Titration and Maintenance

Adjusting treatment to just the right level

  • Levothyroxine has a narrow therapeutic index
  • Regardless of the indication for use, careful dosage titration is necessary to avoid the consequences of over- or under-treatment

Recommended TSH Ranges1,2

Recommended TSH ranges inforgraphic

Hypothyroidism is diagnosed by measuring TSH levels and levels of free L-thyroxine (T4).

ATA=American Thyroid Association; AACE=American Association of Clinical Endocrinologists; NACB=National Academy of Clinical Biochemistry.

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Dosing and Administration

Dosing and Administration for Adults

UNITHROID should be:

  • Taken in the morning on an empty stomach, at least one-half hour to one hour before any food is eaten
  • Taken ≥4 hours apart from medications known to interfere with absorption of UNITHROID

Take into consideration:

  • Caution should be exercised when administering to patients with underlying cardiovascular disease, to the elderly, and to those with concomitant adrenal insufficiency
  • Patients should be given the minimum dose necessary to achieve the desired response
  • Peak therapeutic effect at a given dose may not be attained for 4 to 6 weeks
  • TSH monitoring and associated dose titration depends on the clinical situation but is generally recommended at 6- to 8-week intervals until normalization
  • Serum TSH concentration should be measured after 8 to 12 weeks for patients who have:
    • Initiated therapy and whose serum TSH has normalized
      • –or–
    • Had their dosage changed
  • When the optimum replacement dose has been attained, laboratory monitoring may be performed every 6 to 12 months
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