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Author: Admin | 2025-04-28
Cardiovascular disease, levothyroxine sodium therapy is contraindicated if the serum TSHlevel is already suppressed due to the risk of precipitating overt thyrotoxicosis (see CONTRAINDICATIONS). If the serum TSH level is not suppressed, LEVOXYL should be usedwith caution in conjunction with careful monitoring of thyroid function for evidence of hyperthyroidismand clinical monitoring for potential associated adverse cardiovascular signs and symptoms ofhyperthyroidism. Precautions for LevoxylGeneralLevothyroxine has a narrow therapeutic index. Regardless of the indication for use, careful dosagetitration is necessary to avoid the consequences of over- or under-treatment. These consequencesinclude, among others, effects on growth and development, cardiovascular function, bone metabolism,reproductive function, cognitive function, emotional state, gastrointestinal function, and on glucose andlipid metabolism. Many drugs interact with levothyroxine sodium necessitating adjustments in dosing tomaintain therapeutic response (see DRUG INTERACTIONS).Effects On Bone Mineral DensityIn women, long-term levothyroxine sodium therapy has been associated with decreased bone mineraldensity, especially in postmenopausal women on greater than replacement doses or in women who arereceiving suppressive doses of levothyroxine sodium. Therefore, it is recommended that patientsreceiving levothyroxine sodium be given the minimum dose necessary to achieve the desired clinicaland biochemical response.Patients With Underlying Cardiovascular DiseaseExercise caution when administering levothyroxine to patients with cardiovascular disorders and to theelderly in whom there is an increased risk of occult cardiac disease. In these patients, levothyroxinetherapy should be initiated at lower doses than those recommended in younger individuals or in patientswithout cardiac disease (see WARNINGS; PRECAUTIONS, Geriatric Use; and DOSAGE AND ADMINISTRATION ). If cardiac symptoms develop or worsen, the levothyroxine dose
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