Lilly launches additional Zepbound vial doses and offers new savings for self-pay patients Eli Lilly and Company

Use the serum free-T4 level to titrate SYNTHROID dosing until the patient is clinically euthyroid and the serum free-T4 level is restored to the upper half of the normal range. In adult patients with primary hypothyroidism, monitor serum TSH levels after an interval of 6 to 8 weeks after any change in dosage. In patients on a stable and appropriate replacement dosage, evaluate clinical and biochemical response every 6 to 12 months and whenever there is a change in the patient’s clinical status. Myxedema coma is a life-threatening emergency characterized by poor circulation and hypometabolism and may result in unpredictable absorption of levothyroxine sodium from the gastrointestinal tract. Use of oral thyroid hormone drug products is not recommended to treat myxedema coma.

Patient Counseling Information

• If so, advise them to stop biotin supplementation at least 2 days before assessing TSH and/or T4 levels see Dosage and Administration (2.4) and Drug Interactions (7.10).
• Stop using Zepbound and call your healthcare provider right away if you have severe pain in your stomach area (abdomen) that will not go away, with or without vomiting.
• Your child’s dose needs may change if the child gains or loses weight.

We anticipate reposting the images once we are able identify and filter out images that do not match the information provided in the drug labels. You may be more likely to have a broken bone while using levothyroxine. You should not use levothyroxine if you are allergic to glycerin or edetate disodium, or if you have an untreated or uncontrolled adrenal gland disorder. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Synthroid only for the indication prescribed. Enter medications to view a detailed interaction report using our Drug Interaction Checker. Do not share this medicine with another person, even if they have the same symptoms you have.

Intravenous levothyroxine

Take levothyroxine tablets and capsules on an empty stomach, at least 30 to 60 minutes before breakfast with a full glass of water. Synthroid (levothyroxine) treats hypothyroidism (low thyroid hormone) and different types of … You may not be able to take Synthroid if you have certain medical conditions. Tell your doctor if you have an untreated or uncontrolled adrenal gland disorder, a thyroid disorder called thyrotoxicosis, or if you have any recent or current symptoms of a heart attack. Evaluate the need for dosage adjustments when regularly administering within one hour of certain foods that may affect SYNTHROID absorption. Adequate therapy usually results in normal TSH and T4 levels after 2 to 3 weeks of therapy.

Food or liquid getting into the lungs during surgery or other procedures that use anesthesia or deep sleepiness (deep sedation). Zepbound may increase the chance of food getting into your lungs during surgery or other procedures. Tell all your healthcare providers that you are taking Zepbound before you are scheduled to have surgery or other procedures. Stop using Zepbound and call your healthcare provider right away if you have severe pain in your stomach area (abdomen) that will not go away, with or without vomiting. Concurrent use of ketamine and SYNTHROID may produce marked hypertension and tachycardia. Closely monitor blood pressure and heart rate in these patients.

Familial hyper- or hypo-thyroxine binding globulinemias have been described, with the incidence of TBG deficiency approximating 1 in 9000. Follow all directions on your prescription label and read all medication guides or instruction sheets. Taking more than your recommended dose will not make this medicine more effective, and may cause serious side effects. Levothyroxine injection is used in adults to treat myxedema coma. It may take several weeks before your body starts to respond to Synthroid. Do not store the crushed tablet/water mixture and do not administer it mixed with foods that decrease absorption of levothyroxine, such as soybean-based infant formula.

Concurrent use of tricyclic (e.g., amitriptyline) or tetracyclic (e.g., maprotiline) antidepressants and SYNTHROID may increase the therapeutic and toxic effects of both drugs, possibly due to increased receptor sensitivity to catecholamines. Toxic effects may include increased risk of cardiac arrhythmias and central nervous system stimulation. Administration of sertraline in patients stabilized on SYNTHROID may result in increased SYNTHROID requirements. Many drugs can exert effects on thyroid hormone pharmacokinetics and metabolism (e.g., absorption, synthesis, secretion, catabolism, protein binding, and target tissue response) and may alter the therapeutic response to SYNTHROID (Tables 5 to 8). Thyroid hormone increases metabolic clearance of glucocorticoids.

• Administration of thyroid hormone in doses higher than those produced physiologically by the gland results in suppression of the production of endogenous hormone.
• The recommended maintenance dosages are 5 mg, 10 mg or 15 mg injected subcutaneously once weekly.
• Do not administer in foods that decrease absorption of SYNTHROID, such as soybean-based infant formula see Drug Interactions (7.9).
• Oral levothyroxine sodium is a synthetic T4 hormone that exerts the same physiologic effect as endogenous T4, thereby maintaining normal T4 levels when a deficiency is present.
• Tell your healthcare provider if you are taking other medicines to treat diabetes, including sulfonylureas or insulin.

Dosage Forms & Strengths

Consider changes in TBG concentration when interpreting T4 and T3 decongestant synthroid values. Measure and evaluate unbound (free) hormone and/or determine the free-T4 index (FT4I) in this circumstance. Pregnancy, infectious hepatitis, estrogens, estrogen-containing oral contraceptives, and acute intermittent porphyria increase TBG concentration. Nephrosis, severe hypoproteinemia, severe liver disease, acromegaly, androgens, and corticosteroids decrease TBG concentration.

Pediatric Dosage

Triiodothyronine (T3) and L-thyroxine (T4) diffuse into the cell nucleus and bind to thyroid receptor proteins attached to DNA. This hormone nuclear receptor complex activates gene transcription and synthesis of messenger RNA and cytoplasmic proteins. Seizures have been reported rarely with the institution of levothyroxine therapy.

The appearance of angina is an indication for a reduction in dosage. In acute, emergency conditions, injectable levothyroxine sodium (T4) may be given intravenously when oral administration is not feasible or desirable, as in the treatment of myxedema coma, or during total parenteral nutrition. Intramuscular administration is not advisable because of reported poor absorption. The dosage of thyroid hormones is determined by the indication and must in every case be individualized according to patient response and laboratory findings. Concurrent use of sympathomimetics and SYNTHROID may increase the effects of sympathomimetics or thyroid hormone. Thyroid hormones may increase the risk of coronary insufficiency when sympathomimetic agents are administered to patients with coronary artery disease.

Additionally, Zepbound is FDA-approved to treat adults with moderate-to-severe obstructive sleep apnea and obesity. Zepbound should be used with a reduced-calorie diet and increased physical activity. It should not be used in children under 18 years of age or with other tirzepatide-containing products or any GLP-1 receptor agonist medicines. Absorption of orally administered T4 from the gastrointestinal tract ranges from 40% to 80%. The majority of the SYNTHROID dose is absorbed from the jejunum and upper ileum.