L - thyroxin 0.50 mg. 50 tablets

What is L-Thyroxin 50 Berlin-Chemie and what it is used
L-Thyroxin 50 Berlin-Chemie is a medicine that contains the thyroid hormone levothyroxine as active substance. It has the same effect as a hormone produced naturally.
You take L-Thyroxin 50 Berlin-Chemie, to replace the missing thyroid hormone and / or to relieve his thyroid.

L-Thyroxine 50 Berlin-Chemie is used for:
replacement (substitution) of the missing thyroid hormone in all types underactive thyroid gland (hypothyroidism);
prevent re-formation of goiter (enlargement of the thyroid gland) after surgery goiter with normal thyroid function;
treatment of benign goiter in normal thyroid function;
Accompanying the treatment of overactive thyroid gland thyreostatics (medications that suppress thyroid function), having reached normal metabolic condition;
malignant tumor of the thyroid, primarily after surgery for tumor growth inhibition and replace the missing thyroid hormone.
L-Thyroxin 50 Berlin-Chemie applies to all age groups.

2. What you need to know before you take L-Thyroxin 50 Berlin-Chemie
Do not take L-Thyroxin 50 Berlin-Chemie:
if you are allergic (hypersensitive) to levothyroxine sodium or any of the other ingredients of this medicine (listed in section. 6);
if you have any of these diseases or any of these:
untreated overactive thyroid gland;
untreated insufficiency of the adrenal cortex;
untreated pituitary failure if it leads to a deficiency of the adrenal cortex that requires treatment;
recent myocardial infarction;
acute inflammation of the heart muscle (myocarditis);
acute inflammation of all layers of the wall of the heart (pankardit).
If you are pregnant, you should not take L-Thyroxine 50 Berlin-Chemie together with medicines that suppress the increased thyroid function (ie. Pomegranate. Thyreostatics) (see also section "Pregnancy and lactation");
Before starting treatment with L-thyroxin 50 Berlin-Chemie, the following diseases or conditions should be excluded or treated:
coronary heart disease;
pain in the heart with a feeling of tightness (angina pectoris);
high blood pressure;
Failure of the pituitary and / or adrenal cortex;
presence of areas of the thyroid gland, which produces uncontrolled thyroid hormones (autonomous function of the thyroid gland).
Warnings and Precautions
If you have experienced a heart attack or have coronary heart disease, heart muscle weakness, heart rhythm disorders (tachycardia) or inflammation of the heart muscle that does not occur acutely or have suffered long periods of reduced thyroid function: in these cases To avoid too high hormone levels in the blood. Therefore the levels of thyroid hormones should be monitored more often. Ask your doctor if you have any severe symptoms of overactive thyroid gland associated with the use of L-Thyroxine 50 Berlin-Chemie (see pt. 4 "Possible Side Effects");
If you suffer from underactive thyroid gland due to pituitary disease. In this case, you may have and failure of the adrenal cortex, which your doctor should treat first (treatment with hydrocortisone);
If it suspects that there are areas in the thyroid gland, which produces hormones uncontrolled. This should be evaluated with further studies of thyroid function prior to treatment;
In postmenopausal women who have a high risk of destruction of the bone (osteoporosis). Thyroid function must be monitored more frequently than your doctor, in order to avoid increased levels of thyroid hormones in the blood;
If you have diabetes or are taking certain anti-coagulants (eg. Dicumarol). Please see section "Other medicines and L-Thyroxin 50 Berlin-Chemie"
If you are treated with sevelamer because of high levels of phosphate in the blood, for example. if you are a patient on dialysis, your doctor will monitor certain indicators of blood on the effectiveness of levothyroxine (see also "Other medicines and L-Thyroxine 50 Berlin-Chemie").
Ask your doctor or pharmacist before taking L-Thyroxine 50 Berlin Chemie.

Misuse
You should not take L-Thyroxin 50 Berlin-Chemie for weight reduction. If the levels of thyroid hormones in blood is normal, the additional administration of thyroid hormone will cause a reduction in body weight. Supplementation can lead to undesirable or even life-threatening reactions, especially in combination with other drugs for weight reduction.

Change Therapy
If you are already being treated of L-Thyroxin 50 Berlin-Chemie, a change of therapy with other thyroid hormone should be performed only by a doctor with tracking and study of blood parameters.

Elderly
In the elderly need more careful dosing (especially in the presence of cardiac problems) and frequent consultation with the doctor.

Other medicines and L-Thyroxin 50 Berlin-Chemie
Please tell your doctor or pharmacist if you are taking / using or have recently taken / used other drugs.

L-Thyroxine 50 Berlin-Chemie influence the effect of the following medicines or groups:
Antidiabetic drugs (drugs that lower blood sugar). If you are diabetic, you need to regularly track blood sugar levels, especially at the beginning of treatment with thyroid hormones. Your doctor will adjust the dose of medication to lower blood sugar as Levothyroxine may reduce the effect of medicines that lower blood sugar;
Coumarin derivatives (anti-clotting drugs). Concomitant treatment with L-thyroxine 50 Berlin-Chemie and coumarin derivatives (eg. Dicumarol) must regularly track blood clotting. Your doctor should reduce the dosage of anticoagulation medication as levothyroxine may increase the effects of anticoagulant agents.
The effect of L-Thyroxin 50 Berlin-Chemie is responding to other medicines, such as:
Medications to reduce blood lipid lowering drugs increased levels of potassium in the blood (ion exchange resins). Drugs to reduce levels of blood lipids (eg. Cholestyramine, colestipol, colesevelam) or drugs to reduce elevated levels of potassium in the blood (calcium or sodium salts of polystyrene sulfonic acid) apply 4 to 5 hours after taking L- Thyroxine 50 Berlin-Chemie. Otherwise, these drugs will inhibit the absorption of levothyroxine from intestines and thus reduce its efficiency;
Sevelamer and lanthanum carbonate. Sevelamer and lanthanum carbonate (drugs to lower elevated levels of phosphate in the blood in patients on hemodialysis) is likely to reduce the absorption and efficacy of levothyroxine. Your doctor will monitor thyroid function more frequently (see also section "Warnings and Precautions");
Aluminium-containing drugs that are associated with gastric acid, iron-containing medicinal products, calcium-containing medicinal products. Take L-Thyroxine 50 Berlin-Chemie at least 2 hours before the aluminum-containing drugs that are associated with gastric acid (antacids, sucralfate), iron-containing or calcium-containing medicinal products. Otherwise, these medicines will prevent the absorption of levothyroxine from the intestine and thus reduce its efficiency;
Propylthiouracil, glucocorticoids, beta-blockers. Propylthiouracil (medicine for overactive thyroid), glucocorticoids (hormones of the adrenal gland, "cortisone") and beta-blockers (drugs that decrease heart rate and decrease blood pressure) inhibit the conversion of levothyroxine in a more active form of liothyronine and thus may reduce the effectiveness of L-Thyroxine 50 Berlin-Chemie;
Amiodarone, iodine-containing contrast media. Amiodarone (a medicine to treat abnormal heart rhythms) and iodinated contrast media (certain medications used in radiological diagnostics) can lead to both increased and a decreased thyroid function due to high iodine content. Caution knotted at the neck if available yet unidentified areas in the thyroid gland, which form uncontrolled thyroid hormones (autonomy). Your doctor will adjust the dosage of L-Thyroxine 50 Berlin-Chemie, if necessary;
The following medicines may increase the effect of L-Thyroxine 50 Berlin-Chemie:
salicylates (medicines against fever and pain);
dicumarol (anti-clotting drugs);
high doses of furosemide (250 mg) (drug to increase the released amount of urine);
clofibrate (a medicament for lowering lipid levels in the blood);
phenytoin (a medicine to treat seizures medicine to treat abnormal heart rhythms);
Birth control pills or hormone replacement therapy. If you are taking estrogen-containing hormonal birth control pills or hormone replacement therapy after menopause, the need of levothyroxine may increase;
Sertraline, chloroquine / proguanil. Sertraline (a medicine for depression) and chloroquine / proguanil (medicines against malaria and rheumatic diseases) decrease the effectiveness of levothyroxine;
Barbiturates, rifampicin, carbamazepine. Barbiturates (drugs to treat seizures, anesthesia, certain hypnotics), rifampicin (antibiotic) and carbamazepine (a medicine to treat seizures) may reduce the effect of levothyroxine;
Protease inhibitors (medicines used to treat HIV infection). If you take levothyroxine, and protease inhibitors (lopinavir, ritonavir), your doctor should closely monitor your disease symptoms and to monitor thyroid function. Levothyroxine may reduce its efficacy when administered with lopinavir / ritonavir;
Tyrosine kinase inhibitors (imatinib and sunitinib). Treatment with imatinib or sunitinib (medicines for the treatment of chronic myeloid leukemia) is associated with the increased needs of levothyroxine in patients with hypothyroidism.
L-Thyroxine 50 Berlin-Chemie with food and drink
You should not take L-Thyroxine 50 Berlin-Chemie with food, especially with such rich in calcium (eg. Milk and dairy products) as this can significantly reduce the absorption of levothyroxine.
If your diet contains soy, your doctor will check more frequently the levels of thyroid hormones in the blood. You may need your doctor to adjust the dose of L-Thyroxine 50 Berlin-Chemie during and after the completion of such a diet (you may need unusually high doses), as products containing soy can impair the absorption of levothyroxine from intestines and thereby reduce its effectiveness.

Pregnancy, lactation and fertility
If you are pregnant or breast-feeding, you think you may be pregnant or planning to become pregnant, ask your doctor or pharmacist before taking this medicine.
Proper treatment with thyroid hormones is particularly important during pregnancy and lactation. Therefore, treatment should be consistent and under the supervision of your doctor. Despite the widespread use during pregnancy has not been established adverse effects on pregnancy or the health of the fetus or newborn.
Thyroid function should be monitored during and after pregnancy. You may need your doctor to adjust the dosage as during pregnancy needs levothyroxine may increase due to increased levels of estrogen (female sex hormone).
During pregnancy should not take L-Thyroxin 50 Berlin-Chemie simultaneously with drugs that suppress the overactive thyroid gland (thyreostatics), as it will require administration of higher doses of antithyroid. Thyreostatics, unlike levothyroxine can reach the bloodstream of the fetus through the placenta and can result in a reduced function of the thyroid gland of the fetus. If you suffer from overactive thyroid gland, your doctor must treat you with extremely low doses of antithyroid drug during pregnancy.
The amount of thyroid hormones in breast milk is very low even at high doses of levothyroxine, and is therefore harmless.
There is no scientific evidence of impaired fertility in men and women. No suspicion or evidence of damage.

Driving and using machines
No studies on the effects on ability to drive and use machines.

3. How to take L-Thyroxin 50 Berlin-Chemie
Always take this medicine exactly as your doctor tells you. If you're not sure, ask your doctor or pharmacist.
The daily dose that you need will be determined by your doctor according to the survey results.

Dosage
Individual treatments are available divisible tablet with different concentration of the active substance, e. for initial therapy, increasing the dose in adult patients and pediatric treatment.

Depending on the symptoms, your doctor will observe the following recommendations:
For the treatment of thyroid gland hypofunction, the starting dose for adults is 25-50 micrograms of levothyroxine sodium per day. On the recommendation of the doctor this dose may be increased at intervals of 2 to 4 weeks from 25-50 micrograms levothyroxine sodium to 100-200 micrograms daily dose levothyroxine sodium (equivalent to 2 to 4 tablets L-Thyroxine 50 Berlin-Chemie);
To prevent the re-formation of the neck after the operation of the neck and in the treatment of benign goiter adopted 75-200 micrograms of levothyroxine sodium per day (equivalent to one and a half to 4 tablets L-Thyroxine 50 Berlin-Chemie);
Accompanying therapy for the treatment of overactive thyroid gland thyreostatics be adopted 50-100 micrograms levothyroxine sodium a day (equivalent to 1 to 2 tablet L-Thyroxine 50 Berlin-Chemie);
After operation of the thyroid gland due to cancer of the thyroid gland, the daily dose is 150-300 micrograms of levothyroxine sodium (equivalent to 3 to 6 tablets L-Thyroxine 50 Berlin-Chemie).
It may be sufficient, and at a lower dose thyroid hormones.

Pediatric patients with underactive thyroid gland (congenital or acquired hypothyroidism)
Maintenance dose for long term treatment of thyroid function with reduced (congenital or acquired hypothyroidism) usually is 100-150 micrograms levothyroxine per m2 body surface area per day. In newborns and infants with congenital underactive thyroid gland, rapid hormone replacement therapy is especially important for normal mental and physical development. The initial recommended dosage is 10-15 micrograms of levothyroxine per kilogram body weight per day during the first three months. Then the doctor will adjust the daily dose individually according to clinical outcomes (particularly levels of thyroid hormones in the blood).
In children with acquired underactive thyroid gland, the starting recommended dose is 12.5 to 50 micrograms levothyroxine per day. The doctor will increase your daily dose gradually every 2-4 weeks until the full replacement dose, whereas especially the levels of thyroid hormones in the blood.

Elderly patients with coronary heart disease patients with underactive thyroid gland
In elderly patients, in patients with coronary heart disease dose in patients with severe or prolonged decrease in thyroid gland, thyroid hormone treatment should be initiated with caution (lower starting dose is increased slowly over long intervals with regular monitoring of thyroid hormones).

Patients with low body weight, and patients with large goiter
Experience has shown that lower doses are also sufficient in patients with low body weight, and increased in patients with thyroid.

Instructions for dividing the tablet
The tablet can be divided into equal doses.
Put the tablet on a hard, flat surface, such as the score line remain the top. If you press a finger to the tablet down at the table will receive two equal halves of the tablet.

Method of administration
Please take the full daily dose in the morning with enough liquid, preferably with a glass of water on an empty stomach at least half an hour before breakfast. The active substance is absorbed better on an empty stomach as compared to before or after meals.
Infants receive the entire dose at once at least half an hour before the first meal of the day. Dissolve the tablet in a little water (10-15 ml) and attach the resulting suspension (the suspension should be prepared immediately before each dose) with a little extra fluid (5-10 ml).

Duration of treatment
L-Thyroxin 50 Berlin-Chemie generally accepted life in decreased thyroid function after surgery of the thyroid gland due to a malignant tumor. Benign goiter or to prevent re-formation of goiter is taken several months or years to life.