ﺑﺎﺯﮔﺸﺖ ﺑﻪ ﺻﻔﺤﻪ ﻗﺒﻠﯽ
خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
نسخه الکترونیک
medimedia.ir

Thyroid extract (desiccated thyroid): Pediatric drug information

Thyroid extract (desiccated thyroid): Pediatric drug information
(For additional information see "Thyroid extract (desiccated thyroid): Drug information" and see "Thyroid extract (desiccated thyroid): Patient drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)
ALERT: US Boxed Warning
Weight reduction:

Drugs with thyroid hormone activity, alone or 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.

Brand Names: US
  • Adthyza;
  • Armour Thyroid;
  • Nature-Throid [DSC];
  • Niva Thyroid;
  • NP Thyroid;
  • Westhroid [DSC];
  • WP Thyroid [DSC]
Therapeutic Category
  • Thyroid Product
Dosing: Neonatal

Note: Doses presented as mg/kg/dose or mg/dose; closely review dosing units; adjust dose based upon clinical response and laboratory parameters. Tablet strengths may vary by manufacturer in terms of grains or mg; dosing recommendations are based on general clinical equivalencies that 1 grain = 60 mg or 65 mg; 1/2 grain = 30 mg or 32.5 mg; and 1/4 grain = 15 mg or 16.25 mg.

Congenital hypothyroidism

Congenital hypothyroidism: Oral: 4.8 to 6 mg/kg/dose or 15 to 32.5 mg/dose once daily. Note: AAP recommends levothyroxine as the preferred treatment for hypothyroidism in neonates (Ref).

Dosing: Pediatric

Note: Doses presented as mg/kg/dose or mg/dose; closely review dosing units; adjust dose based upon clinical response and laboratory parameters. Tablet strengths may vary by manufacturer in terms of grains or mg; dosing recommendations are based on general clinical equivalencies that 1 grain = 60 mg or 65 mg; 1/2 grain = 30 mg or 32.5 mg; and 1/4 grain = 15 mg or 16.25 mg.

Congenital hypothyroidism

Congenital hypothyroidism: Note: Guidelines do not recommend routine use of desiccated thyroid over levothyroxine monotherapy in the management of hypothyroidism (Ref). Infants should have therapy initiated at full doses; Oral:

Infants 1 to 6 months: 4.8 to 6 mg/kg/dose or 15 to 32.5 mg/dose once daily

Infants >6 to 12 months: 3.6 to 4.8 mg/kg/dose or 30 to 48.75 mg/dose once daily

Children 1 to 5 years: 3 to 3.6 mg/kg/dose or 45 to 65 mg/dose once daily

Children 6 to 12 years: 2.4 to 3 mg/kg/dose or 60 to 97.5 mg/dose once daily

Adolescents: Typical doses 1.2 to 1.8 mg/kg/dose or >90 mg/dose once daily

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling.

Dosing: Hepatic Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling.

Dosing: Adult

(For additional information see "Thyroid extract (desiccated thyroid): Drug information")

Hypothyroidism, primary

Hypothyroidism, primary (alternative agent):

Note: Current guidelines do not recommend desiccated thyroid for treatment of hypothyroidism (primary or secondary); levothyroxine monotherapy is preferred. Avoid use during pregnancy (Ref). Tablet strengths may vary by manufacturer in terms of grains or milligrams; dosing recommendations are based on general clinical equivalencies that 1 grain = 60 mg or 65 mg (depending on formulation).

Oral: Initial: 30 or 32.5 mg/day; in patients with cardiovascular disease or long-standing myxedema, initiate at 15 or 16.25 mg/day. May increase dose in 7.5 to 16.25 mg/day increments every 6 weeks if needed based on TSH levels; usual dose range: 60 to 130 mg/day (Ref). Inadequate response to doses up to 180 or 195 mg/day may suggest missed doses or malabsorption.

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling.

Dosing: Hepatic Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling.

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Adverse reactions are often indicative of excess thyroid replacement and/or hyperthyroidism.

<1%, postmarketing, and/or case reports: Abdominal cramps, alopecia, ataxia, cardiac arrhythmia, chest pain, constipation, diaphoresis, diarrhea, dyspnea, fever, headache, heat intolerance, increased appetite, insomnia, menstrual disease, myalgia, nervousness, palpitations, tachycardia, tremor, tremor of hands, vomiting, weight loss

Contraindications

Hypersensitivity to any component of the formulation; untreated thyrotoxicosis; uncorrected adrenal insufficiency

Warnings/Precautions

Disease-related concerns:

• Adrenal insufficiency: Use with caution in patients with adrenal insufficiency; symptoms may be exaggerated or aggravated; contraindicated in patients with uncorrected adrenal insufficiency. Treatment with glucocorticoids should precede thyroid replacement therapy in patients with adrenal insufficiency (ATA/AACE [Garber 2012]).

• Cardiovascular disease: Use reduced initial dosage and conservative dose titration in patients with cardiovascular disease. Overtreatment may increase risk of adverse cardiovascular events, including angina and arrhythmia; patients with developing or worsening cardiac symptoms should have their dose reduced or therapy withheld for 7 days and then resumed at a reduced dose. Chronic untreated hypothyroidism predisposes patients to cardiovascular disease (ATA [Jonklaas 2014]; Razvi 2018).

• Diabetes: Use with caution in patients with diabetes mellitus and diabetes insipidus; symptoms may be exaggerated or aggravated.

• Myxedema: Use with caution in patients with myxedema; symptoms may be exaggerated or aggravated; initial dosage reduction is recommended in patients with long-standing myxedema.

Dosage form specific issues:

• Desiccated thyroid: Contains variable amounts of T3, T4, and other triiodothyronine compounds which are more likely to cause cardiac signs or symptoms due to fluctuating thyroid hormone levels.

Other warnings/precautions:

• Infertility (unapproved use): Thyroid supplements are not recommended for the treatment of female or male infertility, unless associated with hypothyroidism.

• Porcine derived: Some desiccated thyroid products are acquired from porcine thyroid glands of pigs processed for human food; production also occurs at a facility that handles bovine tissues from cows processed for human food. Contamination with porcine or bovine viruses, or other novel or unidentified viruses, is potentially a risk; however, there have been no reported cases of transmission of an infectious illness.

• Weight reduction (unapproved use): [US Boxed Warning]: In euthyroid patients, thyroid supplements within the range of daily hormonal requirements are ineffective for weight reduction. High doses may produce serious or even life-threatening toxic effects particularly when used with some anorectic drugs (eg, sympathomimetic amines).

Warnings: Additional Pediatric Considerations

Overtreatment may result in craniosynostosis in infants and premature closure of epiphyses in children; monitor use closely. May cause transient alopecia in children during the first few months of therapy. In neonates and infants, cardiac overload, arrhythmias, and aspiration from avid suckling may occur during initiation of therapy (eg, first 2 weeks); monitor closely.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Tablet, Oral:

Adthyza: 15 mg, 16.25 mg, 30 mg, 32.5 mg, 60 mg, 65 mg, 90 mg, 97.5 mg, 120 mg, 130 mg

Armour Thyroid: 15 mg, 30 mg, 60 mg, 90 mg, 120 mg

Armour Thyroid: 180 mg [scored]

Armour Thyroid: 240 mg

Armour Thyroid: 300 mg [scored]

Nature-Throid: 16.25 mg [DSC], 32.5 mg [DSC], 48.75 mg [DSC], 65 mg [DSC], 81.25 mg [DSC], 97.5 mg [DSC], 113.75 mg [DSC], 130 mg [DSC], 146.25 mg [DSC], 162.5 mg [DSC], 195 mg [DSC], 260 mg [DSC], 325 mg [DSC]

Niva Thyroid: 15 mg, 30 mg, 60 mg, 90 mg, 120 mg

NP Thyroid: 15 mg, 30 mg, 60 mg, 90 mg, 120 mg

Westhroid: 32.5 mg [DSC], 65 mg [DSC], 97.5 mg [DSC], 130 mg [DSC], 195 mg [DSC]

WP Thyroid: 16.25 mg [DSC], 32.5 mg [DSC], 48.75 mg [DSC], 65 mg [DSC], 81.25 mg [DSC], 97.5 mg [DSC], 113.75 mg [DSC], 130 mg [DSC]

Generic: 15 mg, 30 mg, 60 mg, 90 mg, 120 mg

Generic Equivalent Available: US

Yes

Pricing: US

Tablets (Adthyza Oral)

15 mg (per each): $0.78

16.25 mg (per each): $0.78

30 mg (per each): $0.92

32.5 mg (per each): $0.92

60 mg (per each): $1.02

65 mg (per each): $1.02

90 mg (per each): $1.60

97.5 mg (per each): $1.60

120 mg (per each): $1.87

130 mg (per each): $1.87

Tablets (Armour Thyroid Oral)

15 mg (per each): $0.98

30 mg (per each): $1.16

60 mg (per each): $1.28

90 mg (per each): $2.01

120 mg (per each): $2.35

180 mg (per each): $1.76

240 mg (per each): $2.14

300 mg (per each): $2.52

Tablets (NP Thyroid Oral)

15 mg (per each): $0.89

30 mg (per each): $1.05

60 mg (per each): $1.16

90 mg (per each): $1.82

120 mg (per each): $2.13

Tablets (Thyroid Oral)

15 mg (per each): $0.85

30 mg (per each): $1.00

60 mg (per each): $1.11

90 mg (per each): $1.73

120 mg (per each): $2.03

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Tablet, Oral:

Generic: 30 mg, 60 mg, 125 mg

Additional Information

For purposes of conversion, levothyroxine sodium (T4) 100 mcg is usually considered equivalent to desiccated thyroid 60 to 65 mg (1 grain), thyroglobulin 60 to 65 mg (1 grain), or liothyronine sodium (T3) 25 mcg (Cytomel Prescribing Information 2016). However, these are rough guidelines only and do not obviate the careful re-evaluation of a patient when switching thyroid hormone preparations, including a change from one brand of levothyroxine to another.

Administration: Pediatric

Oral: Administer on an empty stomach (eg, 30 to 60 minutes before breakfast) to increase absorption.

Administration: Adult

Oral: Administer on an empty stomach (eg, 30 to 60 minutes prior to breakfast) to increase absorption.

Storage/Stability

Store at 15°C to 30°C (59°F to 86°F).

Use

Replacement or supplemental therapy in hypothyroidism of any etiology (FDA approved in all ages); pituitary TSH suppressant for the treatment or prevention of various types of euthyroid goiter, thyroid nodules, thyroiditis, multinodular goiter, and thyroid cancer (FDA approved in adults); Note: Not indicated for treatment of transient hypothyroidism associated with subacute thyroiditis.

Note: Clinical practice guidelines do not recommend routine use of desiccated thyroid over levothyroxine monotherapy in the management of hypothyroidism (AAP 2006; ATA [Jonklaas 2014]) or for TSH suppression in the management in thyroid cancer (ATA [Haugen 2015]). Guidelines do not recommend using TSH suppression for benign thyroid nodules in iodine sufficient patients (ATA [Haugen 2015]).

Medication Safety Issues
Older Adult: High-Risk Medication:

Beers Criteria: Desiccated thyroid is identified in the Beers Criteria as a potentially inappropriate medication to be avoided in patients 65 years and older (independent of diagnosis or condition) due to concerns for cardiac effects; safer alternatives are available (Beers Criteria [AGS 2023]).

Metabolism/Transport Effects

None known.

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.

Amezinium: Thyroid Products may enhance the stimulatory effect of Amezinium. Risk C: Monitor therapy

Amiodarone: May diminish the therapeutic effect of Thyroid Products. Risk C: Monitor therapy

Antacids: May decrease the absorption of Thyroid Products. Risk C: Monitor therapy

Apalutamide: May diminish the therapeutic effect of Thyroid Products. Risk C: Monitor therapy

Bile Acid Sequestrants: May decrease the serum concentration of Thyroid Products. Management: Administer oral thyroid products at least 4 hours prior to or one hour after bile acid sequestrants, or monitor for decreased serum concentrations and clinical effects of oral thyroid products during coadministration. Risk D: Consider therapy modification

Calcium Polystyrene Sulfonate: May decrease the serum concentration of Thyroid Products. Management: Consider administering thyroid products at least 4 hours prior to calcium polystyrene sulfonate. Monitor for signs and symptoms of hypothyroidism with concomitant use. Risk D: Consider therapy modification

Calcium Salts: May diminish the therapeutic effect of Thyroid Products. Management: Separate the doses of the thyroid product and the oral calcium supplement by at least 4 hours. Monitor for decreased therapeutic effects of thyroid products if an oral calcium supplement is initiated/dose increased. Risk D: Consider therapy modification

CarBAMazepine: May decrease the serum concentration of Thyroid Products. Risk C: Monitor therapy

Cardiac Glycosides: Thyroid Products may decrease the serum concentration of Cardiac Glycosides. Specifically, returning to a euthyroid state from a hypothyroid state may decrease the serum concentration of cardiac glycosides. Risk C: Monitor therapy

Ciprofloxacin (Systemic): May decrease the serum concentration of Thyroid Products. Risk C: Monitor therapy

Estrogen Derivatives: May diminish the therapeutic effect of Thyroid Products. Risk C: Monitor therapy

Fosphenytoin: May decrease the serum concentration of Thyroid Products. Phenytoin may also displace thyroid hormones from protein binding sites. Risk C: Monitor therapy

Furosemide: May decrease the protein binding of Thyroid Products. This may lead to a transient increase in free thyroid hormone concentrations and to a later decrease in total thyroid hormone concentrations. Risk C: Monitor therapy

Lanthanum: May decrease the serum concentration of Thyroid Products. Management: Separate the administration of thyroid products and lanthanum by at least 4 hours. Risk D: Consider therapy modification

Nirmatrelvir and Ritonavir: May diminish the therapeutic effect of Thyroid Products. Risk C: Monitor therapy

PHENobarbital: May decrease the serum concentration of Thyroid Products. Risk C: Monitor therapy

Phenytoin: May decrease the serum concentration of Thyroid Products. Phenytoin may also displace thyroid hormones from protein binding sites. Risk C: Monitor therapy

Piracetam: May enhance the adverse/toxic effect of Thyroid Products. Specifically, symptoms including confusion, irritability, and sleep disorder have been described during concomitant use. Risk C: Monitor therapy

Primidone: May decrease the serum concentration of Thyroid Products. Risk C: Monitor therapy

RifAMPin: May decrease the serum concentration of Thyroid Products. Risk C: Monitor therapy

Ritonavir: May diminish the therapeutic effect of Thyroid Products. Risk C: Monitor therapy

Selective Serotonin Reuptake Inhibitors: May diminish the therapeutic effect of Thyroid Products. Thyroid product dose requirements may be increased. Risk C: Monitor therapy

Sodium Iodide I131: Thyroid Products may diminish the therapeutic effect of Sodium Iodide I131. Management: Discontinue thyroid products before sodium iodide I-131 administration, and avoid concurrent use. Stop triiodothyronine (T3) 2 weeks before, and stop thyroxine (T4) 4 weeks before, sodium iodide I-131 administration. Risk X: Avoid combination

Sodium Polystyrene Sulfonate: May decrease the serum concentration of Thyroid Products. Management: Consider administering thyroid products at least 4 hours prior to sodium polystyrene sulfonate. Monitor for signs and symptoms of hypothyroidism with concomitant use. Risk D: Consider therapy modification

Somatropin: May diminish the therapeutic effect of Thyroid Products. Risk C: Monitor therapy

Soybean: May diminish the therapeutic effect of Thyroid Products. Risk C: Monitor therapy

Theophylline Derivatives: Thyroid Products may increase the metabolism of Theophylline Derivatives. Risk C: Monitor therapy

Tricyclic Antidepressants: Thyroid Products may enhance the arrhythmogenic effect of Tricyclic Antidepressants. Thyroid Products may enhance the stimulatory effect of Tricyclic Antidepressants. Risk C: Monitor therapy

Vitamin K Antagonists (eg, warfarin): Thyroid Products may enhance the anticoagulant effect of Vitamin K Antagonists. Risk C: Monitor therapy

Reproductive Considerations

Overt hypothyroidism increases the risk of irregular menses and infertility; thyroid replacement is recommended to normalize thyroid function in infertile patients with overt hypothyroidism who desire to become pregnant. Thyroid replacement may also be used in infertile patients with subclinical hypothyroidism using assisted reproductive techniques to become pregnant; however, desiccated thyroid is not the preferred thyroid replacement agent (ATA [Alexander 2017]).

Pregnancy Considerations

Endogenous thyroid hormones minimally cross the placenta. Desiccated thyroid has not been found to adversely affect the fetus following maternal use during pregnancy; however, normal levels of maternal thyroid hormones are required for fetal development. Untreated maternal hypothyroidism can be associated with adverse effects in both the mother and fetus, including spontaneous abortion, stillbirth, premature birth, low birth weight, impaired neurocognitive development in the offspring, abruptio placentae, gestational hypertension, and preeclampsia (ACOG 2020; ATA [Alexander 2017]).

Thyroid replacement therapy minimizes the risk of adverse pregnancy outcomes in patients with overt hypothyroidism and treatment is recommended for all patients with overt hypothyroidism during pregnancy (ACOG 2020; ATA [Alexander 2017]); however, maternal supplementation with desiccated thyroid does not provide the fetus with sufficient concentrations of T4 required for the developing fetal brain. Therefore, desiccated thyroid is not the preferred treatment of maternal hypothyroidism and should not be used in pregnant patients (ACOG 2020; ATA [Alexander 2017]).

Due to alterations of endogenous maternal thyroid hormones, hypothyroid patients treated with a thyroid replacement product prior to pregnancy require a dose increase as soon as pregnancy is confirmed (ATA [Alexander 2017]). Close monitoring of pregnant patients is recommended (ATA [Alexander 2017]).

Monitoring Parameters

T4, TSH, heart rate, blood pressure, clinical signs of hypo- and hyperthyroidism; growth, bone development (children); TSH is the most reliable guide for evaluating adequacy of thyroid replacement dosage. TSH may be elevated during the first few months of thyroid replacement despite patients being clinically euthyroid. In cases where T4 remains low and TSH is within normal limits, an evaluation of "free" (unbound) T4 is needed to evaluate further increase in dosage. Free T4 (not TSH) should be monitored to guide treatment in patients with central hypothyroidism (ATA [Jonklaas 2014]).

In congenital hypothyroidism, adequacy of replacement should be determined using both TSH and total- or free-T4. During the first 3 years of life, total- or free-T4 should be maintained in the upper 1/2 of the normal range; this should result in normalization of the TSH. In some patients, TSH may not normalize due to a resetting of the pituitary-thyroid feedback as a result of in utero hypothyroidism. Monitor closely for cardiac overload, arrhythmias and aspiration from avid suckling.

Pediatric patients: Monitor closely for under/overtreatment. Undertreatment may decrease intellectual development and linear growth, and lead to poor school performance due to impaired concentration and slowed mentation. Overtreatment may adversely affect brain maturation, accelerate bone age (leading to premature closure of the epiphyses and reduced adult height); craniosynostosis has been reported in infants. Perform routine clinical examinations at regular intervals (to assess mental and physical growth and development). Treated children may experience a period of catch-up growth. Monitor TSH and total or free T4 at 2 and 4 weeks after starting treatment, every 1 to 2 months during the first year of life, every 2 to 3 months between ages 1 to 3 years, and every 3 to 12 months thereafter until growth is completed (AAP 2006; ATA [Jonklaas 2014]); repeat tests 2 weeks after any change in dosage.

Adults: TSH 4 to 6 weeks after treatment initiation or dose changes, 4 to 6 months after adequate replacement dose determined, followed by every 12 months thereafter (or more frequently depending on clinical situation) (ATA [Jonklaas 2014]).

Reference Range
Thyroid Function Tests

Lab Parameters

Age

Normal Range

T4 (thyroxine) serum concentration

1-7 days

10.1-20.9 mcg/dL

8-14 days

9.8-16.6 mcg/dL

1 month to 1 year

5.5-16.0 mcg/dL

>1 year

4.0-12.0 mcg/dL

Free thyroxine index (FTI)

1-3 days

9.3-26.6

1-4 weeks

7.6-20.8

1-4 months

7.4-17.9

4-12 months

5.1-14.5

1-6 years

5.7-13.3

>6 years

4.8-14.0

T3 serum concentration

Newborns

100-470 ng/dL

1-5 years

100-260 ng/dL

5-10 years

90-240 ng/dL

10 years to Adult

70-210 ng/dL

T3 uptake

35%-45%

TSH serum concentration

Cord

3-22 micro international units/mL

1-3 days

<40 micro international units/mL

3-7 days

<25 micro international units/mL

>7 days

0-10 micro international units/mL

Mechanism of Action

The primary active compound is T3 (triiodothyronine), which may be converted from T4 (thyroxine) and then circulates throughout the body to influence growth and maturation of various tissues; exact mechanism of action is unknown; however, it is believed the thyroid hormone exerts its many metabolic effects through control of DNA transcription and protein synthesis; involved in normal metabolism, growth, and development; promotes gluconeogenesis, increases utilization and mobilization of glycogen stores and stimulates protein synthesis, increases basal metabolic rate

Pharmacokinetics (Adult Data Unless Noted)

Onset of action: Liothyronine (T3): ~3 hours

Absorption: Thyroxine (T4): 40% to 80%; T3: 95%; desiccated thyroid contains T4, T3, and iodine (primarily bound)

Protein binding: T4: >99% bound to plasma proteins including thyroxine-binding globulin, thyroxine-binding prealbumin, and albumin

Metabolism: Hepatic to triiodothyronine (active); ~80% T4 deiodinated in kidney and periphery; glucuronidation/conjugation also occurs; undergoes enterohepatic recirculation

Half-life elimination:

T4: Euthyroid: 6 to 7 days; Hyperthyroid: 3 to 4 days; Hypothyroid: 9 to 10 days

T3: 0.75 days (Brent, 2011)

Time to peak: Serum: T4: 2 to 4 hours; T3: 2 to 3 days

Excretion: Urine (major route of elimination); partially feces

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (BG) Bulgaria: Thyreoidea siccata;
  • (EE) Estonia: Thyreoidin | Thyreoidinum;
  • (GB) United Kingdom: Erfa thyroid;
  • (IE) Ireland: Armour thyroid;
  • (IT) Italy: Cinetic;
  • (LT) Lithuania: Neytabs thymum;
  • (NO) Norway: Thyreoid glostrup | Thyroid naf | Wp thyroid;
  • (NZ) New Zealand: Armour thyroid;
  • (PR) Puerto Rico: Armour thyroid;
  • (RO) Romania: Tiroida;
  • (RU) Russian Federation: Thiramyn | Thyreoidin;
  • (TW) Taiwan: Thyrodin;
  • (UA) Ukraine: Thyreoidin;
  • (UY) Uruguay: Tiroidina
  1. 2023 American Geriatrics Society Beers Criteria Update Expert Panel. American Geriatrics Society 2023 updated AGS Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2023;71(7):2052-2081. doi:10.1111/jgs.18372 [PubMed 37139824]
  2. Adthyza (thyroid tablets, USP) [prescribing information]. Woburn, MA: Azurity Pharmaceuticals Inc; October 2022.
  3. Alexander EK, Pearce EN, Brent GA, et al. 2017 Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and the postpartum. Thyroid. 2017;27(3):315-389. doi:10.1089/thy.2016.0457 [PubMed 28056690]
  4. American Academy of Pediatrics, Section on Endocrinology and Committee on Genetics, American Thyroid Association, et al. Update of Newborn Screening and Therapy for Congenital Hypothyroidism. Pediatrics,. 2006;117(6):2290-303. [PubMed 16740880]
  5. American College of Obstetricians and Gynecologists (ACOG). ACOG Practice Bulletin No. 223: Thyroid disease in pregnancy. Obstet Gynecol. 2020;135(6):e261-e274. doi:10.1097/AOG.0000000000003893 [PubMed 32443080]
  6. Armour Thyroid (thyroid tablet) [prescribing information]. Madison, NJ: Allergan; June 2018.
  7. Baskin HJ, Cobin RH, Duick DS, et al. American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for the Evaluation and Treatment of Hyperthyroidism and Hypothyroidism. Endocr Pract. 2002;8(6):457-469.
  8. Bhasin S, Wallace W, Lawrence JB, et al. Sudden Death Associated With Thyroid Hormone Abuse. Am J Med. 1981;71(5):887-890. [PubMed 7304660]
  9. Brent GA, Koenig RJ. Chapter 39. Thyroid and Anti-Thyroid Drugs. In: Brunton LL, Chabner BA, Knollmann BC, eds. Goodman & Gilman's The Pharmacological Basis of Therapeutics. 12th ed. McGraw-Hill Medical; 2011.
  10. Cytomel (liothyronine sodium) [prescribing information]. New York, NY: Pfizer; June 2016.
  11. Fleseriu M, Hashim IA, Karavitaki N, et al. Hormonal replacement in hypopituitarism in adults: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2016;101(11):3888-3921. doi:10.1210/jc.2016-2118 [PubMed 27736313]
  12. Garber KR, Cobin RH, Gharib H, et al; American Association of Clinical Endocrinologists and American Thyroid Association Taskforce on Hypothyroidism in Adults. Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Endocr Pract. 2012;18(6):988-1028. [PubMed 23246686]
  13. Gharib H, Papini E, Garber JR, et al; AACE/ACE/AME Task Force on Thyroid Nodules. American Association of Clinical Endocrinologists, American College of Endocrinology, and Associazione Medici Endocrinologi medical guidelines for clinical practice for the diagnosis and management of thyroid nodules--2016 update. Endocr Pract. 2016;22(5):622-639. doi:10.4158/EP161208.GL [PubMed 27167915]
  14. Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016;26(1):1-133. doi:10.1089/thy.2015.0020 [PubMed 26462967]
  15. Helfand M, Crapo LM. Monitoring Therapy in Patients Taking Levothyroxine. Ann Intern Med. 1990;113(6):450-454. [PubMed 2143640]
  16. Hoang TD, Olsen CH, Mai VQ, Clyde PW, Shakir MK. Desiccated thyroid extract compared with levothyroxine in the treatment of hypothyroidism: a randomized, double-blind, crossover study. J Clin Endocrinol Metab. 2013;98(5):1982-1990. doi:10.1210/jc.2012-4107 [PubMed 23539727]
  17. Johnson DG, Campbell S. Hormonal and Metabolic Agents. In: Bressler R, Katz MD, eds. Geriatric Pharmacology. McGraw-Hill; 1993:427-450.
  18. Jonklaas J, Bianco AC, Bauer AJ, et al. Guidelines for the treatment of hypothyroidism: prepared by the American Thyroid Association task force on thyroid hormone replacement. Thyroid. 2014;24(12):1670-1751. doi:10.1089/thy.2014.0028 [PubMed 25266247]
  19. Nature-Throid (thyroid USP) tablets [prescribing information]. Cave Creek, AZ: RLC Labs; received July 2020.
  20. Nature-Throid (thyroid USP) tablets [prescribing information]. Cave Creek, AZ: RLC Labs; April 2013.
  21. NP Thyroid (thyroid USP) tablets [prescribing information]. Alpharetta, GA: Acella Pharmaceuticals LLC; October 2019.
  22. Pearce SH, Brabant G, Duntas LH, et al. 2013 ETA Guideline: Management of subclinical hypothyroidism. Eur Thyroid J. 2013;2(4):215-228. doi:10.1159/000356507 [PubMed 24783053]
  23. Razvi S, Jabbar A, Pingitore A, et al. Thyroid hormones and cardiovascular function and diseases. J Am Coll Cardiol. 2018;71(16):1781‐1796. doi:10.1016/j.jacc.2018.02.045 [PubMed 29673469]
  24. Refer to manufacturer's labeling.
  25. Sanders LR. Pituitary, Thyroid, Adrenal and Parathyroid Diseases in the Elderly. Geriatric Medicine. 1990;475-487.
  26. Sawin CT, Geller A, Hershman JM, et al. The Aging Thyroid. The Use of Thyroid Hormone in Older Persons. JAMA. 1989;261(18):2653-2655. [PubMed 2709545]
  27. Shakir MKM, Brooks DI, McAninch EA, et al. Comparative effectiveness of levothyroxine, desiccated thyroid extract, and levothyroxine+liothyronine in hypothyroidism. J Clin Endocrinol Metab. 2021;106(11):e4400-e4413. doi:10.1210/clinem/dgab478 [PubMed 34185829]
  28. Watts NB. Use of a Sensitive Thyrotropin Assay for Monitoring Treatment With Levothyroxine. Arch Intern Med. 1989;149(2):309-312. [PubMed 2644903]
Topic 86692 Version 248.0

آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟