Drilldown: Medicines
Medicines > fda max 
:
4 g/d (rarely tolerated due to GI effects) or
40 mg/d typical; up to 240 mg/d for Zollinger-Ellison or
No fixed maximum; titrated to TSH target
:
4 g/d (rarely tolerated due to GI effects) or
40 mg/d typical; up to 240 mg/d for Zollinger-Ellison or
No fixed maximum; titrated to TSH target Use the filters below to narrow your results.
generic:
brand:
classes:
[[:Category:Antibacterials|Antibacterial]] (1) ·
[[:Category:Antisecretory_agents|Gastric acid suppressant]] (2) ·
[[:Category:Hormone_replacement|Hormone replacement]] (2) ·
[[:Category:Macrolide_antibiotics|Macrolide antibiotic]] (1) ·
[[:Category:Prokinetics|Prokinetic (off-label)]] (1) ·
[[:Category:Proton_pump_inhibitors|Proton pump inhibitor (PPI)]] (2) ·
[[:Category:Thyroid_hormones|Thyroid hormone]] (2)
mechanism:
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-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-00000117-QINU`"' Compared with omeprazole, pantoprazole has a more linear pharmacokinetic profile and is metabolized predominantly via CYP2C19 with CYP3A4 contribution; less CYP2C19-driven drug interaction with clopidogrel than omeprazole'"`UNIQ--ref-00000118-QINU`"'. (1) ·
'"`UNIQ--vote-000008E1-QINU`"' Like omeprazole, it is an acid-activated prodrug that covalently and irreversibly binds the H+/K+ ATPase. CYP2C19 PGx remains clinically relevant for both'"`UNIQ--ref-000008E2-QINU`"'. (1)
uses:
'"`UNIQ--vote-00000018-QINU`"', '"`UNIQ--vote-00000019-QINU`"' (1) ·
'"`UNIQ--vote-00000033-QINU`"', '"`UNIQ--vote-00000034-QINU`"', '"`UNIQ--vote-00000035-QINU`"' (1) ·
'"`UNIQ--vote-00000119-QINU`"', '"`UNIQ--vote-0000011A-QINU`"', '"`UNIQ--vote-0000011B-QINU`"', '"`UNIQ--vote-0000011C-QINU`"' (1) ·
'"`UNIQ--vote-000008E3-QINU`"', '"`UNIQ--vote-000008E4-QINU`"', '"`UNIQ--vote-000008E5-QINU`"', '"`UNIQ--vote-000008E6-QINU`"', '"`UNIQ--vote-000008E7-QINU`"' (1) ·
'"`UNIQ--vote-00000D38-QINU`"', '"`UNIQ--vote-00000D39-QINU`"', '"`UNIQ--vote-00000D3A-QINU`"', '"`UNIQ--vote-00000D3B-QINU`"', '"`UNIQ--vote-00000D3C-QINU`"', '"`UNIQ--vote-00000D3D-QINU`"' (1)
starting dose:
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) ·
20-40 mg PO once daily, 30-60 minutes before breakfast (1) ·
250-500 mg PO QID; 7.5-12.5 mg/kg IV q6h; topical and ophthalmic per formulation (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) ·
40 mg PO or IV once daily (1)
preparations:
15, 30, 60, 90, 120, 180, 240, 300 mg tablets (1/4 to 5 grains; 1 grain = 60 mg) (1) ·
20 mg, 40 mg delayed-release tablets; 40 mg IV vial; oral suspension 40 mg/packet (1) ·
20, 40 mg delayed-release capsules; 2.5, 5, 10, 20, 40 mg oral suspension packets; 20, 40 mg IV (1) ·
25, 50, 75, 88, 100, 112, 125, 137, 150, 175, 200, 300 mcg tablets; oral capsule and IV/IM also available (1) ·
250, 500 mg base or stearate tablets; ER tablets; ethyl succinate 200 mg/5 mL suspension; 500 mg, 1 g IV (lactobionate); 2% topical solution/gel; 0.5% ophthalmic ointment (1)
fda max: (Click arrow to add another value)
routes:
onset:
duration:
halflife:
T4 ~7 days; T3 ~1 day'"`UNIQ--ref-0000001A-QINU`"' (1) ·
~1 hour (plasma); pharmacodynamic effect persists 24+ hours'"`UNIQ--ref-0000011D-QINU`"' (1) ·
~1.5 hours (plasma); pharmacodynamic effect 24+ hours via target turnover'"`UNIQ--ref-000008E8-QINU`"' (1) ·
~1.5-2 hours'"`UNIQ--ref-00000D3E-QINU`"' (1) ·
~7 days (euthyroid); longer in hypothyroidism (~9-10 days), shorter in hyperthyroidism'"`UNIQ--ref-00000036-QINU`"' (1)
bioavailability:
40-80% (oral); reduced by food, calcium, iron, PPIs, fiber; take fasting with water'"`UNIQ--ref-00000037-QINU`"' (1) ·
Variable; reduced by food, calcium, iron, PPIs'"`UNIQ--ref-0000001B-QINU`"' (1) ·
~30-65% (oral; acid-labile, hence enteric-coated formulations; food affects absorption variably)'"`UNIQ--ref-00000D3F-QINU`"' (1) ·
~64-90% (oral; increases at higher doses and with multi-day dosing)'"`UNIQ--ref-000008E9-QINU`"' (1) ·
~77% (oral; not affected by food or antacids)'"`UNIQ--ref-0000011E-QINU`"' (1)
pregnancy:
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.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) ·
Generally considered safe; commonly used in pregnancy.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) ·
Generally considered safe; widely used in obstetric reflux.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</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) ·
Widely used in obstetric reflux; reassuring data.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1)
Showing below up to 5 results in range #1 to #5.