When administered levothyroxine is absorbed almost exclusively in the upper small intestine (up to 80% of applied dose on an empty stomach). The maximum serum concentration achieved after cytomel dosage about 6 hours after ingestion. After absorption of more than 99% of the drug is bound to serum proteins (thyroxine-binding globulin, thyroxine binding prealbumin, and albumin). Therapeutic effect was observed within 3-5 days after the beginning of oral therapy. Levothyroxine is metabolized primarily in the liver, kidney, muscle, brain tissue.
The metabolites are excreted in the urine and bile. The half-life of levothyroxine is 6-7 days. After ingestion liothyronine is absorbed mainly in the small intestine in an amount of 78-95% of the dose. Maximum plasma concentration is achieved in about 2-3 days. Therapeutic effect stops after 7-9 days after the end of therapy. 90.7% liothyronine binds to thyroxine binding globulin in a small amount – from thyroxine binding prealbumin and albumin. During pregnancy or after treatment with estrogens is an increase in binding ability, in severe hypoproteinemia binding capacity may be reduced. Liothyronine is metabolized primarily in the liver, kidney, muscle, brain tissue. The half-life liothyronine -. 24 hours Absorbability inorganic iodine in the small intestine is almost 100%. Displayed iodine in urine.
- hypothyroidism cytomel dosage;
- Treatment of euthyroid goiter;
- prevention of goiter recurrence after resection of the thyroid gland.Contraindications
- Individual hypersensitivity to the drug;
- acute myocardial infarction, angina III-1V functional class;
- acute myocarditis;
- untreated adrenal insufficiency;
- dermatitis herpetiformis (Duhring’s disease).Precautions should be prescribed the drug for diseases of the cardiovascular system: ischemic heart disease (atherosclerosis, angina pectoris I-II functional class, history of myocardial infarction), heart failure, hypertension, tachycardia, tachyarrhythmia; diabetes mellitus, diabetes insipidus, a heavy long-existing hypothyroidism, malabsorption syndrome, elderly patients (may require dose adjustment).
Use during pregnancy and lactation
During pregnancy and breast-feeding therapy with thyroid hormones, appointed about hypothyroidism, should be continued. The amount of thyroid hormone secreted by breast milk during lactation (even during the treatment with high doses of the drug), is insufficient to cause any disturbances in the child. However, breast-feeding period, the drug should be taken with caution, strictly within the recommended doses under medical supervision.
Dosage and administration
The daily dose is selected individually by the attending physician based on clinical and laboratory data.
Generally, treatment is initiated with per day. Depending on the individual needs cytomel dosage of the initial dose can be gradually increased every 1-2 weeks prior to a maintenance dose of 1-2 tablets per day. In elderly patients with cardiovascular disease, patients with adrenocortical insufficiency and in patients with epilepsy, the period of selection of dose and adapting to it can be increased up to 4-6 weeks or more. All daily dose taken once in the morning at least 30 minutes before breakfast, not liquid, squeezed small amounts of liquid. The drug should be carried out regularly.
The duration of the drug is determined by the attending physician. Patients are not recommended to independently modify or discontinue the treatment prescribed by your doctor.
When properly selected dose of medication side effects are not observed. There may be allergic reactions, progression of cardiac insufficiency and angina pectoris.
Very rare hypersensitivity reactions in combination with the “iodine” rhinitis; yododerma, exfoliative dermatitis, angioedema; very rare – fever, iodine, iodine acne, swelling of the salivary glands. When adverse reactions reception should be discontinued and to inform the treating physician.
In case of overdose (especially with too rapid increase in dose at the beginning of treatment), symptoms of hyperthyroidism may occur: palpitations, irregular heartbeat, tremor of fingers, inner restlessness, insomnia, excessive sweating, weight loss, diarrhea. Depending on the severity of the symptoms your doctor may be recommended to decrease the daily dose, a break in treatment for a few days, the appointment of beta-blockers. After cytomel dosage the disappearance of side effects of treatment should be started cautiously with lower doses. In acute intoxication and overdose it is recommended to stop taking the drug and to conduct follow-up examination. Not recommended Tirostaticheskie funds. In applying the drug in very high doses it is shown holding a plasmapheresis.