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Levothyroxine (INN, USAN) or L-thyroxine is a synthetic thyroid hormone that is chemically identical to thyroxine (T₄), which is naturally secreted by the follicular cells of the thyroid gland. It is used to treat thyroid hormone deficiency, and occasionally to prevent the recurrence of thyroid cancer. Like its naturally secreted counterpart, levothyroxine is a chiral compound in the L-form. The related drug dextrothyroxine (D-thyroxine) was used in the past as a treatment for hypercholesterolemia (elevated cholesterol levels) but was withdrawn due to cardiac side effects.

It is on the World Health Organization's List of Essential Medicines, a list of the most important medication needed in a basic health system.^[3]

1 Medical uses
2 Available forms
3 Adverse effects
4 Interactions
5 Dosage
- 5.1 Elderly
- 5.2 Pregnancy
- 5.3 Breastfeeding
- 5.4 Persistent symptoms
- 5.5 Subclinical hypothyroidism
- 5.6 Myxedema coma
- 5.7 Children
6 Mechanism of action
7 Pharmacokinetics
- 7.1 Absorption
- 7.2 Distribution
- 7.3 Metabolism
- 7.4 Elimination
8 Contraindications
9 History
10 Economics
11 Brand names
12 References
13 External links

Medical uses

Levothyroxine is typically used to treat hypothyroidism,^[4] and is the treatment of choice for patients with hypothyroidism,^[5] who often require lifelong thyroid hormone therapy.^[6] It may also be used to treat goiter via its ability to lower thyroid-stimulating hormone (TSH), a hormone that is considered goiter-inducing.^[7]^[8] Levothyroxine is also used as interventional therapy in patients with nodular thyroid disease or thyroid cancer to suppress thyroid-stimulating hormone (TSH) secretion.^[9]

Available forms

Levothyroxine for systemic administration is available as an oral tablet, an intramuscular injection, and as a solution for intravenous infusion.^[10] Furthermore, levothyroxine is available as both brand-name and generic products.^[6] While the United States Food and Drug Administration (FDA) approved the use of generic levothyroxine for brand-name levothyroxine in 2004, the decision was met with disagreement by several medical associations.^[6] The American Association of Clinical Endocrinologists (AACE), the Endocrine Society, and the American Thyroid Association did not agree with the FDA that brand-name and generic formulations of levothyroxine were bioequivalent.^[6] As such, it was recommended that patients be started and kept on either brand-name or generic levothyroxine formulations and not changed back and forth from one to the other.^[6] For patients who do switch products, it is recommended that their TSH and free T4 levels be tested after six weeks to check that they are within normal range.^[6]

Adverse effects

Dosing, which is generally straightforward, must be controlled to achieve free T4 and free T3 levels within the normal reference range and elimination of hypothyroid and hyperthyroid symptoms. Once patients are stabilized annual or semiannual clinical evaluations and TSH monitoring are appropriate.^[11] Long-term suppression of TSH values below normal values will frequently cause cardiac side-effects and contribute to decreases in bone mineral density (low TSH levels are also well known to contribute to osteoporosis).^[12]

Patients prescribed too high a dose of levothyroxine may experience effects that mimic hyperthyroidism.^[13] Overdose can result in heart palpitations, abdominal pain, nausea, anxiousness, confusion, agitation, insomnia, weight loss, and increased appetite.^[14] Allergic reactions to the drug are characterized by symptoms such as difficulty breathing, shortness of breath, or swelling of the face and tongue. Acute overdose may cause fever, hypoglycemia, heart failure, coma, and unrecognized adrenal insufficiency.

Acute massive overdose may be life-threatening; treatment should be symptomatic and supportive. Massive overdose can be associated with increased sympathetic activity and thus require treatment with beta-blockers.^[13]

The effects of overdosing appear 6 hours to 11 days after ingestion.^[14]

Interactions

There are foods and other substances that can interfere with absorption of thyroxine. Examples include calcium and iron supplements taken within four hours of levothyroxine,^[15] as well as soy products within three hours of the medication. Other substances that reduce absorption are aluminium and magnesium containing antacids, simethicone, sucralfate, cholestyramine, colestipol, and polystyrene sulfonate. Grapefruit juice may delay the absorption of levothyroxine, but based on a study of 10 healthy people aged 20–30 (8 men, 2 women) it may not have a significant effect on bioavailability in young adults.^[16] A study of eight women suggested that coffee may interfere with the intestinal absorption of levothyroxine, though at a level less than eating bran.^[17] Certain other substances can cause adverse effects that may be severe. Combination of levothyroxine with ketamine may cause hypertension and tachycardia;^[18] and tricyclic and tetracyclic antidepressants increase its toxicity. On the other hand lithium can cause hyperthyroidism (but most often hypothyroidism) by affecting iodine metabolism of the thyroid itself and thus inhibits synthetic levothyroxine as well.^{[citation needed]}

Dosage

Generic levothyroxine, 25 µg oral tablet

Dosages vary according to the age groups and the individual condition of the patient, body weight and compliance to the medication and diet. Monitoring of the patient's condition and adjustment of the dosage is periodical and necessary. Levothyroxine is taken on an empty stomach approximately half an hour to an hour before meals.^[13] As such, thyroid replacement therapy is usually taken 30 minutes prior to eating in the morning.^[6] For patients with trouble taking levothyroxine in the morning, bedtime dosing is effective as well.^[6] A recent study published in JAMA showed greater efficacy of levothyroxine when taken at bedtime. ^[19]

Poor compliance to thyroid replacement therapy is the most common cause of elevated TSH levels in patients receiving appropriate doses of levothyroxine.^[6]

Elderly

For older patients (over 50 years old) and patients with known or suspected ischemic heart disease, levothyroxine therapy should not be initiated at the full replacement dose.^[20] Since thyroid hormone increases myocardial oxygen demand by increasing heart rate and contractility, starting at higher doses may cause acute coronary syndrome or an arrhythmia.^[6]

Pregnancy

According to the U.S. Food and Drug Administration pregnancy categories, levothyroxoine has been assigned Pregnancy Category A.^[20] Given that no increased risk of congenital abnormalities have been demonstrated in pregnant women taking levothyroxine, therapy should be continued during pregnancy.^[20] Furthermore, therapy should be immediately administered to women diagnosed with hypothyroidism during pregnancy, as hypothyroidism is associated with a higher rate of complications, such as spontaneous abortion, preeclampsia, and premature birth.^[20]

Thyroid hormone requirements increase during and last throughout pregnancy.^[6] As such, it is recommended that pregnant women increase to nine doses of levothyroxine each week, rather than the usual seven, as soon as their pregnancy is confirmed.^[6] Repeat thyroid function tests should be done five weeks after the dosage is increased.^[6]

Breastfeeding

While a minimal amount of thyroid hormones are found in breast milk, the amount does not influence infant plasma thyroid levels.^[10] Furthermore, levothyroxine was not found to cause any adverse events to the infant or mother during breastfeeding.^[10] As adequate concentrations of thyroid hormone are required to maintain normal lactation, it is recommended that appropriate levothyroxine doses be administered during breastfeeding.^[10]

Persistent symptoms

A subset of patients with hypothyroidism treated with an appropriate dose of levothyroxine will describe continuing symptoms despite TSH levels in the normal range.^[6] In these patients, further laboratory and clinical evaluation is warranted as they may have another cause for their symptoms.^[6] Furthermore, it is important to review their medications and possible dietary supplements as several medications can affect thyroid hormone levels in patients on levothyroxine therapy.^[6]

Subclinical hypothyroidism

Subclinical hypothyroidism is defined by an elevated TSH level and a normal-range free T4 level without symptoms.^[6] Such patients may be asymptomatic^[6] and whether they should be treated is controversial.^[5] One benefit of treating this population with levothyroxine therapy is preventing patients' development of hypothyroidism.^[5] As such, it is recommended that treatment should be taken into account for patients with initial TSH levels > 10 mIU/L, patients with elevated thyroid peroxidase antibody titers, patients with symptoms of hypothyroidism and TSH levels between 5–10 mIU/L, and patients who are pregnant or want to become pregnant.^[5] Oral dosing for patients with subclinical hypothyroidism is 1 µg/kg/day.^[10]

Myxedema coma

Myxedema coma is a severe form of hypothyroidism characterized by mental status changes and hypothermia.^[6] As it is a medical emergency with a high mortality rate, patients should be treated in the intensive care unit^[6] with thyroid hormone replacement and aggressive management of individual organ system complications.^[5] For patients with myxedema coma, 200–500 µg IV of levothyroxine should be administered, followed by 100–300 µg the next day if necessary.^[10] Smaller doses should be taken into account for patients with cardiovascular disease.^[10]

Children

Levothyroxine dosing in the pediatric population varies with age and body weight. Doses should be adjusted based on an individual patient's clinical and laboratory results.^[10] The goal of treatment for pediatric patients with hypothyroidism is to reach and preserve normal intellectual and physical development.^[20]

Mechanism of action

Levothyroxine is a synthetic form of thyroxine (T4), an endogenous hormone secreted by the thyroid gland, which is converted to its active metabolite, L-triiodothyronine (T3).^[20] T4 and T3 bind to thyroid receptor proteins in the cell nucleus and cause metabolic effects through the control of DNA transcription and protein synthesis.^[20]

Pharmacokinetics

Absorption

Absorption of orally administered levothyroxine from the gastrointestinal tract ranges from 40–80%, with the majority of the drug absorbed from the jejunum and upper ileum.^[20] Levothyroxine absorption is increased by fasting and decreased in certain malabsorption syndromes, by certain foods, and with age. The bioavailability of the drug is decreased by dietary fiber.^[20]

Distribution

Greater than 99% of circulating thyroid hormones are bound to plasma proteins including thyroxine-binding globulin, thyroxine-binding prealbumin, and albumin.^[10] Only free hormone is metabolically active.^[10]

Metabolism

The primary pathway of thyroid hormone metabolism is through sequential deiodination.^[20] The liver is the main site of T4 deiodination, and along with the kidneys are responsible for about 80% of circulating T3.^[21] In addition to deiodination, thyroid hormones are also excreted through the kidneys and metabolized through conjugation and glucuronidation and excreted directly into the bile and the gut where they undergo enterohepatic recirculation.^[10]

Elimination

Half-life elimination is 6–7 days for euthyroid patients; 9–10 days for hypothyroid patients; 3–4 days for hyperthyroid patients.^[10] Thyroid hormones are primarily eliminated by the kidneys (approximately 80%), with urinary excretion decreasing with age.^[10] The remaining 20% of T4 eliminated in the stool.^[10]

Contraindications

Levothyroxine is contraindicated in patients with hypersensitivity to levothyroxine sodium or any component of the formulation, patients with acute myocardial infarction, and patients with thyrotoxicosis of any etiology.^[10] Levothyroxine is also contraindicated in patients with uncorrected adrenal insufficiency, as thyroid hormones may cause an acute adrenal crisis by increasing the metabolic clearance of glucocorticoids.^[20] For oral tablets, the inability to swallow capsules serves as an additional contraindication.^[10]

History

Thyroxine was first isolated in pure form in 1914 at the Mayo Clinic by Edward Calvin Kendall from extracts of hog thyroid glands.^[22] The hormone was synthesized in 1927 by British chemists Charles Robert Harington and George Barger.

Economics

Levothyroxine is the second most commonly prescribed medication in the United States,^[23] with 23.8 million prescriptions filled each year.^[24]

Brand names

Common brand names include Eltroxin, Euthyrox, Letrox, Levaxin, L-thyroxine, Thyrax, and Thyrax Duotab in Europe; Thyrox, Thyronorm in South Asia; Unithroid, Eutirox, Levoxyl, Synthroid, and Tirosint in North and South America; and Thyrin and Thyrolar in Bangladesh. There are also numerous generic versions.

References

^ Levothyroxine in the ChemIDplus database
^ Harington (1926). Biochem J 20: 310. Missing or empty |title= (help)
^ "WHO Model List of EssentialMedicines" (PDF). World Health Organization. October 2013. Retrieved 22 April 2014. Brian Springer (1995). Spin (Motion picture). Retrieved 2013-02-11. (Wikipedia article: Spin)
^ Vaidya B, Pearce SH (2008). "Management of hypothyroidism in adults". BMJ (Clinical research ed.) 337: a801. doi:10.1136/bmj.a801. PMID 18662921.
^ ^a ^b ^c ^d ^e Roberts CG, Ladenson PW (2004). "Hypothyroidism". The Lancet 363: 798 of 793–803. doi:10.1016/S0140-6736(04)15696-1. PMID 15016491. Retrieved 20 April 2014.
^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j ^k ^l ^m ⁿ ^o ^p ^q ^r ^s ^t Gaitonde DY, Rowley KD, Sweeney LB (August 1, 2012). "Hypothyroidism: An Update". American Academy of Family Physicians. 3 86 (3): 246 of 244–251. PMID 22962987. Retrieved 20 April 2014.
^ Svensson J, Ericsson UB, Nilsson P, Olsson C, Jonsson B, Lindberg B, Ivarsson SA (May 2006). "Levothyroxine treatment reduces thyroid size in children and adolescents with chronic autoimmune thyroiditis". The Journal of Clinical Endocrinology and Metabolism 91 (5): 1729–34. doi:10.1210/jc.2005-2400. PMID 16507633.
^ Dietlein M, Wegscheider K, Vaupel R, Schmidt M, Schicha H (2007). "Management of multinodular goiter in Germany (Papillon 2005): do the approaches of thyroid specialists and primary care practitioners differ?". Nuklearmedizin. Nuclear medicine 46 (3): 65–75. doi:10.1160/nukmed-0068. PMID 17549317.
^ Mandel SJ, Brent GA, Larsen PR (1993). "Levothyroxine Therapy in Patients with Thyroid Disease". Annals of Internal Medicine. 6 119 (6): 492 of 492–502. doi:10.7326/0003-4819-119-6-199309150-00009. PMID 8357116. Retrieved 20 April 2014.
^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j ^k ^l ^m ⁿ ^o ^p "Levothyroxine (Lexi-Drugs)". LexiComp. Retrieved 20 April 2014.
^ Medscape, Hypothyroidism Treatment & Management – Author: Philip R Orlander, MD; Chief Editor: George T Griffing, MD more...
^ Frilling A, Liu C, Weber F (2004). "Benign multinodular goiter". Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society 93 (4): 278–81. PMID 15658668.
^ ^a ^b ^c "Synthroid (Levothyroxine Sodium) Drug Information: Uses, Side Effects, Drug Interactions and Warnings". RxList. Retrieved 2010-07-18.
^ ^a ^b Irizarry, Lisandro (2010-04-23). "Toxicity, Thyroid Hormone". WebMd. Retrieved 2010-10-31.
^ Ruth H. Michel, Patricia J. Neafsey, Laura Cox Dzurec (2004). "Self Medication Practices among Patients taking Levothyroxine". The Internet Journal of Advanced Nursing Practice 6 (2).
^ Lilja JJ, Laitinen K, Neuvonen PJ (September 2005). "Effects of grapefruit juice on the absorption of levothyroxine". Br J Clin Pharmacol 60 (3): 337–41. doi:10.1111/j.1365-2125.2005.02433.x. PMC 1884777. PMID 16120075.
^ Benvenga S, Bartolone L, Pappalardo MA, Russo A, Lapa D, Giorgianni G, Saraceno G, Trimarchi F (March 2008). "Altered Intestinal Absorption of L-Thyroxine Caused by Coffee". Thyroid (New York: Mary Ann Liebert, Inc.) 18 (3): 293–301. doi:10.1089/thy.2007.0222. PMID 18341376. Retrieved 2009-05-16.
^ Jasek, W, ed. (2007). Austria-Codex (in German) (62nd ed.). Vienna: Österreichischer Apothekerverlag. pp. 8133–4. ISBN 978-3-85200-181-4.
^ "Effects of Evening vs Morning Levothyroxine Intake: A Randomized Double-blind Crossover Trial".
^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j ^k "Novothyrox (levothyroxine sodium tablets, USP)" (PDF). Retrieved 20 April 2014.
^ Sherwood, Lauralee (2010). "19 The Peripheral Endocrine Glands". Human Physiology. Brooks/Cole. p. 694. ISBN 978-0-495-39184-5. |access-date= requires |url= (help)
^ Kendall EC (1915). "The isolation in crystalline form of the compound containing iodin, which occurs in the thyroid: Its chemical nature and physiologic activity". J. Am. Med. Assoc. 64: 2042–2043. doi:10.1001/jama.1915.02570510018005.
^ Kleinrock, Michael. "The Use of Medicines in the United States: Review of 2011" (PDF). IMS Institute for Healthcare Informatics. IMS Health Incorporated and Its Affiliates. Retrieved 20 April 2014.
^ Moore, Thomas. "Monitoring FDA MedWatch Reports: Signals for Dabigatran and Metoclopramide" (PDF). QuarterWatch. Institute for Safe Medication Practices. Retrieved 20 April 2014.

External links

Levothyroxine sodium on Drugs.com
Levothyroxine on MedlinePlus
Detailed Euthyrox (Levothroid/Levothyroxine) Consumer Information: Uses, Precautions, Side Effects
U.S. National Library of Medicine: Drug Information Portal – Levothyroxine

UpToDate Contents

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1. 分化型甲状腺癌：マネージメントの概要 differentiated thyroid cancer overview of management
2. 甲状腺機能の臨床検査評価 laboratory assessment of thyroid function
3. Treatment of nontoxic, nonobstructive goiter
4. 妊娠中の甲状腺機能低下症：臨床症状、診断、および治療 hypothyroidism during pregnancy clinical manifestations diagnosis and treatment
5. 潜在性甲状腺機能亢進症 subclinical hyperthyroidism

English Journal

Individually-tailored thyroxine requirement in the same patients before and after thyroidectomy: a longitudinal study.

Del Duca SC1, Santaguida MG1, Brusca N1, Gatto I1, Cellini M1, Gargano L1, Verga Falzacappa C1, Frattaroli FM1, Virili C1, Centanni M2.
European journal of endocrinology / European Federation of Endocrine Societies.Eur J Endocrinol.2015 Sep;173(3):351-7. doi: 10.1530/EJE-15-0314. Epub 2015 Jun 19.
OBJECTIVE: Thyroxine (T4) requirement after total thyroidectomy for differentiated thyroid carcinoma (DTC) is a debated issue. As most of the studies in the area have been retrospective and/or performed with heterogeneous therapeutic approaches, we designed our study to determine T4 requirement in t
PMID 26092761

Effect of the presence of remnant thyroid tissue on the serum thyroid hormone balance in thyroidectomized patients.

Ito M1, Miyauchi A2, Kang S2, Hisakado M2, Yoshioka W2, Ide A2, Kudo T2, Nishihara E2, Kihara M2, Ito Y2, Kobayashi K2, Miya A2, Fukata S2, Nakamura H2, Amino N2.
European journal of endocrinology / European Federation of Endocrine Societies.Eur J Endocrinol.2015 Sep;173(3):333-40. doi: 10.1530/EJE-15-0138. Epub 2015 Jun 15.
OBJECTIVE: We and others recently reported that in total thyroidectomy (TT), serum triiodothyronine (T3) levels during levothyroxine (l-T4) therapy were low compared to the preoperative levels, suggesting that the presence of the thyroid tissue affects the balances of serum thyroid hormone levels. H
PMID 26077156

Molecular mechanisms of human thyrocyte dysfunction induced by low concentrations of polychlorinated biphenyl 118 through the Akt/FoxO3a/NIS pathway.

Guo H1, Yang H1, Chen H1, Li W1, Tang J1, Cheng P1, Xie Y1, Liu Y2, Ding G2, Cui D1, Zheng X1, Duan Y1.
Journal of applied toxicology : JAT.J Appl Toxicol.2015 Sep;35(9):992-8. doi: 10.1002/jat.3032. Epub 2015 Feb 2.
Polychlorinated biphenyls (PCBs) are typical persistent organic pollutants that can interfere with multiple organ systems of humans. Previously, we concluded that persistent exposure to low doses of PCB118 could severely damage the thyroidal structure, dramatically decrease the concentration of seru
PMID 25644787

Japanese Journal

アミオダロン誘発性甲状腺機能低下症のリスクファクターについて

関本裕美,小森勝也,嘉田晃子 [他]
医療 65(5), 258-264, 2011-05
NAID 40018962554

症例入院治療後に粘液水腫性昏睡の悪化を認めた1例

木田明彦,河原利夫,大浜鶴子 [他]
内科 107(2), 361-363, 2011-02
NAID 40018277835

Related Pictures

★リンクテーブル★

リンク元	「薬理学」「レボチロキシン」「サイロキシン」
拡張検索	「levothyroxine sodium」

「薬理学」

Levothyroxine
Names
	IUPAC name (S)-2-Amino-3-[4-(4-hydroxy-3,5-diiodophenoxy)-3,5-diiodophenyl]propanoic acid
	Other names 3,5,3',5'-Tetraiodo-L-thyronine
Identifiers
CAS Registry Number	51-48-9
ATC code	H03AA01
ChEBI	CHEBI:18332
ChEMBL	ChEMBL1624
ChemSpider	5614
DrugBank	DB00451
	InChI InChI=1S/C15H11I4NO4/c16-8-4-7(5-9(17)13(8)21)24-14-10(18)1-6(2-11(14)19)3-12(20)15(22)23/h1-2,4-5,12,21H,3,20H2,(H,22,23)/t12-/m0/s1 ; Key: XUIIKFGFIJCVMT-LBPRGKRZSA-N ; InChI=1/C15H11I4NO4/c16-8-4-7(5-9(17)13(8)21)24-14-10(18)1-6(2-11(14)19)3-12(20)15(22)23/h1-2,4-5,12,21H,3,20H2,(H,22,23)/t12-/m0/s1; Key: XUIIKFGFIJCVMT-LBPRGKRZBS ;
IUPHAR/BPS	2635
Jmol-3D images	Image
MeSH	Thyroxine
PubChem	5819
	SMILES NC(Cc1cc(I)c(Oc2cc(I)c(O)c(I)c2)c(I)c1)C(O)=O ;
UNII	Q51BO43MG4
Pharmacology
Legal status	℞ (Prescription only);
Pregnancy; category	US: A (No risk in human studies);
Routes of; administration	Oral, intravenous
	Pharmacokinetics:
Bioavailability	~100%
Metabolism	Mainly in liver, kidneys, brain and muscles
Biological half-life	ca. 7 days (in hyperthyroidism 3–4 days, in hypothyroidism 9–10 days)
Excretion	Through feces and urine
Properties
Chemical formula	C15H11I4NO4
Molar mass	776.87 g·mol−1
Melting point	231 to 233 °C (448 to 451 °F; 504 to 506 K)
Solubility in water	Slightly soluble (0.105 mg·l−1 at 25 °C)
Hazards
S-phrases	S22-S24/25
Related compounds
Related compounds	Triiodothyronine (tri-iodated); Thyronine (without iodine)
	Except where otherwise noted, data are given for materials in their standard state (at 25 °C [77 °F], 100 kPa).
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	Infobox references

　　[★]

英: pharmacology
関: drug entries

定義

生物系と化学物質の選択的な相互作用を研究する学問 (SPC.2)

生物系と薬の相互作用

薬の生物系に対する相互作用：薬理作用 <-化学の視点
生物系の薬に対する相互作用：薬物動態 <-生物の視点

薬品の命名

Ending of the drug name	Category	Example
～afil	Erectile dysfunction	sildenafil
～ane	Inhalatinal general anesthetic	halothane
～azepam	Benzodiaizepine	diazepam
～azine	Phenothiazine (neuroleptic, antiemetic)	chlorpromazine
～azole	Ailtifungal	ketoconazole
～barbital	Barbiturate	phenobarbital
～caine	Local anesthetic	lidocaine
～cillin	Penicillin	methicillin
～cycline	Antibiotic, protein syntlesis inhibitor	tetracycline
～ipramine	TCA	iimipramine
～navir	Protease inhibitor	saquinavir
～olol	β-antagonist	propranolol
～operidol	Butyrophenone ( neuroleptic )	haloperidol
～oxin	Cardiac glycoside ( inotropic agent )	digoxin
～phylline	Methylxanthine	theophylline
～pril	ACE inhibitor	captopril
～terol	β₂ agonist	albuterol
～tidine	H₂ antagonist	cimtidine
～triptyline	TCA	amitriptyline
～tropine	Pituitary hormone	somatotropine
～zosin	a₁ antagonist	prazosin

薬一覧

薬物代謝

薬理動態

神経伝達物質

貧血治療薬

甲状腺関連物質

甲状腺ホルモン製剤

レボチロキシン levothyroxine
リオチニシン liothyronine

抗甲状腺薬

痛風治療薬

痛風発作予防薬

コルヒチン colchicine

尿酸排泄促進薬

尿酸生成抑制薬

アロプリノール allopurinol

「レボチロキシン」

　　[★]

英: levothyroxine
ラ: levothyroxinum natricum
同: L-チロキシン L-サイロキシン L-thyroxine
化: レボチロキシンナトリウム, levothyroxine sodium、レボチロキシンナトリウム水和物
商: チラーヂンS、Synthroid
関: 甲状腺ホルモン、サイロキシン、薬理学、リオサイロニンナトリウム

概念

甲状腺ホルモン製剤
T₄(サイロキシン)のL体が成分の製剤

「サイロキシン」

　　[★]

英: thyroxine, T4, thyroxin (Z)
同: テトラヨードサイロニン tetraiodothyronine、(薬品名としてはこちらが使われている)チロキシン
関: 甲状腺ホルモン、L-thyroxine、levothyroxine、levothyroxine sodium

[show details]

チロキシン : 約 57,100 件
サイロキシン : 約 27,800 件

「levothyroxine sodium」

　　[★] レボチロキシン、レボチロキシンナトリウム

[ChemIDplus-1] Levothyroxine in the ChemIDplus database

[2] Harington (1926). Biochem J 20: 310. Missing or empty |title= (help)

[3] "WHO Model List of EssentialMedicines" (PDF). World Health Organization. October 2013. Retrieved 22 April 2014. Brian Springer (1995). Spin (Motion picture). Retrieved 2013-02-11. (Wikipedia article: Spin)

[pmid18662921-4] Vaidya B, Pearce SH (2008). "Management of hypothyroidism in adults". BMJ (Clinical research ed.) 337: a801. doi:10.1136/bmj.a801. PMID 18662921.

[Roberts-5] Roberts CG, Ladenson PW (2004). "Hypothyroidism". The Lancet 363: 798 of 793–803. doi:10.1016/S0140-6736(04)15696-1. PMID 15016491. Retrieved 20 April 2014.

[Gaitonde-6] ^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j ^k ^l ^m ⁿ ^o ^p ^q ^r ^s ^t Gaitonde DY, Rowley KD, Sweeney LB (August 1, 2012). "Hypothyroidism: An Update". American Academy of Family Physicians. 3 86 (3): 246 of 244–251. PMID 22962987. Retrieved 20 April 2014.

[pmid16507633-7] Svensson J, Ericsson UB, Nilsson P, Olsson C, Jonsson B, Lindberg B, Ivarsson SA (May 2006). "Levothyroxine treatment reduces thyroid size in children and adolescents with chronic autoimmune thyroiditis". The Journal of Clinical Endocrinology and Metabolism 91 (5): 1729–34. doi:10.1210/jc.2005-2400. PMID 16507633.

[Dietlein_2007-8] Dietlein M, Wegscheider K, Vaupel R, Schmidt M, Schicha H (2007). "Management of multinodular goiter in Germany (Papillon 2005): do the approaches of thyroid specialists and primary care practitioners differ?". Nuklearmedizin. Nuclear medicine 46 (3): 65–75. doi:10.1160/nukmed-0068. PMID 17549317.

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