#levoxyl

Common Brand Names: Levoxyl, Synthroid

Therapeutic Class: Thyroid hormone

Common Injectable Dosage Forms:

Powder for Reconstitution: 0.2 mg and 0.5 mg vials

Dosage Ranges:

Note: doses given are in oral form, IV/IM doses should be given at 50% of oral dose (adults and children).

Children: 2-15 mcg/kg/day, depending on weight and age. Severe or chronic hypothyroidism should be started at 25 mcg/day and adjusted by 25 mcg every 2-4 weeks.

Adults: 1.7 mcg/kg/day. Average starting dose is 100 mcg/day. In severe cases, 12.5-25 mcg/day to start and titrate up to 25 mcg every 2-4 weeks.

For subclinical hypothyroidism: 1 mcg/kg/day.

In thyroid cancer: Doses >2 mcg/kg/day may be necessary to suppress TSH to <0.1 mU/L. Elderly may require less.

For myxedema coma: 200-500 mcg IV the first day, then 100-300 mcg the next day if necessary. Use smaller doses in elderly and those with cardiovascular disease.

Administration and Stability: Dilute vials with 5 mL normal saline, shake well, and use immediately. Do not mix with other solutions. Vials should be stored at room temperature.

Pharmacology/Pharmacokinetics: The exact mechanism of action of levothyroxine is unknown. It is believed that thyroid hormone is involved in DNA transcription and protein synthesis, involved in normal metabolism, growth and development, promotes gluconeogenesis (increasing utilization and mobilization of glycogen stores), and stimulates protein synthesis, and increases basal metabolic rate. When given IV, onset is within 6-8 hours, while peak effect is in 24 hours. Half-life elimination is 3-10 days.

Drug and Lab Interactions: Levothyroxine may potentiate the hypoprothrombinemic effect of warfarin. When administered with tricyclic antidepressants, there is an increased potential for toxicity in both levothyroxine and TCAs. Coadministration with ketamine may cause hypertension and tachycardia. Many medications will decrease levothyroxine levels (phenytoin, phenobarbital, rifampin, etc.). Serum levels of digoxin and theophylline may be altered by thyroid function.

Contraindications/Precautions: Contraindicated in patients with a hypersensitivity to levothyroxine, a recent myocardial infarction, and uncorrected adrenal insufficiency. Use with caution and reduce dosage in patients with angina pectoris or other cardiovascular disease. Levothyroxine is an ineffective and potentially toxic drug for weight loss. High doses may cause serious toxic effects, particularly when used with some anorectic drugs. Pregnancy Category A.

Monitoring Parameters: Thyroid function test, heart rate, blood pressure, s/s hypo- or hyperthyroidism

Adverse Effects: Angina, arrhythmia, hypertension, cardiac arrest, flushing, heart failure, MI, increased pulse, and tachycardia have been reported to some degree. Also possible are anxiety, fatigue, fever, headache, hyperactivity, insomnia, irritability, and nervousness. LFTs may also be elevated. Other miscellaneous effects include heat intolerance, GI symptoms, rash/itching, and arthralgia.

Brand Names: Synthroid, Levoxyl, Levothroid

Generic Available

Common Dosage Forms:

Tablets: 25 mcg, 50 mcg, 75 mcg, 88 mcg, 100 mcg, 112 mcg, 125 mcg, 137 mcg, 150 mcg, 175 mcg, 200 mcg, 300 mcg

Injection: 200 mcg, 500 mcg per vial (following reconstitution)

Dosage equivalence: 0.1 mg L-thyroxine equals approximately 65 mcg thyroid, desiccated

FDA Indications/Dosages:

Replacement therapy for reduced or absent thyroid function of any etiology:

0-1 year of age: 9 mcg/kg/day.

1-5 years of age: 6 mcg/kg/day.

6-10 years of age: 4 mcg/kg/day.

11-20 years of age: 3 mcg/kg/day.

Adults: 25-300 mcg orally once per day.

Myxedema coma or stupor (without severe heart disease: 200-500 mcg intravenously on the first day. Give 100-300 mcg intravenously on the second day. Give 50-100 mcg intravenously on subsequent days. Do not add to other intravenous fluids.

Monitor: TSH

Pharmacology/Pharmacokinetics: The exact mechanism of action for L-thyroxine is unknown although it is thought to be due to protein synthesis control resulting in: (1) a regulation of growth and development; (2) an increase in metabolic rate; (3) inhibition of the secretion of thyrotropin by the pituitary; (4) various effects on lipid and carbohydrate metabolism. Synthetic T4 is similar to that produced in the human thyroid gland. 99% is bound to plasma proteins.

Drug Interactions: May increase the effects of oral anticoagulants. Cholestyramine may decrease the absorption of levothyroxine. May decrease the effectiveness of digitalis glycosides.

Contraindications/Precautions: Use is relatively contraindicated in patients with diagnosed by as yet uncorrected adrenal cortical insufficiency, untreated thyrotoxicosis, and in patients with acute myocardial infarction. NOT FOR THE TREATMENT OF OBESITY OR FOR WEIGHT LOSS. Use with caution in nursing mothers, in patients with cardiovascular disorders (such as angina pectoris), hypopituitarism, or diabetes, and in patients currently taking oral anticoagulants. Pregnancy Category A.

Adverse Effects: Adverse effects other than those indicative of overdosage are rare. Overdosage can result in hypermetabolic states resembling those of endogenous origin. Effects include fever, hypoglycemia, heart failure, fluid loss, tachycardia, anxiety, and insomnia.

Patient Consultation:

Do not discontinue therapy without first consulting a physician.

Take on an empty stomach, one hour before or two hours following a meal.

Notify a physician if signs of hyperthyroidism (overdosage) occur.

Transient loss of hair may be seen in children, but recovery usually occurs.

Store in a cool, dry place away from sunlight and children.

Levoxyl Market report published by Value Market Research delivers a comprehensive market analysis covering of market size, share, value, growth and trends for the forecast period of 2020-2026. The report includes data regarding market attractiveness analysis by segments, company share analysis and recent developments by key players. Moreover, this market report also covers regional and country market analysis in detail.

The research report also covers the comprehensive profiles of the key players in the market and an in-depth view of the competitive landscape worldwide. The major players in the levoxyl market include Abbvie, Mylan, Merck, King Pharmaceuticals (Pfizer), Lannett Company, Novartis, Fresenius Kabi, IBSA, Piramal Critical Care, Abbott, Jerome Stevens. This section includes a holistic view of the competitive landscape that includes various strategic developments such as key mergers & acquisitions, future capacities, partnerships, financial overviews, collaborations, new product developments, new product launches, and other developments.

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Market Dynamics

Rising hypothyroidism and growing awareness about the harmful effects of low thyroid hormone levels on human metabolism will be the driving forces for this market’s growth. The Increasing popularity of eCommerce channels for prescription medicines will provide lucrative opportunities for market growth. Increased collaborations between private and public organizations to spread awareness about hypothyroidism and implement promotional strategies to market the drug will further propel market growth. Growing research and development activities in the field of novel therapeutics, diagnostics, and to increase the efficacy of drugs will boost the market growth. The only roadblock to the growth of this market is the side-effects when taking Levoxyl.   The report covers Porter’s Five Forces Model, Market Attractiveness Analysis and Value Chain analysis. These tools help to get a clear picture of the industry’s structure and evaluate the competition attractiveness at a global level.   Additionally, these tools also give inclusive assessment of each application/product segment in the global market of levoxyl.

Browse Global Levoxyl Market Research Report with detailed TOC at https://www.valuemarketresearch.com/report/levoxyl-market

Market Segmentation

The entire levoxyl market has been sub-categorized into type and application. The report provides an analysis of these subsets with respect to the geographical segmentation. This research study will keep marketer informed and helps to identify the target demographics for a product or service.   By Type

Oral

Injection

By Application

Hospitals

Pharmacy

Others

Regional Analysis

This section covers regional segmentation which accentuates on current and future demand for aerosol valve market across North America, Europe, Asia-Pacific, Latin America, and Middle East & Africa. Further, the report focuses on demand for individual application segment across all the prominent regions.

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I had a little bit of a meltdown while getting ready for work. Nothing really brought it on, I was just in the shower and suddenly my body is like- LET'S HAVE A GOOD CRY.

I had been off my Levoxyl for a couple weeks and I've been back on it for about a week and a half now. I was talking to my friend about said meltdown and she said this happened to me when I was first diagnosed. All the hormones getting into my system, and just every day stress caught up to me. 

So I sat in my bathtub and cried as I attempted to wash my hair properly.