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Levoxyl 100mcg Tablet
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Indications & Clinical Uses
- Levoxyl 100mcg tablets contain levothyroxine sodium, a synthetic form of the thyroid hormone T4.
- Levoxyl is indicated as replacement therapy in hypothyroidism of any cause, whether primary (thyroid), secondary (pituitary) or tertiary (hypothalamic), in adults and children, and as an adjunct to surgery and radioiodine to suppress thyroid-stimulating hormone in well-differentiated thyroid cancer.
- Levoxyl carries a BOXED WARNING that thyroid hormones, including Levoxyl, must not be used for the treatment of obesity or for weight loss; in people with normal thyroid function they do not cause weight loss, and larger doses can cause serious or life-threatening toxicity, particularly with appetite-suppressant drugs.
- Levothyroxine has a narrow therapeutic index, and different levothyroxine products are not automatically interchangeable, so never switch brand or manufacturer without telling your healthcare provider.
- Tablets are supplied from 25 mcg to 200 mcg.
Side Effects
- At the correct dose, Levoxyl (levothyroxine) simply replaces a missing hormone and causes few side effects.
- Almost all unwanted effects are signs of too much thyroid hormone: palpitations, a fast or irregular heartbeat, chest pain, nervousness, tremor, poor sleep, sweating, heat intolerance, muscle weakness, diarrhoea, unexplained weight loss and menstrual irregularity.
- Children may become restless or, rarely, lose some hair in the first months.
- Levoxyl carries a BOXED WARNING against use for obesity or weight loss, because toxic doses can be life-threatening.
- Levoxyl tablets have specifically been associated with reports of choking, gagging, a tablet sticking in the throat and difficulty swallowing, mostly when the tablet was not taken with water.
- Report palpitations, chest pain or a racing heart to your healthcare provider promptly, and tell them if swallowing becomes difficult.
Precautions & Warnings
- Take Levoxyl once daily on an empty stomach, half an hour to one hour before breakfast, with a full glass of water to avoid choking or gagging.
- Levoxyl must not be used in uncorrected adrenal insufficiency, which has to be treated first.
- Because levothyroxine has a narrow therapeutic index, thyroid-stimulating hormone and free T4 are checked about 6 to 8 weeks after starting treatment or changing a dose, and more often in pregnancy.
- Do not substitute another levothyroxine brand or generic without repeating those blood tests.
- Use lower starting doses and extra caution in older people and anyone with heart disease, because over-replacement can trigger angina or abnormal heart rhythms.
- Long-term over-treatment lowers bone density.
- Levothyroxine is needed during pregnancy and the dose usually has to rise.
- Store at 20°C to 25°C, away from heat, moisture and light.
Avoid Interactions
- Many medicines reduce Levoxyl absorption and so weaken its effect: calcium carbonate, iron salts, antacids containing aluminium or magnesium, sucralfate, proton pump inhibitors, sevelamer and the bile acid sequestrants cholestyramine and colesevelam.
- Separate all of these from your Levoxyl dose by at least four hours.
- Soybean products, walnuts, dietary fibre and coffee taken at the same time also reduce absorption.
- Oestrogens raise thyroxine-binding globulin and increase the dose you need, while phenytoin, carbamazepine, rifampicin and phenobarbital speed levothyroxine breakdown.
- Levoxyl increases the response to warfarin and other oral anticoagulants, so clotting tests must be repeated.
- It also alters blood sugar control, so insulin or oral diabetes medicine doses may need adjusting.
- Tell your healthcare provider about every medicine, vitamin and supplement you take, including biotin, which can distort thyroid blood test results.
References
Frequently Asked Questions
Levoxyl 100mcg (levothyroxine sodium) replaces the thyroid hormone T4 in people with an underactive thyroid from any cause, in adults and children. It is also used with surgery or radioiodine to suppress thyroid-stimulating hormone in well-differentiated thyroid cancer. It is taken once every day, usually long term.
Take Levoxyl (levothyroxine) once daily on an empty stomach, half an hour to one hour before breakfast, with a full glass of water. The water matters: Levoxyl tablets have caused choking, gagging and tablets sticking in the throat when swallowed with too little liquid.
Most Levoxyl (levothyroxine) side effects are signs the dose is too high: palpitations, fast or irregular heartbeat, chest pain, tremor, nervousness, sweating, heat intolerance, diarrhoea, weight loss and poor sleep. Report chest pain or a racing heart promptly. Long-term over-treatment can weaken bones.
Never use Levoxyl (levothyroxine) for weight loss. That is a boxed warning, and high doses can be toxic or life-threatening. Separate calcium, iron, antacids, sucralfate, proton pump inhibitors and cholestyramine from your dose by four hours. Soya, walnuts, high-fibre food and coffee also block absorption.
Not without checking first. Levothyroxine has a narrow therapeutic index and Levoxyl is not automatically interchangeable with other levothyroxine tablets, so ask your healthcare provider. If you do switch, thyroid-stimulating hormone and free T4 should be retested about 6 to 8 weeks later to confirm the dose.
Thyroid-stimulating hormone and free T4 are checked about 6 to 8 weeks after starting Levoxyl (levothyroxine) or after any dose change, then periodically once you are stable. Testing is more frequent in pregnancy, when the dose usually needs to rise. Tell the laboratory if you take biotin supplements.
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