Generic Name:

Levothyroxine

Trade Name:

Synthroid

Action:

Exogenous T4

Indications:

Hypothyroidism, Organ Donation

Administration Guidelines:

Usual Dose and Route

Hypothyroidism: 50 – 200 MCG IVP daily according to patient response and TFT's

Organ Donation: 20 MCG IVP over 1 minute, followed by maintenance of 10 MCG / hr

Standard Concentration:

Hypothyroidism: Reconstitute each 200 mcg or 500 mcg vial with 2 and 5 ml respectively with 0.9% NaCl w/o preservatives resulting in a concentration of 100 mcg / ml

Organ Donation: Reconstitute each 200 mcg vial with 500 ml of 0.9% NaCl

Special Considerations:

Hypothyroidism:

- Interim intravenous therapy can be given at 3/4 the oral maintenance dose. Oral therapy should be resumed as soon as possible.

- Discard any unused portion of the reconstituted drug after use

- TFT's should be monitored closely during initiation of therapy

- Should be used with extreme caution in patients with ischemic heart disease

- May require reduction of hyperglycemic therapy in some patients

ORGAN DONATION:

- Consider reducing other pressors as tolerated while titrating levothyroxine to maintain adequate BP

Precautions and Side Effects:

- Pseudo-hyperthyroidism

- Hypertension

- Angina, Tachycardia, Palpitations, Atrial and Ventricular Dysrhythmias

- Hypoglycemia