Do not take an antacid or a product that has iron or calcium in it within 4 hours of taking levothroid.
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Levothyroxine has a narrow therapeutic indexRegardless of the indication for usecareful dosage titration is necessary to avoid the consequences of overor under-treatmentThese consequences includeamong otherseffects on growth and developmentcardiovascular functionbone metabolismreproductive functioncognitive functionemotional stategastrointestinal functionand on glucose and lipid metabolismMany drugs interact with levothyroxine sodiumnecessitating adjustments in dosing to maintain therapeutic responsesee Drug Interactions
Circulating thyroid hormones are greater than 99bound to plasma proteinsincluding thyroxine-binding globulinTBGthyroxine-binding prealbuminTBPAand albuminTBAwhose capacities and affinities vary for each hormoneThe higher affinity of both TBG and TBPA for T 4 partially explains the higher serum levelsslower metabolic clearanceand longer half-life of T 4 compared to T 3Protein-bound thyroid hormones exist in reverse equilibrium with small amounts of free hormoneOnly unbound hormone is metabolically activeMany drugs and physiologic conditions affect the binding of thyroid hormones to serum proteinssee PRECAUTIONSDrug Interactions and Drug-Laboratory Test InteractionsThyroid hormones do not readily cross the placental barriersee PRECAUTIONSPregnancy
If neededlevothyroxine tablets can be crushed and mixed in 1 to 2 teaspoons of plain waterThis mixture must be taken right away.
Get emergency medical help if you have signs of an allergic reactionhivesdifficult breathingswelling of your facelipstongueor throat.
Notify your doctor or dentist that you are taking this medicine prior to any surgery.
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