d duodenal
• cholestyramine and colestipol – used to treat high level of fat in
• polystyrene sulphone resin – used to reduce high levels of
potassium in the blood
• medicines containing iron that are taken by mouth
• rifampicin – used to treat infections
• imatinib – used to treat certain types of cancer
• beta blockers such as atenolol and sotalol – used to treat high
blood pressure and heart problems
• oestrogen containing medicines for hormone replacement
therapy (HRT) and contraception (the ‘pill’)
• androgen containing medicines for male hormone replacement
• corticosteroids such as hydrocortisone and prednisolone –
used to treat inflammation
• amiodarone – used to treat an irregular heart beat
• orlistat – used to treat obesity.
The following may be affected by levothyroxine:
• anticoagulant medicines to prevent blood clots such as warfarin
• medicines to treat diabetes such as insulin and metformin
• tricyclic antidepressants such as amitriptyline, imipramine and
• medicines that stimulate the sympathetic nervous system such as
adrenaline (used to treat severe allergic reactions) or
phenylephrine (a decongestant found in many cold and flu
• digoxin – used to treat heart problems
• anti-inflammatory medicines such as phenylbutazone or aspirin
• propanolol – used to treat high blood pressure and heart
• ketamine – used as an anaesthetic. If you need to have an
operation, please tell your doctor or anaesthetist that you are
Pregnancy and breast-feeding:
If you are pregnant or breast-feeding, think you may be pregnant or
are planning to have a baby, ask your doctor or pharmacist for
advice before taking this medicine. Your doctor will decide if you
should continue treatment with levothyroxine whilst you are
pregnant, particularly in the first three months of your pregnancy.
Driving and using machines
This medicine should not affect your ability to drive and use
Levothyroxine Tablets contain lactose:
This medicine also contains lactose, a sugar. If you have been told
by your doctor that you have an intolerance to some sugars, contact
your doctor before taking this medicine.
3. HOW TO TAKE LEVOTHYROXINE TABLETS
Always take this medicine exactly as your doctor or pharmacist has
told you. Check with your doctor or pharmacist if you are not sure.
You may be taking this medicine for the rest of your life.
Your dose will be decided by your doctor and will depend on the
results of your blood tests. The dose you should take will be on the
label attached by your pharmacist. Swallow the tablets with
plenty of water. You should usually take your tablets before breakfast
or your first meal of the day.
The recommended starting dose is 50 – 100 micrograms every day.
Your doctor may increase the dose you take every 3 – 4 weeks by 50
micrograms until your thyroxine levels are correct. Your final
daily dose may be up to 100 – 200 micrograms daily.
Patients over 50 years of age:
The recommended starting dose will be no more than 50
micrograms every day. The dose may then be increased by 50
micrograms every 3 – 4 weeks until your thyroxine levels are correct.
Your final daily dose will be between 50 – 200 micrograms daily.
Patients over 50 years of age with heart problems:
The starting dose will be 25 micrograms every day or 50 micrograms
every other day. The dose may be increased by 25 micrograms
every 4 weeks until your thyroxine levels are correct.
Your final daily dose will usually be between 50 – 200 micrograms
Use in children:
For young children, your doctor is likely to prescribe Levothyroxine
Oral Solution instead of tablets.
Congenital hypothyroidism in infants:
This is a condition where your baby has been born with a thyroid
gland that does not produce enough thyroxine. The starting dose is
10 -15 micrograms/kg bodyweight per day for the first three months.
The dose will then be adjusted depending on how your baby
responds to the treatment.
Acquired hypothyroidism in children:
This is a condition where your child’s thyroid gland stops working
properly because it has been attacked by their immune system, e.g.
in children with a