A1,
A2,
B,
C1,
C2,
D,
E,
F,
G-H,
I-K,
L,
M,
N,
O,
P1,
P2,
Q-R,
S,
T,
U-V,
W-Z
Armour Thyroid Warnings, Precautions, Pregnancy, Nursing, Abuse - Thyroid tablets
Armour Thyroid Warnings, Precautions, Pregnancy, Nursing, Abuse - Thyroid tablets
WARNINGS
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Drugs with thyroid hormone activity, alone or together
with other therapeutic agents, have been used for the treatment of obesity.
In euthyroid patients, doses within the range of daily hormonal requirements
are ineffective for weight reduction. Larger doses may produce serious
or even life-threatening manifestations of toxicity, particularly when
given in association with sympathomimetic amines such as those used for
their anorectic effects.
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The use of thyroid hormones in the therapy of obesity, alone
or combined with other drugs, is unjustified and has been shown to be ineffective.
Neither is their use justified for the treatment of male or female infertility
unless this condition is accompanied by hypothyroidism.
PRECAUTIONS
General
Thyroid hormones should be used with great caution in a number
of circumstances where the integrity of the cardiovascular system, particularly
the coronary arteries, is suspected. These include patients with angina pectoris
or the elderly, in whom there is a greater likelihood of occult cardiac disease.
In these patients therapy should be initiated with low doses, i.e., 15-30 mg
Armour Thyroid. When, in such patients, a euthyroid state can only be reached
at the expense of an aggravation of the cardiovascular disease, thyroid hormone
dosage should be reduced.
Thyroid hormone therapy in patients with concomitant diabetes
mellitus or diabetes insipidus or adrenal cortical insufficiency aggravates
the intensity of their symptoms. Appropriate adjustments of the various therapeutic
measures directed at these concomitant endocrine diseases are required. The
therapy of myxedema coma requires simultaneous administration of glucocorticoids
(See DOSAGE AND ADMINISTRATION).
Hypothyroidism decreases and hyperthyroidism increases the
sensitivity to oral anticoagulants. Prothrombin time should be closely monitored
in thyroid-treated patients on oral anticoagulants and dosage of the latter
agents adjusted on the basis of frequent prothrombin time determinations. In
infants, excessive doses of thyroid hormone preparations may produce craniosynostosis.
INFORMATION FOR THE PATIENT
Patients on thyroid hormone preparations and parents of children
on thyroid therapy should be informedthat:
1. Replacement therapy is to be taken essentially for life,
with the exception of cases of transient hypothyroidism, usually associated
with thy-roiditis, and in those patients receiving a therapeutic trial of the
drug.
2. They should immediately report during the course of therapy
any signs or symptoms of thyroid hormone toxicity, e.g., chest pain, increased
pulse rate, palpitations, excessive sweating, heat intolerance, nervousness,
or any other unusual event.
3. In case of concomitant diabetes mellitus, the daily dosage
of antidiabetic medication may need readjustment as thyroid hormone replacement
is achieved. If thyroid medication is stopped, a downward readjustment of the
dosage of insulin or oral hypoglycemic agent may be necessary to avoid hypoglycemia.
At all times, close monitoring of urinary glucose levels is mandatory in such
patients.
4. In case of concomitant oral anticoagulant therapy, the prothrombin
time should be measured frequently to determine if the dosage of oral anticoagulants
is to be readjusted.
5. Partial loss of hair may be experienced by children in the
first few months of thyroid therapy, but this is usually a transient phenomenon
and later recovery is usually the rule.
Laboratory Tests
Treatment of patients with thyroid hormones requires the periodic
assessment of thyroid status by means of appropriate laboratory tests besides
the full clinical evaluation. The TSH suppression test can be used to test the
effectiveness of any thyroid preparation bearing in mind the relative insensitivity
of the infant pituitary to the negative feedback effect of thyroid hormones.
Serum T4 levels can be used to test the effectiveness of all thyroid
medications except T3. When the total serum T4 is low
but TSH is normal, a test specific to assess unbound (free) T4 levels
is warranted. Specific measurements of T4 and T3 by competitive
protein binding or radioimmunoassay are not influenced by blood levels of organic
or inorganic iodine.
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