Parenteral Manual


Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
Eltroxin, Synthroid, T4, Thyroxine sodium
Thyroid hormone
Original Date: 
August 2005
Revised Date: 
September 2011
  • 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.

- Solutions Compatible: NS

- Additives/Above Cassette Compatible: no information

- Y-site Compatible: no information

- Incompatible: no infomation


(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

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





(For neonatal dosages, refer to Neonatal IV Drug Manual.)

  • Pediatric


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
  • Monitor T4, TSH, HR, BP

The information contained on this website is provided for informational purposes only, as a guide to assist physicians, nurses and other healthcare providers in deciding on the appropriate care required for a particular patient. At all times, physicians, nurses and other healthcare providers must exercise their independent clinical judgment, based on their knowledge, training and experience, taking into account the specific facts and circumstances of each patient, when deciding on the appropriate course of investigation and/or treatment to recommend in a particular clinical situation.

CHEO has made every effort to ensure that the information contained on this website is as current and accurate as possible. However, changes can occur due to ongoing research and the constant influx of new information. Where possible, hospitals and healthcare practitioners should verify the information before acting on it.

Reliance on any information in this website is at the user's own risk. CHEO is not responsible or liable for any harm, loss or other consequences from the use or misuse of the information on this website.