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Product Description
THYROXINE:
Available as Thyroxine Tablets in 25 microgram, 50 microgram and 100 microgram strengths. May also supplied under the trade name Eltroxinâ.
Thyroxine, also known as tetraiodothyronine or “T4” for short is an endogenous prohormone released from the follicular cells of the thyroid gland. T4 is converted into the more potent T3 (triiodothyronine) by enzymes called deiodinases. T4 is active on its own but is about 1/3 as potent as T3. Thyroid hormones affect nearly every area of function in the body from a cellular level, from heart rate and metabolism and body temperature to regulation of growth. T3 and T4 release is stimulated by thyroid-stimulating hormone or TSH, which is released from the pituitary. The amount of circulating T3 and T4 is self-limiting through a simple feedback system, whereby increases in thyroid hormones result in decreases of TSH from the pituitary.
Thyroxine is the main hormone produced by the thyroid gland. It plays an important role in regulating many of the body’s metabolic functions. Hypothyroidism is the condition that results from under-production of thyroxine by the thyroid gland either because the gland is naturally underactive or because radioiodine therapy or surgery for an overactive gland has resulted in underactivity. Thyroxine is taken to replace the deficiency which exists in such situations and therefore to restore normal metabolic activity.
Thyroxine has a very long action in the body and is taken as a single daily dose, usually in the morning preferably before breakfast. The actual dose may vary from patient to patient since it is requires to be tailored to the individual’s requirement. This is determined by a simple blood test which will allow the Doctor to adjust the dose from time to time as necessary. For most patients, the dose lies in the range from 50 microgram to 200 microgram daily. Note that thyroxine treatment is started at low dosage (as low as 25 microgram daily in older patients and in those with heart conditions such as angina) then increased gradually as required in order to limit the risk of heart rhythm disturbances and chest pain (see below).
Since thyroxine is a replacement therapy, few side effects should be anticipated providing the dosage is suitably tailored to need. When daily doses exceed what is actually required there is a tendency for increased metabolic activity which may result in palpitations and chest pain (especially in those with heart disease), muscle cramps, sweating, tremors, diarrhoea, restlessness, insomnia and headaches. However such problems, should they occur, will readily respond to a reduction in dosage.
Very occasionally allergic reactions (usually skin rashes) have been reported with tablets from different suppliers. This suggests that something in the tablet, other than thyroxine, may be implicated and a change of brand will generally overcome such problems.
substances which might interfere with your treatment
If thyroxine is started (or if the dose becomes excessive) in a diabetic patient there is likely to be a requirement for increased dosage of insulin or oral anti-diabetic therapy. Similarly the dose of warfarin may require to be reduced in patients who are anticoagulated.
Some anticonvulsants (anti-epileptic medicines) including phenytoin and carbamazepine (Tegretol) may alter the metabolism of thyroxine by the liver. Because of this, the dose of thyroxine may require to be altered if these are started or stopped in a patient controlled on thyroxine. This also applies when carbamazepine (Tegretol) is used in the treatment of some types of nerve pain.
It may be necessary to adjust the dose of thyroxine upwards if the oral contraceptive pill is commenced.
Thyroxine tablets should be stored in the container in which they have been dispensed and kept in a cool dry place.
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