Sign (characteristic of thyrotoxicosis): palpitations, heart rhythm disturbances, heart pain, anxiety, tremor, sleep disturbance, increased sweating, increased appetite, decreased body weight, diarrhea.
Treatment: depending on the severity of the symptoms, it is recommended to reduce the daily dose of the drug, or interrupt treatment for several days or prescribe beta-blockers. After the disappearance of side effects, treatment should be started with caution with a lower dose.
Individual hypersensitivity to the drug, untreated thyrotoxicosis, acute myocardial infarction, angina pectoris of functional class III–IV, acute myocarditis, untreated adrenal insufficiency.
Diotroxin increases the effect of indirect anticoagulants (perhaps a decrease in their dose).
The use of tricyclic antidepressants with Diotroxin can lead to an increase in the action of antidepressants.
Thyroid hormones can increase the need for insulin and oral hypoglycemic drugs. More frequent control of blood sugar is recommended during the periods of starting treatment with the drug, as well as when the dosage mode changes.
Diotroxin reduces the effect of cardiac glycosides.
With the simultaneous use of colestiramine, colestipol and aluminum hydroxide, the plasma concentration of the drug is reduced by inhibiting its absorption in the intestine.
With simultaneous use with anabolic steroids, asparaginase, tamoxifen, pharmacokinetic interaction at the level of protein binding is possible.
With simultaneous use with phenytoin, salicylates, clofibrate, furosemide in large doses (250 mg), the content of thyroid hormones not bound to plasma proteins increases.
Taking estrogen-containing drugs increases the content of thyroxine-binding globulin, which may increase the need for Diotroxin in some patients. Somatotropin, when used simultaneously with Diotroxin, can accelerate the closure of epiphyseal growth zones.
Taking phenobarbital, carbamazepine and rifampicin may increase the clearance of levothyroxine and require an increase in the dose of Diotroxine.
Side effects are usually not observed when properly applied under the supervision of a doctor.
Possible-allergic reactions, progression of heart failure and angina pectoris.
Hypothyroidism of any genesis.
Euthyroid goiter.
Replacement treatment and prevention of recurrence of goiter after thyroid resection.
Thyroid cancer (after surgical treatment).
Levothyroxine. When ingested, levothyroxine is absorbed almost exclusively in the upper part of the small intestine. Absorbed up to 80% of the taken dose of the drug. Eating reduces the absorption of levothyroxine. Cmax in serum, it is achieved about 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, about 80% of levothyroxine is monodeodate with the formation of triiodothyronine and inactive products. Thyroid hormones are metabolized mainly 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 the urine and bile. You1/2 levothyroxine - 6-7 days. With thyrotoxicosis T1/2 shortens to 3-4 days, and with hypothyroidism lengthens to 9-10 days.
Liothyronine. Absorption by ingestion-95% (for 4 h). Plasma protein binding is high. You1/2 - 2.5 days.
Diotroxin
Levothyroxine Sodium, Liothyronine
Inside, at least 30 minutes before breakfast, without chewing and drinking enough liquid, once.
The daily dose is determined individually depending on the indications.
Hypothyroidism. Adults: initial dose - 1 table. per day, then it is possible to increase the dose by 1 table. every 2-4 weeks until the daily maintenance dose is reached-table 2-5.
Children: When selecting the dose with long-term treatment, the body weight, height and area of the child's body are taken into account. The average recommended maintenance dose is 2-2. 5 table. per day.
Euthyroid goiter. Adults: the initial dose - 1-2 table. per day, the maintenance dose — 3-6 table. per day.
Adolescents: the initial dose-1-1. 5 table. per day, the maintenance dose-2.5-3.5 table. per day.
Children: 0.5-1 table. per day.
Prevention of recurrence of goiter after surgical treatment: adults - 2-3 table. per day.
After surgical treatment for thyroid cancer: the initial dose - 3 table. per day, the maintenance dose is 6 tables. per day.
Taking the drug should be carried out regularly.
The duration of treatment is determined by the form of the disease. As a rule, with hypothyroidism and after a thyroidectomy for thyroid cancer, treatment is carried out throughout life. The duration of use of euthyroid goiter, as well as for the purpose of preventing the recurrence of goiter after surgical treatment, is several months or years before use throughout life.
