Euthyrox Dosage/Direction for Use

In order to treat each patient according to individual needs, tablets are available with a levothyroxine sodium content ranging from 25 to 150 mcg. Patients, therefore, usually need to take only one tablet per day.
The dosage recommendations given are only guidelines.
The individual daily dose should be determined on the basis of laboratory tests and clinical examinations. As a number of patients show elevated concentrations of T4 and fT4, basal serum concentration of thyroid-stimulating hormone provides a more reliable basis for subsequent treatment. In elderly patients, in patients with coronary heart disease, and in patients with severe or long-existing hypothyroidism, special caution is required when initiating therapy with thyroid hormones, that is, a low initial dose should be given which should then be increased slowly and at lengthy intervals with frequent monitoring of thyroid hormones. A maintenance dose lower than that required for complete correction of TSH levels may be considered. Experience has shown that a lower dose is sufficient in low-weight patients and in patients with a large nodular goiter. Treatment generally starts with a low dose which is increased every 2-4 weeks, until full individual dose is reached. During the initial weeks of treatment, laboratory tests have to be done in order to adjust the dose.
For neonates and infants with congenital hypothyroidism, where rapid replacement is important, the initial recommended dosage is 10 to 15 mcg per Kg body weight per day for the first 3 months. Thereafter, the dose should be adjusted individually according to the clinical findings and thyroid hormone and TSH values.
The usual dose range is shown in the table as follows. A lower individualized dose may be sufficient if a patient is an elderly, has heart problems, has severe or long-standing thyroid sub-function or has a low body weight or a large goiter. (See table.)

Click on icon to see table/diagram/image

The daily doses can be given in a single administration. Take a single daily dose in the morning on an empty stomach, half an hour before breakfast, preferably with a little liquid (for example, half a glass of water).
Infants receive the entire daily dose at least 30 minutes before the first meal of the day. Immediately before use, the tablet can be crushed and mixed with some water and then given to the child with some more liquid. Always prepare the mixture freshly, as required.
Duration of treatment may vary depending on the condition for which levothyroxine (Euthyrox) is used. For benign euthyroid goiter, a treatment duration of 6 months up to 2 years is necessary. If the medical treatment is not sufficient within this time, surgery or radioiodine therapy of the goiter should be considered. In the case of substitution in hypothyroidism and after strumectomy or thyroidectomy as well as for relapse prophylaxis after euthyroid goiter removal, treatment is usually continued for life.
Concomitant therapy of hyperthyroidism after achieving euthyroid status is indicated for the period in which the anti-thyroid agent is given.
The dose should not be doubled to make up for a forgotten tablet. The normal dose should be taken the following day.