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Do not allow suspension to settle before discarding the excess
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| bet | 594/654 | | Sana | 03.01.2022 | | Hajmi | 1,5 Mb. | | #14803 |
Do not allow suspension to settle before discarding the excess.
Immediately discard any excess from the syringe, leaving only dose to be administered in the syringe (eg if 10 microgram is to be delivered, dispose of 4 mL, leaving only 1 mL in the syringe).
Administer the medication immediately, just before a feed.
Administration
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Can be administered in the morning or evening, preferably before feed. Should be administered in the same way, at the same time every day.
Levothyroxine should not be mixed with substances that interfere with gastrointestinal absorption, such as soy protein formula, concentrated iron or calcium [ensure at least a 2-hour interval].
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Monitoring
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The goal of initial therapy is to raise free T4 concentration to the upper end of the normal range within 2 weeks of starting therapy and decrease the TSH to <20 mU/L within the first month.[1, 2]
The goal of maintenance therapy is to normalise the TSH and aim for free T4 in the upper half of the normal range.[2]
The baby is re-examined and repeat thyroid tests are performed at two weeks after starting therapy, at 6 weeks, at 3 months and 2–3-monthly for the first year of life.
More frequent review may be necessary if problems arise.
Thereafter, clinical examination and thyroid function testing occurs three-monthly unless there has been a significant dose change, a change to or from soy-based formula or there is a clinical indication. Reviews can be done at about four-monthly intervals after the age of three years and in older children four- to six-monthly.[1]
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