Levothyroxine

CLINICAL USE

Hypothyroidism

DOSE IN NORMAL RENAL FUNCTION

25–300 micrograms daily depending on thyroid hormone levels

PHARMACOKINETICS

  • Molecular weight                           :798.9
  • %Protein binding                           :99.97
  • %Excreted unchanged in urine     : 30–55
  • Volume of distribution (L/kg)       :8.7–9.7
  • half-life – normal/ESRD (hrs)      :6–7 days/ Unchanged

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50     : Dose as in normal renal function
  • 10 to 20     : Dose as in normal renal function
  • <10           : Dose as in normal renal function

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                :Not dialysed. Dose as in normal renal function
  • HD                     :Not dialysed. Dose as in normal renal function
  • HDF/high flux   :Not dialysed. Dose as in normal renal function
  • CAV/VVHD      :Not dialysed. Dose as in normal renal function

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs

  • Anticoagulants: effect of coumarins and phenindione enhanced

    ADMINISTRATION

    Reconstition

    –

    Route

    Oral

    Rate of Administration

    –

    Comments

    –

    OTHER INFORMATION

    Uraemic toxins may result in inhibition of the enzyme associated with conversion of L-thyroxine to liothyronine

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