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In patients with secondarypituitaryor tertiaryhypothalamichypothyroidismthe levothyroxine sodium dose should be titrated until the patient is clinically euthyroid and the serum freeT 4 level is restored to the upper half of the normal range.

In generallevothyroxine therapy should be instituted at full replacement doses as soon as possibleDelays in diagnosis and institution of therapy may have deleterious effects on the child’s intellectual and physical growth and development.

If your symptoms or health problems do not get better or if they become worsecall your doctorDo not share your drugs with others and do not take anyone else’s drugsKeep a list of all your drugsprescriptionnatural productsvitaminsOTCwith youGive this list to your doctorTalk with the doctor before starting any new drugincluding prescription or OTCnatural productsor vitaminsSome drugs may have another patient information leafletCheck with your pharmacistIf you have any questions about Synthroidlevothyroxine tabletsplease talk with your doctornursepharmacistor other health care providerIf you think there has been an overdosecall your poison control center or get medical care right awayBe ready to tell or show what was takenhow muchand when it happened.

All drugs may cause side effectsHowevermany people have no side effects or only have minor side effectsCall your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

Exercise caution when administering levothyroxine to patients with cardiovascular disorders and to the elderly in whom there is an increased risk of occult cardiac diseaseIn these patientslevothyroxine therapy should be initiated at lower doses than those recommended in younger individuals or in patients without cardiac diseasesee WARNINGSPRECAUTIONSGeriatric Useand DOSAGE AND ADMINISTRATIONIf cardiac symptoms develop or worsenthe levothyroxine dose should bereduced or withheld for one week and then cautiously restarted at a lower doseOvertreatment with levothyroxine sodium may have adverse cardiovascular effects such as an increase in heart ratecardiac wall thicknessand cardiac contractility and may precipitate angina or arrhythmiasPatients with coronary artery disease who are receiving levothyroxine therapy should be monitored closely during surgical proceduressince the possibility of precipitating cardiac arrhythmias may be greater in those treated with levothyroxineConcomitant administration of levothyroxine and sympathomimetic agents to patients with coronary artery disease may precipitate coronary insufficiency.

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i used thyroid meds since the early 1960 s; had used synthetics with little success; then i got armour; wonderfully effective; then, when i could not get it any more i was put onto synthroid; arggggggg. d; arggggggg.

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