Levotabs is a replacement for a hormone that is normally produced by your thyroid gland to regulate the body's energy and metabolism. Levotabs is given when the thyroid does not produce enough of this hormone on its own.
Levotabs treats hypothyroidism (low thyroid hormone). Levotabs is also used to treat or prevent goiter (enlarged thyroid gland), which can be caused by hormone imbalances, radiation treatment, surgery, or cancer.
Levotabs should not be used to treat obesity or weight problems.
Levotabs may also be used for purposes not listed in this medication guide.
Levotabs indications
An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.
sponsored
Hypothyroidism
Levotabs is indicated in pediatric and adult patients as a replacement therapy in primary (thyroidal), secondary (pituitary), and tertiary (hypothalamic) congenital or acquired hypothyroidism.
Levotabs is indicated in pediatric and adult patients as an adjunct to surgery and radioiodine therapy in the management of thyrotropin-dependent well-differentiated thyroid cancer.
Limitations of Use:
Levotabs is not indicated for suppression of benign thyroid nodules and nontoxic diffuse goiter in iodine-sufficient patients as there are no clinical benefits and overtreatment with Levotabs may induce hyperthyroidism.
Levotabs is not indicated for treatment of hypothyroidism during the recovery phase of subacute thyroiditis.
How should I use Levotabs?
Use Levotabs solution as directed by your doctor. Check the label on the medicine for exact dosing instructions.
Levotabs solution is usually given as an injection at your doctor's office, hospital, or clinic. If you will be using Levotabs solution at home, a health care provider will teach you how to use it. Be sure you understand how to use Levotabs solution. Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions.
Do not use Levotabs solution if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged.
Always carefully check that you have drawn up the correct dose before administration.
Keep this product, as well as syringes and needles, out of the reach of children and pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.
Levotabs solution works best if you use it at the same time each day.
Continue to use Levotabs solution even if you feel well. Do not miss any doses.
It may take several weeks before you notice an improvement in your symptoms. Do not stop or change your dose of Levotabs solution without first checking with your doctor.
If you miss a dose of Levotabs solution, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.
Ask your health care provider any questions you may have about how to use Levotabs solution.
Uses of Levotabs in details
There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.
sponsored
Levotabs is used to treat an underactive thyroid (hypothyroidism). It replaces or provides more thyroid hormone, which is normally produced by the thyroid gland. Low thyroid hormone levels can occur naturally or when the thyroid gland is injured by radiation/medications or removed by surgery. Having enough thyroid hormone is important for maintaining normal mental and physical activity. In children, having enough thyroid hormone is important for normal mental and physical development.
This medication is also used to treat other types of thyroid disorders (such as certain types of goiters, thyroid cancer).
This medication should not be used to treat infertility unless it is caused by low thyroid hormone levels.
How to use Levotabs
Take this medication by mouth as directed by your doctor, usually once daily on an empty stomach, 30 minutes to 1 hour before breakfast. Take this medication with a full glass of water unless your doctor directs you otherwise.
If you are taking the capsule form of this medication, swallow it whole. Do not split, crush, or chew. People who cannot swallow the capsule whole (such as infants or small children) should use the tablet form of the medication.
For infants or children who cannot swallow whole tablets, crush the tablet and mix in 1 to 2 teaspoons (5 to 10 milliliters) of water, and give using a spoon or dropper right away. Do not prepare a supply in advance or mix the tablet in soy infant formula. Consult your pharmacist for more information.
Dosage is based on your age, weight, medical condition, laboratory test results, and response to treatment.
Use this medication regularly in order to get the most benefit from it. To help you remember, take it at the same time each day.
Do not stop taking this medication without first consulting with your doctor. Thyroid replacement treatment is usually taken for life.
There are different brands of Levotabs available. Do not change brands without first consulting your doctor or pharmacist.
Certain medications (such as cholestyramine, colestipol, colesevelam, antacids, sucralfate, simethicone, iron, sodium polystyrene sulfonate, calcium supplements, orlistat, sevelamer, among others) can decrease the amount of thyroid hormone that is absorbed by your body. If you are taking any of these drugs, separate them from this medication by at least 4 hours.
Symptoms of low thyroid hormone levels include tiredness, muscle aches, constipation, dry skin, weight gain, slow heartbeat, or sensitivity to cold. Tell your doctor if your condition worsens or persists after several weeks of taking this medication.
The goal of replacement therapy is to achieve and maintain a clinical and biochemical euthyroid state. The goal of suppressive therapy is to inhibit growth and/or function of abnormal thyroid tissue. The dose of Levotabs™ (Levotabs sodium tablets) that is adequate to achieve these goals depends on a variety of factors including the patient's age, body weight, cardiovascular status, concomitant medical conditions, including pregnancy, concomitant medications, and the specific nature of the condition being treated. Hence, the following recommendations serve only as dosing guidelines. Dosing must be individualized and adjustments made based on periodic assessment of the patient's clinical response and laboratory parameters.
Levotabs™ (Levotabs sodium tablets) should be taken in the morning on an empty stomach, at least one-half hour before any food is eaten. Levotabs™ (Levotabs sodium tablets) should be taken at least 4 hours apart from drugs that are known to interfere with its absorption.
Due to the long half-life of Levotabs, the peak therapeutic effect at a given dose of Levotabs sodium may not be attained for 4-6 weeks.
Caution should be exercised when administering Levotabs™ (Levotabs sodium tablets) to patients with underlying cardiovascular disease, to the elderly, and to those with concomitant adrenal insufficiency.
Specific Patient Populations
Hypothyroidism in Adults and in Children in Whom Growth and Puberty are Complete
Therapy may begin at full replacement doses in otherwise healthy individuals less than 50 years old and in those older than 50 years who have been recently treated for hyperthyroidism or who have been hypothyroid for only a short time (such as a few months). The average full replacement dose of Levotabs sodium is approximately 1.7 mcg/kg/day (e.g., 100-125 mcg/day for a 70 kg adult). Older patients may require less than 1 mcg/kg/day. Levotabs sodium doses greater than 200 mcg/day are seldom required. An inadequate response to daily doses ≥ 300 mcg/day is rare and may indicate poor compliance, malabsorption, and/or drug interactions.
For most patients older than 50 years or for patients under 50 years of age with underlying cardiac disease, an initial starting dose of 25-50 mcg/day of Levotabs sodium is recommended, with gradual increments in dose at 6-8 week intervals, as needed. The recommended starting dose of Levotabs sodium in elderly patients with cardiac disease is 12.5-25 mcg/day, with gradual dose increments at 4-6 week intervals. The Levotabs sodium dose is generally adjusted in 12.5-25 mcg increments until the patient with primary hypothyroidism is clinically euthyroid and the serum TSH has normalized.
In patients with severe hypothyroidism, the recommended initial Levotabs sodium dose is 12.5-25 mcg/day with increases of 25 mcg/day every 2-4 weeks, accompanied by clinical and laboratory assessment, until the TSH level is normalized.
In patients with secondary (pituitary) or tertiary (hypothalamic) hypothyroidism, the Levotabs sodium dose should be titrated until the patient is clinically euthyroid and the serum free-T concentrations, the recommended initial starting dose is 50 mcg/day of Levotabs sodium.
Infants and Children
Levotabs therapy is usually initiated at full replacement doses, with the recommended dose per body weight decreasing with age. However, in children with chronic or severe hypothyroidism, an initial dose of 25 mcg/day of Levotabs sodium is recommended with increments of 25 mcg every 2-4 weeks until the desired effect is achieved.
Hyperactivity in an older child can be minimized if the starting dose is one-fourth of the recommended full replacement dose, and the dose is then increased on a weekly basis by an amount equal to one-fourth the full-recommended replacement dose until the full recommended replacement dose is reached.
Table 3: Levotabs Sodium Dosing Guidelines for Pediatric Hypothyroidism
AGE
Daily Dose Per Kg Body Weight The dose should be adjusted based on clinical response and laboratory parameters (see PRECAUTIONS, Laboratory Tests and Pediatric Use).
Pregnancy- Pregnancy may increase Levotabs requirements.
Subclinical Hypothyroidism- If this condition is treated, lower Levotabs sodium dose (e.g., 1 mcg/kg/day) than that used for full replacement may be adequate to normalize the serum TSH level. Patients who are not treated should be monitored yearly for changes in clinical status and thyroid laboratory parameters.
TSH Suppression in Well-differentiated Thyroid Cancer and Thyroid Nodules - The target level for TSH suppression in these conditions has not been established with controlled studies. In addition, the efficacy of TSH suppression for benign nodular disease is controversial. Therefore, the dose of Levotabs™ (Levotabs sodium tablets) used for TSH suppression should be individualized based on the specific disease and the patient being treated. In the treatment of well differentiated (papillary and follicular) thyroid cancer, Levotabs is used as an adjunct to surgery and radioiodine therapy. Generally, TSH is suppressed to < 0.1 mU/L, and this usually requires a Levotabs sodium dose of greater than 2 mcg/kg/day. However, in patients with high-risk tumors, the target level for TSH suppression may be
Protease Inhibitors: Protease inhibitors (e.g. ritonavir, indinavir, lopinavir) may influence the effect of Levotabs. Close monitoring of thyroid hormone parameters is recommended. If necessary, the Levotabs dose has to be adjusted.
Phenytoin: Phenytoin may influence the effect of Levotabs by displacing Levotabs from plasma proteins resulting in an elevated fT4 and fT3 fraction. On the other hand, phenytoin increases the hepatic metabolisation of Levotabs. Close monitoring of thyroid hormone parameters is recommended.
Influence of Levotabs on Other Medicinal Products: Antidiabetic Medicinal Products: Levotabs may reduce the effect of antidiabetics. Therefore, it is necessary to check blood glucose levels frequently at the start of thyroid hormone therapy. If necessary, the anti-diabetic dose has to be adjusted.
Coumarin Derivates: Levotabs may intensify the effect of anticoagulants by displacing them from plasma protein bounds, which may increase the risk of haemorrhage e.g. CNS or gastrointestinal bleeding, especially in elderly patients. Therefore, it is necessary to check the coagulation parameters regularly at the start of and during concomitant therapy. If necessary, the anticoagulant dose has to be adjusted.
The Following Medicinal Products Intensify the Effect of Levotabs: Salicylates, dicumarol, furosemide, clofibrate;
Salicylates, dicumarol, furosemide in high doses (250 mg), clofibrate and other substances can displace Levotabs from plasma proteins, resulting in an elevated fT4 fraction.
The Following Medicinal Products May Reduce the Effect of Levotabs: Orlistat: Hypothyroidism and / or reduced control of hypothyroidism may occur when orlistat and Levotabs are taken at the same time. This could be due to a decreased absorption of iodine salts and / or Levotabs.
Sevelamer: Sevelamer may decrease Levotabs absorption. Therefore, it is recommended that patients are monitored for changes in thyroid function at the start or end of concomitant treatment. If necessary, the Levotabs dose has to be adjusted.
Tyrosine kinase inhibitors: Tyrosine kinase inhibitors (e.g. imatinib, sunitinib) may decrease the efficacy of Levotabs. Therefore, it is recommended that patients are monitored for changes in thyroid function at the start or end of concomitant treatment. If necessary, the Levotabs dose has to be adjusted.
Ion exchange resins: Ion exchange resins (e.g. cholestyramine or cholestipol) inhibit the absorption of Levotabs. It is therefore recommended that Levotabs be taken 4 - 5 hours before administration of such agents.
Aluminium containing medicinal products, iron-containing medicinal products, calcium carbonate: Aluminium-containing medicinal products (antacids, sucralfate) have been reported in literature as potentially decreasing the effect of Levotabs. It is therefore recommended that Levotabs be administered at least 2 hours prior to the administration of aluminium-containing medicinal products. The same applies to iron-containing medicinal products and calcium carbonate.
Propylthiouracil, glucocorticoids, beta-sympatholytics, and iodine-containing contrast media: These substances inhibit the peripheral conversion of T4 to T3.
Amiodarone: This substance inhibits the peripheral conversion of T4 to T3.
Due to its high iodine content amiodarone can trigger hyperthyroidism as well as hypothyroidism. Particular caution is advised in the case of nodular goiter with possibly unrecognised autonomy.
Sertraline, chloroquine/proguanil: These substances decrease the efficacy of Levotabs and increase the serum TSH level.
Medicinal Products Leading to Hepatic Enzyme Induction (e.g. Barbiturates, Carbamazepine): These substances can increase the hepatic clearance of Levotabs.
Oestrogens: Women using oestrogen-containing contraceptives or postmenopausal women under hormone-replacement therapy may have an increased need for Levotabs.
Interaction with Food: Soy containing compounds: Soy containing compounds can decrease the intestinal absorption of Levotabs. Therefore, a dosage adjustment of Levotabs may be necessary, in particular at the beginning or after termination of nutrition with soy supplements.
Applies to Levotabs: oral capsule liquid filled, oral tablet
Other dosage forms:
injection powder for solution
As well as its needed effects, Levotabs (the active ingredient contained in Levotabs) may cause unwanted side effects that require medical attention.
Major Side Effects
If any of the following side effects occur while taking Levotabs, check with your doctor immediately:
Less common:
Chest pain or discomfort
decreased urine output
difficult or labored breathing
difficulty with swallowing
dilated neck veins
extreme fatigue
fainting
fast, slow, irregular, pounding, or racing heartbeat or pulse
fever
heat intolerance
hives or welts
increased blood pressure
increased pulse
irregular breathing
irritability
menstrual changes
nausea
pain or discomfort in the arms, jaw, back, or neck
shortness of breath
skin itching, rash, or redness
sweating
swelling of the eyes, face, lips, throat, or tongue
tightness in the chest
tremors
troubled breathing
Rare
Blurred or double vision
dizziness
eye pain
lack or slowing of normal growth in children
limp or walk favoring one leg
pain in the hip or knee
seizures
severe headache
If any of the following symptoms of overdose occur while taking Levotabs, get emergency help immediately:
Symptoms of overdose:
Change in consciousness
cold, clammy skin
confusion
disorientation
fast or weak pulse
lightheadedness
loss of consciousness
sudden headache
sudden loss of coordination
sudden slurring of speech
Minor Side Effects
Some Levotabs side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:
Less common:
Abdominal or stomach cramps
change in appetite
crying
diarrhea
false or unusual sense of well-being
fear
feeling not well or unhappy
feeling of discomfort
feeling of warmth
feeling things are not real
feelings of suspicion and distrust
hair loss
headache
increased appetite
mental depression
muscle weakness
nervousness
quick to react or overreact emotionally
rapidly changing moods
redness of the face, neck, arms, and occasionally, upper chest
Since thyroid hormone occurs naturally in the body, almost anyone can take Levotabs. You should not use this medication if you have had a heart attack, a thyroid disorder called thyrotoxicosis, or an adrenal gland problem that is not controlled by treatment.
Before you take Levotabs, tell your doctor if you have a serious thyroid disorder (thyrotoxicosis), heart disease, coronary artery disease, diabetes, anemia, problems with your pituitary or adrenal glands, a history of blood clots, if you have recently had a heart attack, or if you are having any symptoms of a heart attack (chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling).
If you use insulin or take diabetes medicine by mouth, ask your doctor if your dose needs to be changed when you start using Levotabs.
Different brands of Levotabs may not work the same. If you get a prescription refill and your new pills look different, talk with your pharmacist or doctor.
It may take several weeks before your body starts to respond to this medication. Do not stop taking the medicine suddenly, even if you feel well.
Many other medicines can be affected by your thyroid hormone levels. Other medicine may also increase or decrease the effects of Levotabs. Tell your doctor about all medications you use, start using, or stop using during your treatment with Levotabs. This includes prescription, over-the-counter, vitamin, and herbal products. Keep a list of all your medicines and show it to any healthcare provider who treats you.
The results of a survey conducted on ndrugs.com for Levotabs are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Levotabs. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.
User reports
Consumer reported useful
No survey data has been collected yet
Consumer reported price estimates
No survey data has been collected yet
Consumer reported time for results
No survey data has been collected yet
1 consumer reported age
Users
%
30-45
1
100.0%
Consumer reviews
There are no reviews yet. Be the first to write one!
