Drilldown: Medicines

Benzonatate (1) · Cefdinir (1) · Guaifenesin (1) · Levothyroxine (1) · Thyroid (desiccated) (1)

Armour Thyroid, NP Thyroid, Nature-Throid, WP Thyroid (1) · Mucinex, Robitussin, Tussin (1) · Omnicef (discontinued in US under brand); mostly generic (1) · Synthroid, Levoxyl, Tirosint, Unithroid, Euthyrox (1) · Tessalon, Zonatuss (1)

[[:Category:Antitussives|Antitussive]] (1) · [[:Category:Beta-lactam_antibiotics|β-lactam antibiotic]] (1) · [[:Category:Cephalosporins|Cephalosporin (third-generation)]] (1) · [[:Category:Expectorants|Expectorant]] (1) · [[:Category:Hormone_replacement|Hormone replacement]] (2) · [[:Category:Mucolytics|Mucolytic]] (1) · [[:Category:Thyroid_hormones|Thyroid hormone]] (2)

None (1) · Synthetic T4 (thyroxine); peripherally deiodinated to T3 (triiodothyronine), the active hormone. '"`UNIQ--vote-00000031-QINU`"' Narrow therapeutic index; brand-to-generic switches can shift TSH and require re-titration'"`UNIQ--ref-00000032-QINU`"'. (1) · '"`UNIQ--vote-00000015-QINU`"' Pediatric ingestion (capsule chewed or punctured) releases the free local anesthetic and causes seizures, cardiac arrhythmia, and death'"`UNIQ--ref-00000016-QINU`"'. (1) · '"`UNIQ--vote-00000016-QINU`"' Brand-to-brand and lot-to-lot variability in T3:T4 ratio is greater than with synthetic levothyroxine, which is why endocrine guidelines prefer the synthetic'"`UNIQ--ref-00000017-QINU`"'. (1) · '"`UNIQ--vote-0000104D-QINU`"' Adequate hydration is at least as important as the drug in producing the expectorant effect clinically. Used in combination with dextromethorphan, decongestants, or antihistamines in many proprietary OTC cold preparations. (1)

'"`UNIQ--vote-00000017-QINU`"' (1) · '"`UNIQ--vote-00000018-QINU`"', '"`UNIQ--vote-00000019-QINU`"' (1) · '"`UNIQ--vote-00000033-QINU`"', '"`UNIQ--vote-00000034-QINU`"', '"`UNIQ--vote-00000035-QINU`"' (1) · '"`UNIQ--vote-000009DF-QINU`"', '"`UNIQ--vote-000009E0-QINU`"', '"`UNIQ--vote-000009E1-QINU`"', '"`UNIQ--vote-000009E2-QINU`"', '"`UNIQ--vote-000009E3-QINU`"' (1) · '"`UNIQ--vote-0000104E-QINU`"', '"`UNIQ--vote-0000104F-QINU`"' (1)

1.6 mcg/kg/d in young healthy adults; 25-50 mcg/d in elderly or cardiac disease, titrated by TSH at 6-8 weeks (1) · 100-200 mg PO TID (max 600 mg/d) (1) · 200-400 mg PO q4h (IR); 600-1200 mg PO q12h (Mucinex 12-Hour ER) (1) · 30 mg PO daily (1/2 grain); titrate by TSH at 6-8 weeks; 60 mg desiccated thyroid is approximately equivalent to 88-100 mcg levothyroxine (1) · 300 mg PO BID, or 600 mg PO once daily, ×5-10 days; pediatric 14 mg/kg/d (1)

100, 150, 200 mg liquid-filled capsules ("perles") (1) · 100, 200, 400 mg IR tablets; 600 mg, 1200 mg Mucinex ER tablets; many liquid formulations and combination products with dextromethorphan, pseudoephedrine, antihistamines (1) · 15, 30, 60, 90, 120, 180, 240, 300 mg tablets (1/4 to 5 grains; 1 grain = 60 mg) (1) · 25, 50, 75, 88, 100, 112, 125, 137, 150, 175, 200, 300 mcg tablets; oral capsule and IV/IM also available (1) · 300 mg capsules; 125, 250 mg/5 mL suspension (1)

None · Indication-specific · 40 mg/d · 10 mg/d · 20 mg/d · 80 mg/d · 10 mg/d (adults) · 100 mg/d · 4 g/d · 400 mg/d · 40 mg/d typical; up to 240 mg/d for Zollinger-Ellison · 5 mg/d · 50 mg/d · 600 mg/d · No fixed ceiling; titrate to clinical effect and tolerability with CDC opioid prescribing guidance constraints on morphine-milligram-equivalent (MME) totals · No fixed maximum; titrated to TSH target · TID per eye · Titrated to glucose; no fixed ceiling · Titrated to glucose; no fixed maximum · '''20 mg/day in adults >60 years''' per FDA's 2011-2012 QT-prolongation warning; 40 mg/day in adults ≤60

Other values:

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IV (1) · Oral (4) · Oral (swallow whole) (1)

15-20 minutes (1) · 30 minutes (1) · Hours (1) · TSH normalization 4-8 weeks (1) · TSH normalization 4-8 weeks; symptomatic improvement weeks to months (1)

12-24 hours (1) · 3-8 hours (1) · 4 hours (IR); 12 hours (ER) (1) · Steady-state at 4-6 weeks (2)

Not well characterized'"`UNIQ--ref-00000018-QINU`"' (1) · T4 ~7 days; T3 ~1 day'"`UNIQ--ref-0000001A-QINU`"' (1) · ~1 hour'"`UNIQ--ref-00001050-QINU`"' (1) · ~1.7 hours'"`UNIQ--ref-000009E4-QINU`"' (1) · ~7 days (euthyroid); longer in hypothyroidism (~9-10 days), shorter in hyperthyroidism'"`UNIQ--ref-00000036-QINU`"' (1)

16-21% capsule, 25% suspension (oral; iron and antacids reduce absorption substantially)'"`UNIQ--ref-000009E5-QINU`"' (1) · 40-80% (oral); reduced by food, calcium, iron, PPIs, fiber; take fasting with water'"`UNIQ--ref-00000037-QINU`"' (1) · High (oral)'"`UNIQ--ref-00001051-QINU`"' (1) · Not well characterized'"`UNIQ--ref-00000019-QINU`"' (1) · Variable; reduced by food, calcium, iron, PPIs'"`UNIQ--ref-0000001B-QINU`"' (1)

First-line in pregnancy; dose typically increased 25-30% due to estrogen-driven rise in TBG and fetal demand. Lactation safe at physiologic doses.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Generally considered acceptable.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Generally considered safe in pregnancy.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Limited human data; animal reproductive studies not conducted<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Synthetic levothyroxine is the standard-of-care in pregnancy; desiccated thyroid use in pregnancy is not well studied.'"`UNIQ--ref-0000001C-QINU`"' (1)

OTC in US (1) · [[USLegal:Prescription only|Rx-only]] in US (4)