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Levothyroxine is contraindicated in patients with untreated subclinical (suppressed serum TSH level with normal T 3 and T 4 levels) or overt thyrotoxicosis of how to buy synthroid etiology and in patients with acute myocardial infarction. Levothyroxine is contraindicated in patients with uncorrected adrenal insufficiency since thyroid hormones may precipitate an acute adrenal crisis by increasing the metabolic clearance of glucocorticoids (see PRECAUTIONS ). SYNTHROID is contraindicated in patients with hypersensitivity to any of the inactive ingredients in SYNTHROID tablets (See DESCRIPTION – Inactive Ingredients ).

Concurrent use of tricyclic (e.g..amitriptyline) or tetracyclic (e.g..maprotiline) antidepressants and SYNTHROID may increase the therapeutic and toxic effects of both drugs.possibly due to increased receptor sensitivity to catecholamines. Toxic effects may include increased risk of cardiac arrhythmias and central nervous system stimulation. SYNTHROID may accelerate the onset of action of tricyclics. Administration of sertraline in patients stabilized on SYNTHROID may result in increased SYNTHROID requirements.

In children in whom a diagnosis of permanent hypothyroidism has not been established.discontinue SYNTHROID administration for a trial period.but only after the child is at least 3 years of age. Obtain serum T4 and TSH levels at the end of the trial period.and use laboratory test results and clinical assessment to guide diagnosis and treatment.if warranted.

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 How to buy synthroid used for TSH suppression should be individualized based on the specific disease and the patient being treated.

Concurrent use of sympathomimetics and SYNTHROID may increase the effects of sympathomimetics or thyroid hormone. Thyroid hormones may increase the risk of coronary insufficiency when sympathomimetic agents are administered to patients with coronary artery disease.

It may take several weeks before your body starts to respond to levothyroxine. Keep using this medicine even if you feel well. You may need to use levothyroxine for the rest of your life.

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In patients with severe hypothyroidismthe recommended initial levothyroxine sodium dose is 12.5-25 mcg/day with increases of 25 mcg/day every 2-4 weeksaccompanied by clinical and laboratory assessmentuntil the TSH level is normalized.

Check with your doctor immediately if any of the following side effects occur while taking levothyroxine:

Take a missed dose as soon as you think about itIf it is close to the time for your next doseskip the missed dose and go back to your normal timeDo not take 2 doses at the same time or extra doses.

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Adequacy of therapy should be assessed by measuring serum freeT 4 levelswhich should be maintained in the upper half of the normal range in these patients.

Do not share this medicine with another personeven if they have the same symptoms you have.

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Cardiac function was evaluated in twenty patients requiring TSH suppression for either thyroid goiter or following thyroidectomy and radioactive iodine therapy for thyroid cancer and in twenty ageand sex-matched controlsTSH suppression was associated with an increased incidence of premature ventricular beatsan increased left ventricular mass indexand enhanced left ventricular systolic functionThe clinical significance of these changes remains to be determinedRef]

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