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Levothyroxine is also effective in the suppression of pituitary TSH secretion in the treatment or prevention of various types of euthyroid goitersincluding thyroid nodulesHashimoto’s thyroiditismultinodular goiter andas adjunctive therapy in the management of thyrotropin-dependent well-differentiated thyroid cancersee INDICATIONS AND USAGEPRECAUTIONSDOSAGE AND ADMINISTRATION
Rapid or irregular heartbeat or pulse heart palpitations chest pain difficulty breathing leg cramps headache nervousness irritability sleeplessness tremors change in appetite weight gain or loss vomiting diarrhea excessive sweating heat intolerance fever changes in menstrual periods hives or skin rash any other unusual medical event.
Common side effects of levothyroxine include tremorschange in appetiteand irregular heartbeats.
Circulating thyroid hormones are greater than 99bound to plasma proteinsincluding thyroxine-binding globulinTBGthyroxine-binding prealbuminTBPAand albuminTBAwhose capacities and affinities vary for each hormoneThe higher affinity of both TBG and TBPA for T 4 partially explains the higher serum levelsslower metabolic clearanceand longer half-life of T 4 compared to T 3Protein-bound thyroid hormones exist in reverse equilibrium with small amounts of free hormoneOnly unbound hormone is metabolically activeMany drugs and physiologic conditions affect the binding of thyroid hormones to serum proteinssee PRECAUTIONSDrug Interactions and Drug-Laboratory Test InteractionsThyroid hormones do not readily cross the placental barriersee PRECAUTIONSPregnancy
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