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    3. L-Thyroxine-Farmak 25mcg, 2p x 50 tablets — Made in Ukraine — Free Delivery

    L-Thyroxine-Farmak 25mcg, 2p x 50 tablets — Made in Ukraine — Free Delivery


    Brand: Farmak
    Product Code: L-Thyroxine-Farmak 25mcg
    Availability: In Stock
    $20.72
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    Pharmachologic effect

    Thyroid hormone preparation. Synthetic levorotatory isomer of thyroxine. In small doses, it has anabolic effect. In medium doses, it stimulates growth and development, increases tissue oxygen demand, stimulates the metabolism of proteins, fats and carbohydrates, stimulates the activity of the cardiovascular system and the central nervous system. In high doses, it inhibits the production of TSHR of the hypothalamus and TSH of the pituitary gland.
    Pharmacokinetics
    After oral administration, it is absorbed from the gastrointestinal tract, absorption is 48-79%. Taking on an empty stomach increases the absorption of the active substance. Cmax in plasma is achieved after about 6 hours. Plasma protein binding (thyroxine-binding globulin, thyroxine-binding prealbumin and albumin) is more than 99%. Vd is 0.5 l / kg. Distribution occurs mainly in the liver, brain and muscles.
    In various tissues, monodeiodination of approximately 80% of sodium levothyroxine occurs with the formation of triiodothyronine (T3) and inactive products. A small amount of the active substance undergoes deamination and decarboxylation with the formation of tetraiodothyroacetic acid, as well as conjugation with sulfuric and glucuronic acids (in the liver).
    T1 / 2 is 6-7 days. About 15% is excreted by the kidneys and bile in unchanged form and in the form of conjugates.
    Indications of the active substances of the preparation L-Tyroxin-Farmak
    Hypothyroidism; euthyroid goiter; as replacement therapy and for the prevention of recurrence of goiter after resection of the thyroid gland; thyroid cancer (after surgery); diffuse toxic goiter: after reaching the euthyroid state with antithyroid preparations (in the form of combination or monotherapy); as a diagnostic tool when performing a thyroid suppression test.

    Dosage regimen

    The method of application and dosage regimen of a particular preparation depends on its form of release and other factors. The optimal dosage regimen is determined by the doctor. It is necessary to strictly observe the compliance of the used dosage form of a particular preparation with the indications for use and the dosage regimen.
    Set individually depending on the indications. Applied at a dose of 12.5-200 mcg 1 time / day 20-30 minutes before meals.
    When conducting a differential diagnostic test of thyroid suppression - once at a dose of 3 mg or within 2 weeks, 200 μg 1 time / day.

    Side effect

    Symptoms of hyperthyroidism: possible (when used in high doses, including when the dose is increased too quickly at the beginning of the course of treatment) tachycardia, palpitation, arrhythmias, angina attacks, headache, nervousness, tremor, sleep disturbances, feeling of internal anxiety, muscle weakness and cramps, weight loss, diarrhea, menstrual irregularities, vomiting.

    Contraindications for use

    Hypersensitivity to levothyroxine sodium; untreated thyrotoxicosis; acute myocardial infarction, acute myocarditis; untreated adrenal cortex insufficiency.
    With care: in diseases of the cardiovascular system - coronary artery disease (atherosclerosis, angina pectoris, myocardial infarction in history), arterial hypertension, arrhythmias; with diabetes mellitus, severe long-term hypothyroidism, malabsorption syndrome (dose adjustment may be required).
    Application during pregnancy and lactation
    During pregnancy and lactation (breastfeeding), levothyroxine sodium should be used with caution, strictly in recommended doses, under medical supervision.
    The use in combination with thyrostatic agents during pregnancy is contraindicated due to the increased risk of hypothyroidism in the fetus.
    Application in children
    It is possible to use in children according to indications in doses and dosage forms recommended according to age.
    Use in elderly patients
    In elderly patients and with prolonged hypothyroidism, treatment should be started gradually.

    special instructions

    Use with extreme caution in patients with cardiovascular diseases (including coronary artery disease, heart failure, arterial hypertension). In such cases, levothyroxine sodium should be used at a low initial dose, increasing it slowly and at long intervals.
    In hypothyroidism caused by damage to the pituitary gland, it is necessary to find out whether there is simultaneously an adrenal cortex insufficiency. In this case, GCS replacement therapy should be started before starting treatment for hypothyroidism with thyroid hormones in order to avoid the development of acute adrenal insufficiency.
    In elderly patients and with prolonged hypothyroidism, treatment should be started gradually.
    Use with caution in diabetes mellitus and diabetes insipidus.
    When conducting a differential diagnostic test of thyroid suppression, patients with diabetes mellitus are advised to increase the dose of antidiabetic agents.
    In some cases, thyroid hormones can cause or aggravate the previous myasthenic syndrome.

    Preparation interactions

    Levothyroxine sodium potentiates the action of indirect anticoagulants (coumarin derivatives), reduces the effectiveness of oral hypoglycemic agents.
    In patients with hypothyroidism and concomitant diabetes mellitus, at the beginning of replacement therapy with thyroid hormone preparations, an increase in the need for insulin or oral hypoglycemic agents is possible.
    Salicylates, dicumarin, furosemide (250 mg), clofibrate can displace levothyroxine from its connection with plasma proteins.
    Sucralfate, aluminum hydroxide, calcium carbonate reduce the absorption of levothyroxine from the gastrointestinal tract.
    Cholestyramine reduces the absorption of levothyroxine sodium from the gastrointestinal tract.
    When ritonavir is used, the need for levothyroxine may increase.
    With the use of sertraline in patients with hypothyroidism, it is possible to reduce the effects of levothyroxine sodium.
    With the rapid intravenous administration of phenytoin while taking levothyroxine sodium, an increase in the level of free levothyroxine in the blood plasma is possible, and arrhythmias may occur.
    With the simultaneous use of chloroquine, an increase in the metabolism of levothyroxine is possible, apparently due to the induction of microsomal liver enzymes by chloroquine. In patients receiving levothyroxine sodium, when using proguanil or chloroquine, an increase in TSH concentration is possible.
    The use of tricyclic antidepressants with levothyroxine sodium can lead to an increase in the effect of antidepressants.
    Levothyroxine sodium reduces the action of cardiac glycosides. With the simultaneous use of colestyramine, colestipol and aluminum hydroxide, the plasma concentration of sodium levothyroxine is reduced by inhibiting its absorption in the intestine.
    With simultaneous use with anabolic steroids, asparaginase, tamoxifen, pharmacokinetic interaction is possible at the level of protein binding.
    Growth hormone, when used simultaneously with sodium levothyroxine, can accelerate the closure of the epiphyseal growth zones.
    Taking phenobarbital, carbamazepine and rifampicin may increase the clearance of sodium levothyroxine and require an increase in the dose.
    Estrogens increase the concentration of the thyroglobulin-related fraction, which can lead to a decrease in the effectiveness of the preparation.
    Amiodarone, aminoglutethimide, para-aminosalicylic acid (PASK), ethionamide, antithyroid preparations, beta-blockers, chloral hydrate, diazepam, levodopa, dopamine, metoclopramide, lovastatin, somatostatin affect the synthesis, secretion, distribution and metabolism of sodium. Foods containing soy may reduce the absorption of levothyroxine sodium (dose adjustment may be required).

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