Levoxyl.
• Thyrotoxicosis: Avoid use in patients with untreated thyrotoxicosis (overactive thyroid) as it can exacerbate the condition.
• Acute Myocardial Infarction: Not recommended for use during acute heart attacks.
• Adrenal Insufficiency: Untreated adrenal insufficiency must be corrected before starting Levoxyl.

Side Effects

Common Side Effects

• Weight loss
• Increased appetite
• Nervousness
• Tremor
• Excessive sweating
• Headache

Serious Side Effects

• Chest pain
• Rapid or irregular heartbeat
• Shortness of breath
• Severe allergic reactions (e.g., rash, itching, swelling, difficulty breathing)
• Seizures
• Severe headache

Precautions

• Heart Health: Inform your doctor of any history of heart disease, as levothyroxine can increase the workload on your heart.
• Bone Health: Long-term use may affect bone density; ensure adequate calcium and vitamin D intake.
• Diabetes: Monitor blood sugar levels closely, as levothyroxine can affect glucose control.
• Regular Monitoring: Regular blood tests are essential to ensure the correct dosage and to monitor thyroid function.
• Pregnancy and Breastfeeding: Dose adjustments may be necessary during pregnancy and breastfeeding; consult your doctor.

Storage Instructions

• Store Levoxyl tablets at room temperature between 20°C to 25°C (68°F to 77°F).
• Keep the tablets in their original container to protect them from light and moisture.
• Keep out of reach of children.

References

https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/021301s038lbl.pdf