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Symptoms and Signs: In addition to exaggeration of side effects, the following symptoms may for example be seen: agitation, confusion, irritability, hyperactivity, headache, sweating, mydriasis, tachycardia, arrhythmias, tachypnea, pyrexia, increased bowel movements and convulsions. The appearance of clinical hyperthyroidism may be delayed for up to five days. Thyrotoxicosis crisis has been occasionally reported following massive or chronic intoxication, leading to cardiac arrhythmias, heart failure and coma.
Treatment: The goal of therapy is restoration of clinical and biochemical euthyroid state by omitting or reducing Levothyroxine sodium dosage, and other measures as needed depending on clinical status. Treatment is symptomatic, and tachycardia has been controlled in adults by 40 mg doses of propranolol given every 6 h and other symptoms by diazepam and/or chlorpromazine as appropriate.
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