thyroid desiccated (Rx)

Brand and Other Names:Armour Thyroid, Adthyza, more...NP Thyroid, Nature-Throid (DSC)

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

DISCLAIMER: This drug has not been found by FDA to be safe and effective, and this labeling has not been approved by FDA; see information about unapproved drugs

tablet

  • Armour Thyroid: 15mg, 30mg, 60mg, 90mg, 120mg, 180mg, 240mg, 300mg
  • Adthyza: 16.25mg, 32.5mg, 65mg, 97.5mg, 130mg
  • NP Thyroid: 15mg, 30mg, 60mg, 90mg, 120mg

Hypothyroidism

Indicated as replacement or supplemental therapy in patients with hypothyroidism of any etiology, except transient hypothyroidism during the recovery phase of subacute thyroiditis

Armour Thyroid or NP Thyroid

  • Initiate with low, incremental dosing 15-30 mg PO qDay, may increase by 15 mg/day q2-3Weeks (or 30 mg/day q30Days)
  • Cardiovascular disease: Initiate at lower dose of 15 mg PO qDay
  • Myxedema: Start at lower dose of 15 mg PO qDay, THEN after 2 weeks 30 mg PO qDay, THEN after 2 weeks 60 mg PO qDay
  • Typical maintentance dose: 60-120 mg PO qDay
  • Failure to respond to doses of 180 mg/day suggests lack of compliance or malabsorption

Adthyza

  • Initiate with low doses in increments, which depend on cardiovascular status
  • Initial: 32.5 mg PO qDay, with adjustments of 16.25 mg q2-3Weeks
  • Cardiovascular disease: Initiate at lower dose of 16.25 mg/day
  • Typical maintenance dose: 65-130 mg PO qDay
  • Failure to respond to doses of 195 mg/day suggests lack of compliance or malabsorption

Thyroid cancer

  • Exogenous thyroid hormone may produce regression of metastases from follicular and papillary carcinoma of the thyroid and is used as ancillary therapy of these conditions with radioactive iodine
  • TSH should be suppressed to low or undetectable levels
  • Therefore, larger amounts of thyroid hormone than those used for replacement therapy are required. Medullary carcinoma of the thyroid is usually unresponsive to this therapy

Pituitary TSH Suppression

Indicated as pituitary TSH suppressants for treatment or prevention of various types of euthyroid goiters, including thyroid nodules, subacute or chronic lymphocytic thyroiditis (Hashimoto disease), multinodular goiter, and for management of thyroid cancer

Administration of thyroid hormone in doses higher than those produced physiologically by the gland results in suppression of the production of endogenous hormone

This is the basis for the thyroid suppression test and is used as an aid to diagnosis mild hyperthyroidism when base line laboratory tests appear normal, or to demonstrate thyroid gland autonomy in patients with Grave’s ophthalmopathy

Usual suppressive dose (T4)

  • 1.56 mcg/kg/day PO x 7-10 days

Dosing Considerations

Readjustment of thyroid hormone dosage should be made within the first 4 weeks of therapy, after proper clinical and laboratory evaluations, including serum levels of T4, bound and free, and TSH

Current guidelines do not recommend desiccated thyroid for treatment of hypothyroidism (primary or secondary); levothyroxine monotherapy is preferred

Desiccated thyroid contains variable amounts of T3, T4, and other triiodothyronine compounds which are more likely to cause signs or symptoms due to fluctuating levels

Dosage Forms & Strengths

DISCLAIMER: This drug has not been found by FDA to be safe and effective, and this labeling has not been approved by FDA; see information about unapproved drugs

tablet

  • Armour Thyroid: 15mg, 30mg, 60mg, 90mg, 120mg, 180mg, 240mg, 300mg
  • Adthyza: 16.25mg, 32.5mg, 65mg, 97.5mg, 130mg
  • NP Thyroid: 15mg, 30mg, 60mg, 90mg, 120mg

Congenital Hypothyroidism

<6 months: 4.8-6 mg/kg PO qDay

6-12 months: 3.6-4.8 mg/kg PO qDay

1-5 years: 3-3.6 mg/kg PO qDay

6-12 years: 2.4-3 mg/kg PO qDay

≥12 years: 1.2-1.8 mg/kg PO qDay

Armour Thyroid or NP Thyroid

  • <6 months: 15-30 mg/day
  • 6-12 months: 30-45 mg/day
  • 1-5 years: 45-60 mg/day
  • 6-12 years: 60-90 mg/day
  • ≥12 years: >90 mg/day

Adthyza

  • <6 months: 16.25-32.5 mg/day
  • 6-12 months: 32.5-48.75 mg/day
  • 1-5 years: 48.75-65 mg/day
  • 6-12 years: 65-97.5 mg/day
  • ≥12 years: >97.5 mg/day

Dosing Considerations

Readjustment of thyroid hormone dosage should be made within the first 4 weeks of therapy, after proper clinical and laboratory evaluations, including serum levels of T4, bound and free, and TSH

Current guidelines do not recommend desiccated thyroid for treatment of hypothyroidism (primary or secondary); levothyroxine monotherapy is preferred

Desiccated thyroid contains variable amounts of T3, T4, and other triiodothyronine compounds which are more likely to cause signs or symptoms due to fluctuating levels

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Interactions

Interaction Checker

and thyroid desiccated

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      Serious - Use Alternative

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            Contraindicated (1)

            • sodium iodide I-131

              thyroid desiccated will decrease the level or effect of sodium iodide I-131 by Other (see comment). Contraindicated. Use of thyroid products or iodine before and during treatment with sodium iodide I-131 decreases uptake of sodium iodide I-131 by the thyroid gland

            Serious - Use Alternative (12)

            • antithrombin alfa

              thyroid desiccated increases effects of antithrombin alfa by pharmacodynamic synergism. Avoid or Use Alternate Drug.

            • antithrombin III

              thyroid desiccated increases effects of antithrombin III by pharmacodynamic synergism. Avoid or Use Alternate Drug.

            • argatroban

              thyroid desiccated increases effects of argatroban by pharmacodynamic synergism. Avoid or Use Alternate Drug.

            • bemiparin

              thyroid desiccated increases effects of bemiparin by pharmacodynamic synergism. Avoid or Use Alternate Drug.

            • bivalirudin

              thyroid desiccated increases effects of bivalirudin by pharmacodynamic synergism. Avoid or Use Alternate Drug.

            • dalteparin

              thyroid desiccated increases effects of dalteparin by pharmacodynamic synergism. Avoid or Use Alternate Drug.

            • enoxaparin

              thyroid desiccated increases effects of enoxaparin by pharmacodynamic synergism. Avoid or Use Alternate Drug.

            • fondaparinux

              thyroid desiccated increases effects of fondaparinux by pharmacodynamic synergism. Avoid or Use Alternate Drug.

            • heparin

              thyroid desiccated increases effects of heparin by pharmacodynamic synergism. Avoid or Use Alternate Drug.

            • lycopus

              lycopus decreases effects of thyroid desiccated by pharmacodynamic antagonism. Contraindicated. Lycopus blocks peripheral conversion of T4 to T3.

            • phenindione

              thyroid desiccated increases effects of phenindione by pharmacodynamic synergism. Avoid or Use Alternate Drug.

            • protamine

              thyroid desiccated increases effects of protamine by pharmacodynamic synergism. Avoid or Use Alternate Drug.

            Monitor Closely (31)

            • amitriptyline

              thyroid desiccated increases effects of amitriptyline by Other (see comment). Use Caution/Monitor. Comment: Increased catecholamine receptor sensitivity; may increase CNS and cardiovascular effects, including arrhythmias.

            • amoxapine

              thyroid desiccated increases effects of amoxapine by Other (see comment). Use Caution/Monitor. Comment: Increased catecholamine receptor sensitivity; may increase CNS and cardiovascular effects, including arrhythmias.

            • carbonyl iron

              carbonyl iron decreases levels of thyroid desiccated by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

            • cholestyramine

              cholestyramine decreases levels of thyroid desiccated by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

            • clomipramine

              thyroid desiccated increases effects of clomipramine by Other (see comment). Use Caution/Monitor. Comment: Increased catecholamine receptor sensitivity; may increase CNS and cardiovascular effects, including arrhythmias.

            • colesevelam

              colesevelam will decrease the level or effect of thyroid desiccated by Mechanism: inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer thyroid hormones at least 4 hr before colesevelam. Elevated thyroid-stimulating hormone (TSH) in patients receiving thyroid hormone.

            • desipramine

              thyroid desiccated increases effects of desipramine by Other (see comment). Use Caution/Monitor. Comment: Increased catecholamine receptor sensitivity; may increase CNS and cardiovascular effects, including arrhythmias.

            • digoxin

              thyroid desiccated decreases effects of digoxin by unknown mechanism. Use Caution/Monitor.

            • doxepin

              thyroid desiccated increases effects of doxepin by Other (see comment). Use Caution/Monitor. Comment: Increased catecholamine receptor sensitivity; may increase CNS and cardiovascular effects, including arrhythmias.

            • doxepin cream

              thyroid desiccated increases effects of doxepin cream by Other (see comment). Use Caution/Monitor. Comment: Increased catecholamine receptor sensitivity; may increase CNS and cardiovascular effects, including arrhythmias.

            • eluxadoline

              eluxadoline increases levels of thyroid desiccated by decreasing metabolism. Use Caution/Monitor. Eluxadoline may increase the systemic exposure of coadministered OATP1B1 substrates.

            • ferric maltol

              ferric maltol decreases levels of thyroid desiccated by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

            • ferrous fumarate

              ferrous fumarate decreases levels of thyroid desiccated by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

            • ferrous gluconate

              ferrous gluconate decreases levels of thyroid desiccated by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

            • ferrous sulfate

              ferrous sulfate decreases levels of thyroid desiccated by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

            • imipramine

              thyroid desiccated increases effects of imipramine by Other (see comment). Use Caution/Monitor. Comment: Increased catecholamine receptor sensitivity; may increase CNS and cardiovascular effects, including arrhythmias.

            • insulin degludec

              thyroid desiccated decreases effects of insulin degludec by pharmacodynamic antagonism. Use Caution/Monitor. Thyroid hormones regulate carbohydrate metabolism, gluconeogenesis, and glycogen stores mobilization; dose of antidiabetic agents may need adjustment and increased frequency of glucose monitoring may be required.

            • insulin degludec/insulin aspart

              thyroid desiccated decreases effects of insulin degludec/insulin aspart by pharmacodynamic antagonism. Use Caution/Monitor. Thyroid hormones regulate carbohydrate metabolism, gluconeogenesis, and glycogen stores mobilization; dose of antidiabetic agents may need adjustment and increased frequency of glucose monitoring may be required.

            • insulin inhaled

              thyroid desiccated decreases effects of insulin inhaled by pharmacodynamic antagonism. Use Caution/Monitor. Thyroid hormones regulate carbohydrate metabolism, gluconeogenesis, and glycogen stores mobilization; dose of antidiabetic agents may need adjustment and increased frequency of glucose monitoring may be required.

            • iron dextran complex

              iron dextran complex decreases levels of thyroid desiccated by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

            • iron sucrose

              iron sucrose decreases levels of thyroid desiccated by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

            • lanthanum carbonate

              lanthanum carbonate decreases levels of thyroid desiccated by cation binding in GI tract. Use Caution/Monitor. Administer oral thyroid products at least 2 hr before or after lanthanum. Interaction applies only to oral thyroid products only. .

            • levonorgestrel oral/ethinylestradiol/ferrous bisglycinate

              levonorgestrel oral/ethinylestradiol/ferrous bisglycinate will decrease the level or effect of thyroid desiccated by unknown mechanism. Modify Therapy/Monitor Closely. The estrogen component of combined hormonal contraceptives (CHCs) may raise the serum concentrations of thyroxine-binding globulin. Women on thyroid hormone replacement therapy may need increased doses of thyroid hormone with use of CHCs.

            • metformin

              thyroid desiccated decreases effects of metformin by pharmacodynamic antagonism. Use Caution/Monitor. Patient should be closely observed for loss of blood glucose control; when drugs are withdrawn from a patient receiving metformin, patient should be observed closely for hypoglycemia.

            • nateglinide

              thyroid desiccated decreases effects of nateglinide by pharmacodynamic antagonism. Use Caution/Monitor. Coadministration may reduce nateglinide's hypoglycemic action.

            • nortriptyline

              thyroid desiccated increases effects of nortriptyline by Other (see comment). Use Caution/Monitor. Comment: Increased catecholamine receptor sensitivity; may increase CNS and cardiovascular effects, including arrhythmias.

            • polysaccharide iron

              polysaccharide iron decreases levels of thyroid desiccated by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

            • protriptyline

              thyroid desiccated increases effects of protriptyline by Other (see comment). Use Caution/Monitor. Comment: Increased catecholamine receptor sensitivity; may increase CNS and cardiovascular effects, including arrhythmias.

            • rose hips

              rose hips decreases levels of thyroid desiccated by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

            • trimipramine

              thyroid desiccated increases effects of trimipramine by Other (see comment). Use Caution/Monitor. Comment: Increased catecholamine receptor sensitivity; may increase CNS and cardiovascular effects, including arrhythmias.

            • warfarin

              thyroid desiccated increases effects of warfarin by unspecified interaction mechanism. Use Caution/Monitor.

            Minor (26)

            • amobarbital

              amobarbital decreases levels of thyroid desiccated by increasing metabolism. Minor/Significance Unknown.

            • butabarbital

              butabarbital decreases levels of thyroid desiccated by increasing metabolism. Minor/Significance Unknown.

            • butalbital

              butalbital decreases levels of thyroid desiccated by increasing metabolism. Minor/Significance Unknown.

            • carbamazepine

              carbamazepine decreases levels of thyroid desiccated by increasing metabolism. Minor/Significance Unknown.

            • colestipol

              colestipol decreases levels of thyroid desiccated by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

            • dexlansoprazole

              dexlansoprazole decreases levels of thyroid desiccated by increasing gastric pH. Applies only to oral form of both agents. Minor/Significance Unknown. Conflicting evidence regarding this interaction exists.

            • eslicarbazepine acetate

              eslicarbazepine acetate decreases levels of thyroid desiccated by increasing metabolism. Minor/Significance Unknown.

            • esomeprazole

              esomeprazole decreases levels of thyroid desiccated by increasing gastric pH. Applies only to oral form of both agents. Minor/Significance Unknown. Conflicting evidence regarding this interaction exists.

            • ethotoin

              ethotoin decreases levels of thyroid desiccated by increasing metabolism. Minor/Significance Unknown.

              ethotoin decreases levels of thyroid desiccated by plasma protein binding competition. Minor/Significance Unknown.

            • fosphenytoin

              fosphenytoin decreases levels of thyroid desiccated by increasing metabolism. Minor/Significance Unknown.

              fosphenytoin decreases levels of thyroid desiccated by plasma protein binding competition. Minor/Significance Unknown.

            • glandular products

              glandular products increases effects of thyroid desiccated by pharmacodynamic synergism. Minor/Significance Unknown. Additive effects with thyroid glandular extract.

            • guggul

              guggul decreases effects of thyroid desiccated by pharmacodynamic antagonism. Minor/Significance Unknown.

            • lansoprazole

              lansoprazole decreases levels of thyroid desiccated by increasing gastric pH. Applies only to oral form of both agents. Minor/Significance Unknown. Conflicting evidence regarding this interaction exists.

            • omeprazole

              omeprazole decreases levels of thyroid desiccated by increasing gastric pH. Applies only to oral form of both agents. Minor/Significance Unknown. Conflicting evidence regarding this interaction exists.

            • oxcarbazepine

              oxcarbazepine decreases levels of thyroid desiccated by increasing metabolism. Minor/Significance Unknown.

            • pantoprazole

              pantoprazole decreases levels of thyroid desiccated by increasing gastric pH. Applies only to oral form of both agents. Minor/Significance Unknown. Conflicting evidence regarding this interaction exists.

            • pentobarbital

              pentobarbital decreases levels of thyroid desiccated by increasing metabolism. Minor/Significance Unknown.

            • phenobarbital

              phenobarbital decreases levels of thyroid desiccated by increasing metabolism. Minor/Significance Unknown.

            • phenytoin

              phenytoin decreases levels of thyroid desiccated by increasing metabolism. Minor/Significance Unknown.

              phenytoin decreases levels of thyroid desiccated by plasma protein binding competition. Minor/Significance Unknown.

            • piracetam

              piracetam, thyroid desiccated. Mechanism: unknown. Minor/Significance Unknown. Combination of piracetam and T3+T4 produced confusion, sleep disorder in single case.

            • primidone

              primidone decreases levels of thyroid desiccated by increasing metabolism. Minor/Significance Unknown.

            • rabeprazole

              rabeprazole decreases levels of thyroid desiccated by increasing gastric pH. Applies only to oral form of both agents. Minor/Significance Unknown. Conflicting evidence regarding this interaction exists.

            • rifampin

              rifampin decreases levels of thyroid desiccated by increasing metabolism. Minor/Significance Unknown.

            • secobarbital

              secobarbital decreases levels of thyroid desiccated by increasing metabolism. Minor/Significance Unknown.

            • shepherd's purse

              shepherd's purse decreases effects of thyroid desiccated by unspecified interaction mechanism. Minor/Significance Unknown. Theoretical interaction.

            • theophylline

              thyroid desiccated decreases levels of theophylline by increasing elimination. Minor/Significance Unknown.

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            Adverse Effects

            Frequency Not Defined

            Adverse effects typically suggest excess thyroid replacement and/or hyperthyroidism

            Abdominal cramps, constipation, diarrhea, vomiting

            Alopecia

            Ataxia

            Cardiac arrhythmia, chest pain, palpitations, tachycardia

            Diaphoresis, dyspnea, fever, headache, heat intolerance

            Increased appetite, weight loss

            Insomnia

            Menstrual disease

            Myalgia

            Nervousness, tremor, tremor of hands

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            Warnings

            Black Box Warnings

            Drugs with thyroid hormone activity, alone or together with other therapeutic agents, used for the treatment of obesity; in euthyroid patients, doses within 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

            Contraindications

            Hypersensitivity to thyroid hormone

            Untreated thyrotoxicosis, untreated adrenal insufficiency

            Thyroid therapy of obesity, alone or combined with other drugs, is unjustified and has been shown to be ineffective

            Cautions

            In infants, excessive doses of thyroid hormone preparations may produce craniosynostosis

            Cardiovascular disease

            • Use with great caution where the integrity of the cardiovascular system, particularly the coronary arteries, is suspected, such as angina pectoris or elderly individuals, in whom there is a greater likelihood of occult cardiac disease
            • In these patients, initiate with low doses
            • 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

            Endocrine diseases

            • Thyroid hormone therapy in patients with concomitant diabetes mellitus, diabetes insipidus, or adrenal cortical insufficiency aggravates symptom intensity
            • Adjust therapeutic measures directed at these concomitant endocrine diseases are required
            • Therapy of myxedema coma requires simultaneous administration of glucocorticoids

            Drug interaction overview

            • Oral anticoagulants
              • Dosage modification/monitor
              • Hypothyroidism decreases and hyperthyroidism increases sensitivity to oral anticoagulants
              • Monitor prothrombin time closely
              • Adjust oral anticoagulant dose according to prothrombin time
            • Insulin or oral hypoglycemic
              • Dosage modification/monitor
              • Initiating thyroid replacement therapy may cause increases in insulin or oral hypoglycemic requirements
              • Effects depend upon a variety of factors (eg, dose and type of thyroid preparations, endocrine status of patient)
            • Cholestyramine or colestipol
              • Modify dosage regimen
              • Cholestyramine or colestipol binds both levothyroxine (T4) and liothyronine (T3) in the intestine, thus impairing absorption
              • Separate dosing by 4-5 hr between administration of cholestyramine or colestipol and thyroid hormones
            • Estrogen, oral contraceptives
              • Higher thyroid dose may be needed
              • Estrogens tend to increase serum thyroxine-binding globulin (TBg)
              • Patients with a nonfunctioning thyroid gland who receive thyroid replacement therapy, free levothyroxine (T4) may be decreased when estrogens are started thus increasing thyroid requirements
              • However, if the thyroid gland has sufficient function, the decreased free T4 will result in a compensatory increase in T4 output by the thyroid
              • Patients may need to increase their thyroid dose if estrogens or estrogen-containing oral contraceptives are given
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            Pregnancy & Lactation

            Pregnancy

            Desiccated thyroid is not recommended for treatment during pregnancy; levothyroxine is the treatment of choice for females who are pregnant or trying to become pregnant

            Thyroid hormones do not readily cross the placental barrier; clinical experience to date does not indicate any adverse effect on fetuses when thyroid hormones are administered to pregnant females

            On the basis of current knowledge, thyroid replacement therapy to hypothyroid females should not be discontinued during pregnancy

            Lactation

            Minimal amounts of thyroid hormones are excreted in human milk; thyroid is not associated with serious adverse reactions and does not have a known tumorigenic potential; however, caution should be exercised when thyroid is administered to a nursing females

            Pregnancy Categories

            A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA: Information not available.

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            Pharmacology

            Mechanism of Action

            Natural thyroid hormone from animals; increase basal metabolic rate, increase utilization and mobilization of glycogen store, promotes gluconeogenesis

            Absorption

            Onset: Initial effect: 3hr

            Bioavailability: 48-80%

            Peak plasma time

            • T4: 2-4 hr
            • T3: 2-3 Days

            Distribution

            Protein Bound: >99%

            Metabolism

            Metabolism: Hepatic; also in kidney and intestinal walls

            Metabolites: Levothyroxine (T4), liothyronine (T3), reverse triiodothyronine (rT3)

            Elimination

            Excretion: Urine (major), feces (partially)

            Half-Life

            • T4: 6-7 days (euthyroid); 3-4 days (hyperthyroid); 9-10 (hypothyroid)
            • T3: 2.5 days
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            Images

            BRAND FORM. UNIT PRICE PILL IMAGE
            thyroid (pork) oral
            -
            60 mg tablet
            thyroid (pork) oral
            -
            30 mg tablet
            thyroid (pork) oral
            -
            120 mg tablet
            thyroid (pork) oral
            -
            90 mg tablet
            thyroid (pork) oral
            -
            15 mg tablet
            Niva Thyroid oral
            -
            120 mg tablet
            Niva Thyroid oral
            -
            90 mg tablet
            Niva Thyroid oral
            -
            60 mg tablet
            Niva Thyroid oral
            -
            15 mg tablet
            Armour Thyroid oral
            -
            60 mg tablet
            Armour Thyroid oral
            -
            240 mg tablet
            Armour Thyroid oral
            -
            180 mg tablet
            Armour Thyroid oral
            -
            120 mg tablet
            Armour Thyroid oral
            -
            90 mg tablet
            Armour Thyroid oral
            -
            15 mg tablet
            Armour Thyroid oral
            -
            30 mg tablet
            Armour Thyroid oral
            -
            300 mg tablet
            NP Thyroid oral
            -
            60 mg tablet
            NP Thyroid oral
            -
            90 mg tablet
            NP Thyroid oral
            -
            30 mg tablet
            NP Thyroid oral
            -
            120 mg tablet
            NP Thyroid oral
            -
            15 mg tablet

            Copyright © 2010 First DataBank, Inc.

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            Patient Handout

            Patient Education
            thyroid (pork) oral

            THYROID - ORAL

            (THYE-royd)

            COMMON BRAND NAME(S): Adthyza, Armour Thyroid

            WARNING: This medication should not be used for weight loss. Normal doses of this medication will not work for weight loss, and large doses of this medication may cause serious, possibly fatal side effects, especially when taken with diet pills.

            USES: Thyroid hormone is used to treat underactive thyroid (hypothyroidism). It is a natural product made from animal thyroid glands (usually a pig's). It replaces or provides more thyroid hormone, which is normally produced by the thyroid gland. Low thyroid hormone levels can occur naturally or when the thyroid gland is injured by radiation/medications or removed by surgery. Having enough thyroid hormone is important for maintaining normal mental and physical activity. In children, having enough thyroid hormone is important for normal mental and physical development.This medication is also used to treat other types of thyroid disorders (such as certain types of goiters, thyroid cancer) and also to test for thyroid function.This medication should not be used to treat infertility unless it is caused by low thyroid hormone levels.Older adults should discuss the risks and benefits of this medication with their doctor or pharmacist.

            HOW TO USE: Take this medication by mouth as directed by your doctor, usually once daily on an empty stomach, 30 minutes to 1 hour before breakfast.The dosage is based on your medical condition, lab tests, and response to treatment. For children, the dosage is also based on age/weight.Use this medication regularly in order to get the most benefit from it. To help you remember, take it at the same time each day.Do not stop taking this medication without first consulting with your doctor. Thyroid replacement treatment is usually taken for life.Certain medications (cholestyramine, colestipol, colesevelam, antacids, sucralfate, simethicone, iron, sodium polystyrene sulfonate, calcium carbonate, orlistat) can decrease the amount of thyroid hormone that is absorbed by your body. If you are taking any of these drugs, separate them from this medication by at least 4 hours.There are different brands of thyroid hormone available. Do not change brands without first consulting your doctor or pharmacist.Symptoms of low thyroid hormone levels include tiredness, muscle aches, constipation, dry skin, weight gain, slow heartbeat, or sensitivity to cold. Tell your doctor if your condition gets worse or lasts after several weeks of taking this medication.

            SIDE EFFECTS: Hair loss may occur during the first few months of treatment. This effect is usually temporary as your body adjusts to this medication. If this effect lasts or gets worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects of high thyroid hormone levels, including: increased sweating, sensitivity to heat, mental/mood changes (such as nervousness, mood swings), tiredness, diarrhea, shaking (tremor), headache, shortness of breath.Get medical help right away if you have any very serious effects of high thyroid hormone levels, including: chest pain, fast/pounding/irregular heartbeat, swelling hands/ankles/feet, seizures.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

            PRECAUTIONS: Before taking thyroid hormone, tell your doctor or pharmacist if you are allergic to it; or to pork products; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: increased thyroid hormones (thyrotoxicosis), decreased adrenal gland function, heart disease (such as coronary artery disease, irregular heartbeat), high blood pressure, diabetes.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be more sensitive to the side effects of this drug, especially chest pain, fast/pounding/irregular heartbeat.Current information shows that this drug may be used during pregnancy. Tell your doctor if you are pregnant because your dose may need to be adjusted.Thyroid hormone passes into breast milk but is unlikely to harm a nursing infant. Consult your doctor before breast-feeding.

            DRUG INTERACTIONS: See also How to Use Section.Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

            OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: fast/pounding/irregular heartbeat, loss of consciousness, confusion, seizures.

            NOTES: Do not share this medication with others.Lab and/or medical tests (such as thyroid function) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.

            MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up unless your doctor tells you to do so. Call your doctor if you miss 2 or more doses in a row. Ask your doctor ahead of time what to do about a missed dose and follow your doctor's specific directions.

            STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

            Information last revised May 2023. Copyright(c) 2023 First Databank, Inc.

            IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
            Additional Offers
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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.