Alternate Name(s):
Eltroxin, Synthroid, T4, Thyroxine sodium
Classification:
Thyroid hormone
Original Date:
August 2005
Revised Date:
September 2011
Indications:
- Replacement or supplemental therapy in congenital or acquired hypothyroidism where a rapid onset of action in required or when the oral route is precluded.
- Treatment or prevention of euthyroid goiter
- organ preservation for potential organ donors
Reconstitution and Stability:
- Reconstitute 500 mcg lyophilized powder with 5 mL of NS to get 100 mcg/mL - DO NOT use bacteriostatic NS. Shake until clear solution obtained
- Use immediately after reconstitution . Discard unused portion.
Compatibility:
- Solutions Compatible: NS
- Additives/Above Cassette Compatible: no information
- Y-site Compatible: no information
- Incompatible: no infomation
Administration:
(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)
| SC | NO |
| IM | YES, absorption variable so IV preferred |
| IV Direct | YES Usual dilution: 100 microgram/mL Infusion time: 2-3 minutes |
| IV Intermittent Infusion | NO |
| IV Continuous Infusion | NO |
Dosage:
(For neonatal dosages, refer to Neonatal IV Drug Manual.)
- Pediatric:
|
Age |
IV dose is 50-75% of the oral doses listed below |
|
0-3 months |
10-15 mcg/kg/day |
|
3-6 months |
8-10 mcg/kg/day |
|
6-12 months |
6-8 mcg/kg/day |
|
1-5 years |
5-6 mcg/kg/day |
|
6-12 years |
4-5 mcg/kg/day |
|
> 12 years |
2-3 mcg/kg/day |
|
Growth and puberty complete |
1.7 mcg/kg/day |
- organ donor: 50 - 100 mcg IV bolus x 1 dose, then 25 - 50 mcg IV Q12H
- Adults: Hypothyroidism: IV or IM dose is 50 % of the oral dose
Potential hazards of parenteral administration:
- Tachycardia, arrhythmias, angina, palpitations, hypertension: Use with caution in patients with cardiovascular disease
- Nervousness, insomnia, fever, headache, pseudotumor cerebri
- Diarrhea, cramps
- May potentiate the use of anticoagulants
Notes:
- Monitor T4, TSH, HR, BP
References: