Metherspan
Generic Name
Levothyroxine Sodium
Manufacturer
Hypothetical Pharma Inc.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| metherspan 125 mcg tablet | ৳ 0.55 | ৳ 5.50 |
Description
Overview of the medicine
Metherspan 125 mcg Tablet contains Levothyroxine Sodium, a synthetic thyroid hormone used to treat hypothyroidism (underactive thyroid gland). It works by replacing the hormone that the thyroid gland normally produces, which helps to restore the body's metabolism and energy levels.
Uses & Indications
Dosage
Adults
Initial dose typically 25-50 mcg daily, adjusted by 12.5-25 mcg increments every 4-6 weeks based on clinical response and TSH levels. Maintenance dose usually 100-200 mcg daily.
Elderly
Initial dose typically 12.5-25 mcg daily, with careful titration due to increased sensitivity to thyroid hormones and risk of cardiac events.
Renal_impairment
No specific dose adjustment is generally required. Monitor TSH and clinical response closely.
How to Take
Take Metherspan orally once daily, preferably on an empty stomach 30-60 minutes before breakfast, or at bedtime (3-4 hours after the last meal) to optimize absorption. Do not take with food or other medications.
Mechanism of Action
Levothyroxine Sodium acts as a synthetic form of thyroxine (T4), a hormone naturally produced by the thyroid gland. In the body, T4 is converted to its more active form, triiodothyronine (T3). These thyroid hormones bind to nuclear receptors and regulate gene expression, influencing metabolism, growth, and development across various organ systems.
Pharmacokinetics
Onset
Therapeutic effects begin within 3-5 days; full effect may take several weeks.
Excretion
Mainly excreted in urine (about 80%) and feces (about 20%).
Half life
Approximately 6-7 days (euthyroid individuals); 9-10 days (hypothyroid individuals).
Absorption
Approximately 48-79% absorbed orally, primarily from the small intestine. Absorption is affected by food and other medications.
Metabolism
Primarily deiodination in the liver, kidney, and other tissues to T3 and reverse T3 (rT3).
Side Effects
Contraindications
- Untreated subclinical or overt hyperthyroidism.
- Acute myocardial infarction.
- Untreated adrenal insufficiency.
- Known hypersensitivity to levothyroxine or any components of the tablet.
Drug Interactions
Insulin/Oral Hypoglycemics
Thyroid hormones may increase blood glucose. Monitor diabetic control and adjust antidiabetic medication.
Soybean products, dietary fiber
Can reduce absorption. Adjust dosage as needed.
Antacids, Iron, Calcium Supplements
May decrease levothyroxine absorption. Separate administration by at least 4 hours.
Oral Anticoagulants (e.g., Warfarin)
Levothyroxine can increase the anticoagulant effect. Monitor INR and adjust anticoagulant dose.
Bile Acid Sequestrants (e.g., Cholestyramine)
May reduce levothyroxine absorption. Administer levothyroxine 4-5 hours before these agents.
Certain Seizure Medications (e.g., Phenytoin, Carbamazepine)
May increase levothyroxine metabolism, requiring higher doses.
Antidepressants (e.g., Sertraline, Tricyclic antidepressants)
May increase thyroid hormone requirements or alter response.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include signs of hyperthyroidism such as increased heart rate, palpitations, nervousness, tremor, headache, insomnia, sweating, weight loss, and diarrhea. Management involves reducing the dose or temporarily discontinuing the drug, and symptomatic treatment (e.g., beta-blockers for cardiac symptoms).
Pregnancy & Lactation
Levothyroxine is considered safe and essential during pregnancy. Thyroid hormone requirements may increase during pregnancy; dose adjustments may be needed. It is also safe during lactation; minimal amounts are excreted in breast milk and generally do not affect the infant.
Side Effects
Contraindications
- Untreated subclinical or overt hyperthyroidism.
- Acute myocardial infarction.
- Untreated adrenal insufficiency.
- Known hypersensitivity to levothyroxine or any components of the tablet.
Drug Interactions
Insulin/Oral Hypoglycemics
Thyroid hormones may increase blood glucose. Monitor diabetic control and adjust antidiabetic medication.
Soybean products, dietary fiber
Can reduce absorption. Adjust dosage as needed.
Antacids, Iron, Calcium Supplements
May decrease levothyroxine absorption. Separate administration by at least 4 hours.
Oral Anticoagulants (e.g., Warfarin)
Levothyroxine can increase the anticoagulant effect. Monitor INR and adjust anticoagulant dose.
Bile Acid Sequestrants (e.g., Cholestyramine)
May reduce levothyroxine absorption. Administer levothyroxine 4-5 hours before these agents.
Certain Seizure Medications (e.g., Phenytoin, Carbamazepine)
May increase levothyroxine metabolism, requiring higher doses.
Antidepressants (e.g., Sertraline, Tricyclic antidepressants)
May increase thyroid hormone requirements or alter response.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include signs of hyperthyroidism such as increased heart rate, palpitations, nervousness, tremor, headache, insomnia, sweating, weight loss, and diarrhea. Management involves reducing the dose or temporarily discontinuing the drug, and symptomatic treatment (e.g., beta-blockers for cardiac symptoms).
Pregnancy & Lactation
Levothyroxine is considered safe and essential during pregnancy. Thyroid hormone requirements may increase during pregnancy; dose adjustments may be needed. It is also safe during lactation; minimal amounts are excreted in breast milk and generally do not affect the infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 to 36 months from the date of manufacture, when stored under recommended conditions.
Availability
Pharmacies, Hospitals
Approval Status
Approved by FDA and DGDA
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have established the efficacy and safety of levothyroxine for hypothyroidism. Ongoing research focuses on optimal dosing strategies, combination therapies, and long-term outcomes in specific patient populations.
Lab Monitoring
- Serum TSH levels (primary indicator for dose adjustment).
- Free T4 levels (to confirm diagnosis and in certain situations).
- Lipid profile (as hypothyroidism affects cholesterol levels).
- Bone mineral density (for long-term use, especially in postmenopausal women, due to risk of osteoporosis if over-treated).
Doctor Notes
- Emphasize the importance of consistent daily dosing and taking the medication on an empty stomach to ensure stable TSH levels.
- Counsel patients on potential drug and food interactions, particularly with calcium, iron, antacids, and coffee, advising proper separation times.
- Stress the need for regular TSH monitoring (initially every 4-6 weeks during titration, then annually) to prevent over- or under-treatment.
- Advise patients to report symptoms of hyperthyroidism (palpitations, nervousness, weight loss) or persistent hypothyroidism (fatigue, weight gain) to facilitate timely dose adjustment.
Patient Guidelines
- Take Metherspan exactly as prescribed by your doctor. Do not stop taking it without consulting your doctor.
- Take it at the same time each day, preferably on an empty stomach before breakfast.
- Inform your doctor about all other medications, supplements, and herbal products you are taking.
- Regular blood tests (TSH) are essential to monitor your thyroid function and adjust the dose.
- Do not switch between different brands of levothyroxine without consulting your doctor, as their potency may vary.
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Metherspan generally does not impair your ability to drive or operate machinery. However, if you experience side effects like nervousness or tremor, exercise caution.
Lifestyle Advice
- Maintain a balanced diet and engage in regular physical activity to support overall health and weight management.
- Manage stress effectively as it can impact thyroid function.
- Ensure adequate sleep for better energy levels and well-being.
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