Tell your doctor, if you are taking,

• medicines for epilepsy such as carbamazepine, phenytoin, primidone and barbiturates
• sertraline,used to treat depression and anxiety disorders
• antacids,used to treat indigestion
• medicines containing calcium salts
• cimetidine,used to reduce excess stomach acid
• proton pump inhibitors such as omeprazole, lansoprazole and pantoprazole - used to reduce the amount of acid produced by the stomach
• sucralfate,used to treat and prevent stomach and duodenal ulcers
• cholestyramine and colestipol,used to treat high level of fat in the blood
• polystyrene sulphone resin,used to reduce high levels of potassium in the blood
• medicines containing iron that are taken by mouth
• rifampicin,used to treat infections
• imatinib,used to treat certain types of cancer
• beta blockers such as atenolol, propanolol and sotalol – used to treat high blood pressure and heart problems
• oestrogen containing medicines for hormone replacement therapy (HRT) and contraception (the ‘pill’)
• androgen containing medicines for male hormone replacement therapy
• corticosteroids such as hydrocortisone and prednisolone – used to treat inflammation
• amiodarone,used to treat an irregular heart beat
• anticoagulant medicines to prevent blood clots such as warfarin
• medicines to treat diabetes such as insulin and metformin
• tricyclic antidepressants such as amitriptyline, imipramine and dosulepin
• medicines that stimulate the sympathetic nervous system such as adrenaline
• anti-inflammatory medicines such as phenylbutazone or aspirin
• ketamine,used as an anaesthetic

• Take this medicine on schedule as prescribed by your doctor
• It is important not to leave out any meal while taking this medicine
• Swallow the tablets whole with at least half glass of water
• You should usually take your tablets before breakfast or your first meal of the day

 Adults:

• The recommended starting dose is 50 – 100 micrograms every day. Your doctor may increase the dose you take every 3 – 4 weeks by 50 micrograms until your thyroxine levels are correct. Your final daily dose may be up to 100 – 200 micrograms daily

 Patients over 50 years of age:

• The recommended starting dose will be no more than 50 micrograms every day. The dose may then be increased by 50 micrograms every 3 – 4 weeks until your thyroxine levels are correct. Your final daily dose will be between 50 – 200 micrograms daily

 Patients over 50 years of age with heart problems:

• The recommended starting dose will be 25 micrograms every day or 50 micrograms every other day. The dose may be increased by 25 micrograms every 4 weeks until your thyroxine levels are correct. Your final daily dose will usually be between 50 – 200 micrograms daily

 Congenital hypothyroidism in infants:

• This is a condition where your baby has been born with a thyroid gland that does not produce enough thyroxine. The starting dose is 10 -15 micrograms/kg bodyweight per day for the first three months. The dose will then be adjusted depending on how your baby responds to the treatment

 Acquired hypothyroidism in children:

• In children with an autoimmune disease or following a viral infection. The starting dose is 12.5 – 50 micrograms per day. The dose will then be increased every 2 - 4 weeks depending on how your child responds to the medicine

Juvenile myxedema:

• This is a condition where children and adolescents develop severe hypothyroidism (produce very low levels of thyroid hormones)
• The starting dose is 25 micrograms every day. The dose will then be increased by 25 micrograms every 2 – 4 weeks until your child shows mild symptoms of hyperthyroidism (a condition where the thyroid gland produces too much thyroxine). The dose will then be reduced slightly

 If you take more EUTHYROX

• If you swallow a lot of the tablets at the same time, contact your nearest hospital casualty department or tell your doctor immediately

 If you forget to take EUTHYROX

• If you forget to take a dose take it as soon as you remember unless it is nearly time for your next dose. Do not take a double dose to make up for a forgotten dose

 If you stop taking EUTHYROX

• Do not stop taking the tablets unless your doctor has told you to do so