Eutirox or L-thyroxine: pros and cons of drugs. What is the difference between Eutirox and L-thyroxine? What is better thyroxine Berlin Chemi or Eutirox

Date of: 31.10.2023

Although thyroid diseases are not common pathologies, insufficiently active functioning of the organ occurs in many people. Timely detected hypofunction can be well corrected with hormonal drugs, such as L-thyroxine and Eutirox. In cases where the doctor has not made a specific prescription, leaving the right to choose a medicine to the patient, then a comparison of two medications becomes natural. And especially relevant if they are practically no different from each other. Therefore, it is worth understanding in more detail what the advantages of Eutyrox or L-thyroxine are, which will help restore the functioning of the thyroid gland better and faster.

What are the drugs for?

Both drugs are designed to replenish the lack of endogenous thyroid hormones; they are also prescribed for therapy for:

Decreased functioning of the thyroid gland (hypothyroidism)
Euthyroid goiter
Thyroid cancer after surgery
Replacement HT to prevent goiter recurrence after resection
Diffuse goiter (drugs are used as additional agents in complex treatment or in monotherapy).

Also, Eutirox and its competitor L-thyroxine are used as a diagnostic drug for thyroid suppression tests.

Who releases

Manufacturer: German company MERCK.

The drug was developed at the domestic enterprise Ozon. But besides it, there are several drugs on the pharmaceutical market with this name, produced both in Europe and in Russia or the CIS countries. You can recognize them by their name: an indication of the origin of the drug has been added to the name of the drug: Berlin-Chemie, Akri (produced at the Akrikhin company), Farmak (Ukraine), etc.

Comparison of compositions and dosage forms

The active component of Euthyrox and L-Thyroxine is levothyroxine sodium - an artificially synthesized analogue of natural thyroid hormone. The use of the substance in small quantities promotes the activation of growth, the formation and development of tissues, supplying them with oxygen, accelerating the metabolism of proteins, fats, carbohydrates, maintaining the cardiovascular system and central nervous system in a normal state. When prescribed in large doses, the production of hormones by the hypothalamus and pituitary gland is suppressed.

The drug is produced in the form of white tablets with a score line on each side and beveled edges. Each pill is engraved on one surface EM+N (N is the dosage value, the digital value is indicated in accordance with the amount of the active substance). In addition to the fact that this helps to navigate the dosage of the product, the inscription will help identify a fake.

Tablets are available with different levels of levothyroxine: 25, 50, 75, 88, 100, 112, 125, 137 and 150 mcg. This diversity allows you to select the most adequate remedy for varying degrees of thyroid hypofunction.

Excipients of the drug are corn starch, gelatin, primelose (croscamellose sodium), lactose in the form of monohydrate, magnesium stearate (E572). The composition and dosage of additional ingredients is the same in all tablets with different contents of the active substance.

The Russian drug from the Ozon company is available in tablets - white or slightly creamy square-shaped pills with rounded edges. On one surface there is a notch in the shape of a cross, on the other there are embossed letters L-T.

The dosage of the active substance is presented more modestly - in two forms: 50 and 100 mcg in one tablet. Correction of the daily amount is carried out by dividing the pill into several parts along the notch.

Auxiliary ingredients also differ from the first drug. The drug contains: lactose, povidone, E572, CMC, pregelatinized corn starch (i.e., subjected to a gelatinization process).

How does the active substance of drugs work?

After taking the tablet, the medicinal component is absorbed by the body mainly in the upper intestine. The volume of levothyroxine absorbed is about 80%. The absorption of the substance is affected by food intake: if the tablet is taken with food, the process will slow down.

The maximum concentration of the substance in the serum is achieved on average after 5-6 hours. Metabolism of hormones occurs in the liver, kidneys, GM, and muscles. They are excreted from the body in urine and intestinal contents.

The pronounced therapeutic effect of the drugs appears after 1-2 weeks of use, and after the end of the course the same amount of time remains.

Thus, it can be stated that both drugs act identically. The different rates may be affected by the concentration of levothyroxine tablets.

How to take Eutirox and L-Thyroxine

Both drugs are recommended to be taken on an empty stomach half an hour before breakfast. You should not bite or chew the tablets, just drink a small amount of water (100 ml is enough). For newborns and children under 3 years of age, grind the tablet into dust, combine with water until a homogeneous suspension is obtained, and give the entire daily dose at one time in the morning.

The specifics of use and dosage of medications should be determined by the attending doctor, since it is necessary to take into account not only the diagnosis, but also the age of the patient.

From birth to 6 months: 10-15 mcg per kg of weight, but not more than 25-50 mcg per day
From 6 months to 1 year: 6-8 mcg per 1 kg of weight, no more than 50-75 mcg per day
From 1 year to 5 years: 5-6 mcg/kg with HF 75-100 mcg
From 6 years to 12 years: 4-5 mcg/kg with HF 100-150 mcg
Adolescents from 12 years of age: 2-3 mcg/kg with HF 100-200 mcg.

Replacement HT in adults (up to 55 years) for hypothyroidism:

Without concomitant cardiovascular diseases: daily dosage is calculated based on 1.6-1.8 mcg/kg
If there are pathologies of the cardiovascular system: the daily norm is 0.9 mcg per 1 kg of weight. The same amount is prescribed to older patients.

Therapy for long-term severe hypothyroidism begins with the smallest amount of drugs (12.5 mcg per day) and then, based on the body’s response, the further course is adjusted. The dosage is increased gradually - doubling it every two weeks until the amount of drugs necessary to provide maintenance treatment is reached.

Undesirable effects and contraindications

Both products - Eutirox and L-Thyroxine - in recommended doses usually do not cause any complaints. Well tolerated without causing side effects. But there is an opinion that the latter remedy is perceived a little worse by patients with hypersensitivity, provoking allergic reactions.

Contraindications for use are identical; medications are prohibited for therapy with:

Individual hypersensitivity to constituent ingredients
If there is untreated thyrotoxicosis, adrenal or pituitary insufficiency
Congenital lactase deficiency, lactose intolerance, GG malabsorption syndrome (due to lactose content).

If it is necessary for pregnant women to use both drugs, they cannot be combined with antithyroid medications.

Eutirox should not be used in acute forms of MI, myocarditis and pancarditis. It should be prescribed with great precautions if the patient has coronary artery disease, hypertension, heart rhythm disturbances, diabetes, or prolonged hypothyroidism.

L-Thyroxine: the precautions are similar, the instructions only do not mention acute forms of heart pathologies.

Brief conclusions

After studying the properties of the German Euthyrox and the Russian L-Thyroxine, we can come to the conclusion that the competing drugs are almost complete analogues of each other: the same active substance, the same indications and contraindications. It is natural that a patient who has been advised to choose one of two drugs will be confused at the pharmacy.

The advantage of Eutirox is that it is available in various dosages, while Russian L-Thyroxine has only two forms.

In addition, those patients who trust imported drugs more should also choose foreign Eutirox. Otherwise, the only difference lies in the composition of additional ingredients that provide the form of the medicine and the absorption of the active component.

Price question:

Eutirox costs in pharmacies from 94 to 170 rubles per 100 tablets, depending on the dosage.

L-Thyroxine is not much different: a pack of 50 tablets will cost an average of about 97-100 rubles, a pack containing 100 tablets will cost around 150 rubles.

The thyroid gland performs important functions in the body. Thyrocytes synthesize hormones from iodine atoms and other components. The active substances of the thyroid gland affect the metabolic rate, activity of the nervous system, vascular tone, heart rate, digestive tract function, etc.

Thyroid hormones are thyroxine (T4) and triiodothyronine (T3). Thyroid diseases often require the use of synthetic analogues of these substances. Pharmacologists obtain both T4 and T3 chemically. In clinical practice, endocrinologists usually use thyroxine analogues (levothyroxine sodium).

Thyroid hormone medications are prescribed:

with hypothyroidism (primary and secondary);
with euthyroid goiter;
for thyrotoxicosis in combination with thyreostatics;
for the prevention of relapse of thyroid cancer (in suppressive doses).

Thyroxine is taken once a day - strictly in the morning on an empty stomach. The dose is adjusted according to the patient’s well-being and data from regular thyrotropin (TSH) tests.

Any hormonal pills are serious drugs that can only be taken as prescribed by a doctor.

Trade names of levothyroxine tablets

Levothyroxine is one of the most popular hormonal drugs. 2% of the population needs these tablets. Therefore, many pharmaceutical concerns around the world produce levothyroxine preparations. There are such companies in Russia.

In pharmacies in our country you can buy levothyroxine tablets from both domestic and foreign manufacturers.

Are different brands of levothyroxine different?

Different patients have different personal experiences and ideas about which medicine is best. There is no clear opinion among doctors on this matter.

Both “Eutirox” and “L-thyroxine” from any company contain the active ingredient hormone levothyroxine sodium. The immediate therapeutic effect of the tablets is theoretically equivalent. In practice, sometimes it seems that one or another drug works better or worse.

With what it can be connected? Most likely reasons:

errors in the drug dosage regimen;
incorrect dose of the drug;
counterfeit products;
failure to comply with storage conditions after or before purchase;
individual sensitivity to auxiliary components.

It is possible that the production of the chemical active substance itself differs from one manufacturer to another. Somewhere higher quality raw materials and reagents are used. As a result, the degree of activity of levothyroxine may vary slightly.

However, all trademarks of pharmaceutical drugs registered in Russia have undergone licensing and thorough compliance testing.

Each of the drugs replaces the hormonal function of the thyroid gland. Both “Euthirox” and “L-thyroxine” from each company have a noticeable effect in case of severe hypothyroidism after 3-5 days, and in case of subclinical hypothyroidism – after 7-12 days. A significant reduction in goiter volume during treatment is observed after 3-6 months. When the patient has already stopped taking the tablets, their effect gradually disappears over 1-2 weeks (residual effect).

Excipients and doses of levothyroxine

The main differences between “Eutirox” and “L-thyroxine” from any company are the composition of the excipients. Each tablet always contains only a small proportion of the active ingredient. The rest of the mass is taken up by ballast. Excipients do not affect the metabolism and activity of the body.

Each manufacturer uses its own formula of additional components. For example, L-Thyroxine Berlin-Chemie tablets contain calcium hydrogen phosphate, glycerides, and microcrystalline cellulose. Eutirox contains starch, gelatin, magnesium stearate, lactose, etc. The drug "L-Thyroxine-Acri" contains ludipress, magnesium stearate, lactose.

It is possible that differences in excipients affect the rate of absorption of the active component from the gastrointestinal tract. But still, there is no significant difference in the pharmacokinetics of levothyroxine from different companies.

In rare cases, patients are allergic to the auxiliary components of the tablets. The reaction may manifest itself in the form of a rash, itching, swelling, etc. If a person cannot tolerate levothyroxine from a particular manufacturer, then this is not a reason to interrupt hormone replacement therapy. Doctors usually recommend taking a course of antihistamines and changing the drug. For example, you may need to replace "L-Thyroxine Berlin-Chemie" with "Euthirox" or vice versa.

Packages differ in the dose of the active substance and the number of hormonal tablets. It is usually more economical to buy larger packs. The price of one tablet in this package is lower.

The dose of the drug is selected by the attending physician. The most commonly used tablets are levothyroxine sodium 100 mcg. In addition, doses of 25 mcg, 50 mcg, 75 mcg, 125 mcg, 150 mcg are used. It is convenient if the manufacturer produces tablets in all doses. L-Thyroxine Berlin-Chemie has such a wide range. Domestic drugs have a standard range - only 50 mcg and 100 mcg. Now new dosages are appearing from Russian manufacturers - for example, 75 mcg.

The widest range of doses today is presented by the German drug Eutirox. The pharmaceutical company offers tablets of 25 mcg, 50 mcg, 75 mcg, 88 mcg, 100 mcg, 112 mcg, 125 mcg, 137 mcg, 150 mcg. The drug in non-standard dosages (88 mcg, 112 mcg, 137 mcg) is very convenient for patients with high sensitivity to levothyroxine. They don't have to break the pills into pieces.

The cost of thyroxine from different companies varies significantly. The most expensive tablets are from foreign companies. "Euthirox" and "L-Thyroxine Berlin-Chemie" cost approximately the same. Russian drugs are 2-3 times cheaper. Hormones from the Ozone company are probably the most budget-friendly.

The price of levothyroxine is in any case very affordable. Treatment for one month in most cases costs several tens of rubles.

Patients taking hormonal drugs for the thyroid gland often ask: Eutirox or L thyroxine - which is better to choose?

To decide, you need to read the instructions for these drugs and consider their similarities and differences.

Eutirox and its analogue L thyroxine are drugs that compensate for the deficiency and belong to the category of thyroid drugs.

Indications for their use of Eutirox and its analogue are the following main pathologies:

hypothyroidism;
thyroid cancer after surgery;

Medicines are often prescribed to exclude new goiter formations after surgery on the organ. In similar cases, they are also used as part of replacement treatment.

In individual or combination therapy for a toxic type of goiter, drugs are used when the desired condition has already been achieved with the help of thyreostatic drugs.

For reference!

Eutirox can also be used in tests as a diagnostic tool.

Composition and release form

The main substance of these drugs is sodium levothyroxine, an analogue of the thyroid hormone thyroxine.

The auxiliary components in Eutirox are the following:

starch;
magnesium stearate;
croscarmellose sodium;
lactose monohydrate;
gelatin.

Additional components in the l thyroxine content are the following:

calcium hydrogen phosphate;
dextrin;
partial glycerides;
sodium salt of carboxymethyl starch.

Eutirox is produced in the form of round and flat white tablets with a separation on both sides.

Since the medicine can be counterfeited, in order to recognize the original, it is important to pay attention to the branded engraving on one side, which represents the dosage.

Eutirox is available in the following dosages of the main substance (in mcg):

25;	50;	75;	88;	100;	112;	125.

There are also tablets with maximum doses of 137 and 150 mcg.

L thyroxine is produced in the form of flat tablets of 50 (light blue) or 100 mcg (yellow-green) of the active component.

They are produced in blisters of 25 pieces. One cardboard package contains 2 or 4 blisters.

Pharmacokinetics and pharmacodynamics

The active substance of medications is absorbed directly in the small intestine in the amount of up to 80%, and food intake affects this figure and reduces it.

Such drugs are metabolized primarily in the following sites:

brain;
liver;
muscles;
kidneys

A good therapeutic effect of the products, if it is not a fake, is observed after a week or two.

It lasts the same amount of time after stopping the medication.

For reference!

When treating hypothyroidism, the effect takes approximately 5 days to develop. A decrease in goiter is observed over three months or six months.

Dosages, regimens and methods of application

The daily dose is calculated based on the indications in a particular case. It is recommended to take the tablets on an empty stomach in the morning.

The medications should be taken at least half an hour before meals and washed down with ½ glass of water without chewing.

In case of severe hypofunction of the thyroid gland, the use of Eutirox and l thyroxine has the following features:

Therapy begins carefully and with small doses. The dose per day is 12.5 mcg.
Every 14 days it doubles to maintenance.
In this case, the patient's thyroid-stimulating hormone level should be assessed more often.

For a disease such as hypothyroidism, these medications generally need to be used throughout the rest of your life.

When consuming l thyroxine, you can focus on the average daily doses in mcg, presented in the following table:

The congenital form of thyroid hypofunction in childhood is treated based on age.

The dose per day (in mcg) of the active substance is calculated according to the following scheme:

From birth to six months – 25 – 50.
From six months to 1 year – 50 – 75.
From one year to 4 - 5 years - 75 - 100.
From 5 years to 12 - 13 years - 100 - 150.
After 13 years – 100 – 200.

For a child under 3 years of age, the dose of medication per day is prescribed in 1 dose and half an hour before meals.

However, it must first be dissolved in water before use.

Replacement treatment of thyroid hypofunction has the following features:

The daily dose of Euthyrox or l thyroxine for people under 55 years of age and without cardiovascular diseases is determined at 1.8 mcg per 1 kg of weight.
In the presence of such deviations or age after 55 years, the dose per day is calculated according to the scheme 0.9 mcg of the drug per 1 kg of weight.
For females under 55 years of age and without diseases of the cardiovascular system, the initial amount of the active substance per day ranges from 75 to 100 mcg, and for males - from 100 to 150 mcg.
In cases of the presence of these pathologies and for people over 55 years of age, it is reduced to 25 mcg.

The dose of Eutirox or l thyroxine during this treatment is increased every 60 days by 25 mcg until the concentration of thyroid-stimulating hormone is normalized.

If there is an increase in the symptoms of cardiovascular diseases, it is necessary to reconsider the methods of their treatment.

For other diseases, the following dosages of medications are used (in mcg):

The dose per day for euthyroid goiter or after intervention for such a diagnosis ranges from 75 to 200.
As part of a mixed treatment of thyrotoxicosis, it is in the range of 50-100.
After surgery for thyroid cancer, the dose of the drug per day is from 150 to 300.

The duration of the course of therapy is determined by the doctor individually.

If treatment with drugs is aimed at suppressing hypothyroidism, then pregnant and lactating women should continue it.

During pregnancy, the need for thyroxine increases, so the dosage of medications is often increased as prescribed by a specialist.

Their use in combination with thyreostatics during pregnancy/lactation prohibited to avoid the development of hypothyroidism in the unborn child.

Contraindications

Untreated forms of the following pathologies are contraindications to the use of drugs:

thyrotoxicosis;
insufficiency of pituitary hormones.

You should also not use medications if you are hypersensitive to some of their components.

For l thyroxine, restrictions are added in the form of myocarditis and myocardial infarction in acute forms.

Medicines are used with great caution for the following conditions:

high blood pressure;
diabetes;
angina pectoris;
arrhythmia;
ischemic heart diseases.

With such a pathology as malabsorption syndrome, dosage revision may often be necessary.

Eutirox is prescribed with extreme caution to people prone to psychotic reactions. It is also not recommended for certain genetic diseases, including lactase deficiency and galactose intolerance.

Side effects

When using l thyroxine, the following manifestations are possible:

skin itching;
rash;
other allergic reactions.

When using this thyroxine analogue in high doses, hyperthyroidism may develop. It is characterized by the following symptoms:

headache;
muscle cramps;
chest pain;
sweating and fever;
sleep disturbances and irritability;
loss of appetite, vomiting, diarrhea and weight loss;
arrhythmia/tachycardia.

An allergy to Eutirox can occur if the patient is highly sensitive to the drug.

If you follow the instructions, the doctor's instructions and exclude counterfeit drugs, there are no other side effects of the drugs.

Comparison of drugs

To choose which is better - the drug Eutirox or L thyroxine, you need to pay attention to their similarities and differences.

The main similarities between the data of Eutirox and its analogue are the following parameters:

Thyroid hormone preparations with the same pharmacological action.
Indications, dosages and regimen of use are the same.
Both are available from pharmacies with a prescription and have the same shelf life.
Allowed for use by children, as well as during pregnancy and lactation.

Many experts still prefer Eutirox, since it is produced in Germany, and the drug l thyroxine and its analogue l thyroxine-Akri are produced in Russia.

For reference!

How to distinguish Russian-made drugs from Western drugs? It should be noted that there is also a product - thyroxine Berlin-Chemie, which is the most common and is manufactured in Europe.

In this regard, if the country of origin is important, it is possible to choose an imported drug or its domestic analogue.

The differences between Euthyrox and l thyroxine include the following points:

The first drug has significantly more release forms, which simplifies the selection of the desired type at different dosages.
Eutirox practically does not cause, with the exception of allergic reactions in rare cases, while its analogue has a number of possible undesirable manifestations.
On average, the effect of Eutirox is observed after a couple of weeks, and the effect of l thyroxine is noticeable after a few days.
The effect of the latter lasts for a couple of days, so accidentally skipping the drug does not cause serious complications.

In addition, experts under no circumstances recommend combining or alternating these agents.

To some extent, this is due to the various excipients that are included in their composition, although the latter are generally unable to have a serious effect on the human body.

However, replacing one remedy with another can cause complications in some cases.

In any case, the choice must be entrusted to a specialist and not deviate from the treatment regimen prescribed by him.

The thyroid gland is a very important part of the endocrine system, performing the function of internal secretion. Hormones are produced here that regulate homeostasis (constancy of the internal environment) of the human body. Disruption of the functioning of this organ leads to an imbalance of all metabolic processes. Increased production of hormones is called hyperthyroidism, and decreased production is called hypothyroidism. Treatment methods for these conditions are radically different. For hypothyroidism, the patient is prescribed hormone replacement therapy with drugs based on levothyroxine. These include L-thyroxine and Eutirox; the doctor decides which one to choose. It is useful for everyone concerned with this topic to get acquainted with the instructions and patient reviews.

Endocrinologist patients are always interested in Eutyrox or L-thyroxine, which is better to buy for the treatment of the thyroid gland? The question is difficult, given that these are absolute analogues. Both drugs are hormonal drugs and contain the same active substrate - sodium levothyroxine. It is a left-handed stereoisomer of the thyroid hormone thyroxine. It performs the same functions as the endogenous hormone produced by the thyroid gland. The sodium salt of l-thyroxine, after biological transformation in the liver and kidneys, affects all metabolic processes in the human body. The hormone thyroxine (T4) by its nature is a low-active substance; as a result of the action of a special enzyme, it is converted into a functional form - triiodothyronine (T3).

The important properties of the hormone are:

increased oxygen consumption by tissues;
an increase in the strength and frequency of myocardial contractions and blood pressure;
stimulation of mental and physical activity, intellectual activity;
increased blood sugar levels;
regulation of the process of glucose formation in the liver;
promoting the uptake of glucose by cells;
strengthening the process of breaking down fats into fatty acids (lipolysis);
suppression of the formation and deposition of fats in the depot;
increased tissue sensitivity to adrenaline;
increased hematopoiesis in the bone marrow;
decreased reabsorption of water in the renal tubules and tissue swelling.

Based on these functions, it is clear that Eutirox or L-thyroxine have the following indications for use:

Hypothyroidism of various origins: primary - congenital or acquired as a result of diseases of the thyroid gland, it is characterized by an increase in TSH (regulating thyroid-stimulating hormone of the pituitary gland); secondary – develops with lesions of the pituitary gland, while T4 and TSH are at low levels.
Carrying out replacement therapy after resection of the thyroid gland.
Diffuse non-toxic goiter (euthyroidism or uniform enlargement of the gland without dysfunction) - to control the level of TSH in the blood.
Obesity and cretinism associated with hypothyroidism.
Hashimoto's disease (autoimmune inflammation of the thyroid gland).
Basedow's disease (Graves' disease) - as part of a complex of therapy after achieving compensation of thyroid function with thyreostatic drugs.
Hormone-dependent highly differentiated malignant neoplasms (carcinoma) of the thyroid gland.
Thyroid cancer in the postoperative period.
Carrying out a diagnostic functional test.
For weight loss (for example, in bodybuilding).

The effect of thyroid hormones on the body depends on the dose: in small quantities they provoke anabolic effects, and in high quantities they have a powerful opposite effect (protein catabolism).

The drug is a synthesized hormonal agent similar to endogenous thyroxine. Prescribed to replenish endocrine deficiency when thyroid function decreases. Eutirox is produced by a German manufacturer, the release form is tablets containing from 25 to 150 mcg of levothyroxine sodium salt. The tablets are packaged in 50 or 100 pieces per package. Indications for use are described above.

The therapeutic effect begins to appear on days 8-12 of taking the medicine. If the patient has clear clinical signs of decreased thyroid function, the effect of the drug begins earlier (on days 3-5). When treating diffuse goiter, the result becomes noticeable only after 3 months of course use. Excretion of Eutirox's metabolic products occurs through the intestines with bile and through the kidneys with urine. After cessation of therapy, the effect of the drug remains for another 14 days.

The instructions recommend taking the daily dose of the medication in the morning half an hour before breakfast. The tablets should be swallowed whole with half a glass of water. The dosage of Eutirox is selected for each patient individually. It depends on the purpose of use, diagnosis, concomitant pathologies, and the person’s age.

For example:

for euthyroid goiter, the daily dose is from 75 mcg;
prevention of goiter after resection of the thyroid gland is the same;
for Graves' disease, from 50 to 100 mcg as part of a treatment complex;
after surgical removal of gland tissue for cancer, 50 to 200 mcg per day is prescribed.

The duration of therapy is also determined individually. Eutirox can be used in pediatrics for the treatment of congenital forms of hypothyroidism. Dosages are selected according to the child’s age and weight - from 10-15 to 2-3 mcg per kg of body weight. Prescribing and discontinuing Eutirox is the competence of doctors.

The cost of Eutirox depends on the dosage and number of tablets in the package; for 100 pieces the price varies from 98 to 180 rubles.

The drug is a complete analogue of Eutirox with the same mechanism of action and indications for use. Produced in Germany in tablets of 50 and 100 mcg of levothyroxine sodium salt. There is a domestically produced generic El-thyroxine, containing from 25 to 200 mcg of the active ingredient per tablet. The daily dosage of the drug is determined depending on the indications of the individual patient. For people under 56 years of age without pathology of the heart and blood vessels, the drug is prescribed for replacement therapy in a dose of 1.6 to 1.8 mcg per kg of body weight. For patients over 60 years of age, especially those suffering from heart and vascular diseases, the dose is halved. For obese people, the calculation is made based on ideal weight indicators by gender and age.

Dose adjustments for certain groups of patients with hypothyroidism are carried out every 60 days until TSH levels in the blood normalize. If symptoms from the cardiovascular system arise or intensify, changes to the treatment regimen for cardiac pathology are required. For patients with congenital thyroid pathologies, the dose is calculated based on weight and age. For hypothyroidism, L-thyroxine is usually taken for life or for a very long time. In case of thyrotoxicosis, after achieving a normal hormonal (euthyroid) state, it is prescribed together with antithyroid drugs. The duration of the course of therapy in each case is determined by the doctor.

What adverse reactions may develop:

allergic conditions in the form of urticaria, bronchospasm, Quincke's edema;
migraine-type headaches, insomnia, anxiety;
extrasystole, atrial fibrillation, angina pectoris, attacks of angina pectoris, tachycardia;
nausea, diarrhea;
skin itching and rash;
hair loss;
disorders of the female menstrual cycle;
hyperhidrosis of the palms, hyperthermia, weight loss or weight gain, malaise, muscle twitching.

These symptoms are a reason to adjust the dose or discontinue the drug for a while. Cases of sudden death of patients due to acute cardiac dysfunction who used increased doses of L-thyroxine for a long time have been described. After relief of adverse reactions, therapy is resumed with caution, starting with the minimum optimal dose.

For weight loss, the drug is first taken in a daily dose of 50 mcg in 2 doses (morning and afternoon). Therapy is usually supplemented with drugs from the group of beta-blockers in a dose that is selected based on heart rate. Subsequently, the dose of L-thyroxine is gradually increased by 3-6 times, the drug is taken in 3 doses until 18:00 in the evening. At the same time, the dosage of the beta-blocker is increased so that the resting heart rate is within the range of 60-70 beats per minute. The amount of the drug is reduced if undesirable effects occur. Treatment usually lasts from 1 to 1.5 months. You should stop taking the medication gradually, reducing the dose every 2 weeks until complete withdrawal.

If diarrhea occurs while taking the medication, add Imodium or Lopedium (Loperamide).

The intervals between repeated courses of L-thyroxine should be at least a month.

Eutirox, like L-thyroxine, is based on the same active substance (levothyroxine).

However, each of these drugs still has its own characteristics:

Medicines are produced by different manufacturers, so the composition of excipients is different.
There is a difference in the effect of medications. L-thyroxine begins to have a therapeutic effect for hypothyroidism already on the 3-4th day, and Eutirox – on the 2nd week. Complete cure or reduction of goiter occurs after 3 (sometimes 6) months of treatment with both drugs.
Original L-thyroxine, with the correct dose selection and regular use, practically does not cause adverse reactions. In rare cases, Eutirox can still lead to weight gain. Sometimes patients develop allergic dermatitis, very rarely kidney function is impaired, and alopecia appears. In children with convulsive syndrome, the use of L-thyroxine can lead to a worsening of the condition.
Undesirable effects do not depend on the dosage of Eutirox. When treated with small doses of L-thyroxine, such phenomena were not observed.

If a question arises, Eutyrox or L-thyroxine - which is better, your doctor can help answer it. The individual characteristics of the patient’s body, indications for use of the drug and the required dose are important.

You cannot independently cancel a drug prescribed by a doctor, reduce or increase the dose, or replace or alternate taking Eutyrox with L-thyroxine; this may negatively affect the results of treatment.

Eutiroks or L-thyroxine reviews

Eutirox and L-thyroxine have many reviews on the Internet. Some patients taking El-thyroxine complain of side effects of the drug, such as rash, diarrhea, and weight gain. Basically, these manifestations occurred when the drug was taken incorrectly (incorrect dose, uncontrolled use).

Eutirox or L-thyroxine, which is better, the majority of reviews are positive.

Valentina, 58 years old:

“I was diagnosed with autoimmune thyroiditis 3 years ago. The symptoms appeared after a trip to the sea during the hot season. The examination confirmed that there is a lack of hormones, the thyroid gland has greatly increased in size. The endocrinologist prescribed me Euthyrox for the rest of my life. There is an improvement in health and analysis at a dose of 100 mg per day. The only negative is that my not very thick hair has become even sparser. The doctor says that this is due to a deficiency of sex hormones due to age. I hope I don’t go completely bald.”

Evgeniya, 46 years old:

“My reviews for L-thyroxine versus Eutirox. I took the first one for many years, everything was fine. I recently bought Eutirox at the same dose. I suffered for 3 days from nausea and headache. It was hot and cold, and my joints ached. I quit, switched to L-thyroxine again, everything returned to normal. I don’t know what it was. My colleague doesn’t believe me; after surgery on the thyroid gland, she is safely on Eutirox and is happy. Maybe I have a hypersensitive body. I didn’t tell my doctor, but in vain. Tomorrow I'll go and confess. I want to warn everyone not to do experiments, they don’t joke with their health.”

One tablet of L-Thyroxine can contain from 25 to 200 mcg levothyroxine sodium .

The composition of excipients may vary slightly depending on which pharmaceutical company produced the drug.

Release form

The product is available in tablet form and is supplied to pharmacies in packages No. 25, No. 50 or No. 100.

pharmachologic effect

L-Thyroxine is thyroid stimulant , which is used when hypofunction of the thyroid gland (TG) .

Pharmacodynamics and pharmacokinetics

Levothyroxine sodium , which is part of the tablets, performs the same functions as endogenous ones (produced by the human thyroid gland) And . In the body the substance is biotransformed to liothyronine , which, in turn, penetrating into cells and tissues, affects the mechanisms of development and growth, as well as the course of metabolic processes .

In particular, L-Thyroxine is characterized by the ability to influence the oxidative metabolism occurring in mitochondria and selectively regulate the flow of cations both in the intracellular space and outside the cell.

The effect of a substance depends on its dosage: the use of the drug in small doses provokes an anabolic effect, in higher doses it affects mainly cells and tissues, increasing the latter’s need for oxygen, stimulating oxidative reactions, accelerating the breakdown and metabolism of fats, proteins and carbohydrates , activating functions hearts , vascular system And CNS .

Clinical manifestation of action levothyroxine at observed already in the first 5 days after the start of treatment. Over the next 3-6 months, subject to continuous use of the drug, it decreases or completely disappears.

Levothyroxine taken orally is absorbed primarily in the small intestinal tract. Absorption is largely determined by the galenic form of the drug - max up to 80% when taken on an empty stomach.

The substance binds to plasma proteins almost 100%. This is due to the fact that levothyroxine does not respond to any hemoperfusion , nor hemodialysis . Its half-life is determined by the concentration of thyroid hormones in the patient’s blood: when euthyroid states its duration is 6-7 days, with thyrotoxicosis - 3-4 days, for hypothyroidism - 9-10 days).

About a third of the administered substance accumulates in liver . At the same time, it quickly begins to interact with levothyroxine, which is in.

Levothyroxine is broken down primarily in muscle tissue , liver And brain tissue . Active liothyronine , which is a product of the metabolism of the substance, is excreted in the urine and intestinal contents.

Indications for use

L-Thyroxine is used for maintenance HRT when hypothyroid conditions of various origins , including including primary and secondary hypothyroidism developed after surgery on the thyroid gland, as well as conditions provoked by therapy using radioactive iodine preparations .

It is also considered appropriate to prescribe the drug:

at hypothyroidism (both congenital and in the case where the pathology is a consequence of lesions hypothalamic-pituitary system );
for obesity and/or cretinism , which are accompanied by manifestations hypothyroidism ;
at cerebral-pituitary diseases ;
as a prophylactic for recurrent nodular goiter after resection of the thyroid gland (if its function is not changed);
for treatment diffuse euthyroid goiter (L-Thyroxine is used as an independent remedy);
for treatment euthyroid hyperplasia of the thyroid gland , and Graves' disease after compensation for intoxication has been achieved thyroid hormones with help thyreostatic drugs (as part of complex therapy);
at Graves' disease And Hashimoto's disease (in complex treatment);
for the treatment of patients with hormone-dependent well-differentiated malignant neoplasms in the thyroid gland (including papillary or follicular carcinoma );
for suppressive therapy and HRT in patients with malignant neoplasms in the thyroid gland (including after surgery for thyroid cancer ); as a diagnostic tool when conducting tests thyroid suppression .

In addition, thyroxine is often used in bodybuilding as a means of losing weight.

Contraindications

L-Thyroxine is contraindicated for use in:

hypersensitivity to the drug;
acute;
acute inflammatory lesions of the heart muscle ;
untreated thyrotoxicosis ;
untreated hypocorticism ;
hereditary galactosemia , lactase deficiency , malabsorption syndrome .

The drug should be used with caution in patients with diseases of the heart and blood vessels (including including , myocardial infarction in the anamnesis, arterial hypertension ), long-term severe form hypothyroidism , .

The presence of any of the above diseases in the patient is a prerequisite for changing the dose.

Side effects of L-Thyroxine

Correct use of the drug under the supervision of a physician is not accompanied by side effects. In hypersensitive individuals, treatment with levothyroxine may be accompanied by allergic reactions .

Other side effects are usually caused by an overdose of L-Thyroxine. Extremely rarely, they can be triggered by taking the medicine in an incorrectly selected dose, as well as by increasing the dose too quickly (especially in the initial stages of treatment).

Side effects of L-Thyroxine are most often expressed as:

feelings worries , headaches , insomnia , pseudotumor cerebri;
arrhythmias (including atrial fibrillation), tachycardia , angina pectoris , heartbeat , extrasystoles ;
vomiting and;
skin rashes, skin itching , ;
pathologies of the menstrual cycle ;
, hyperthermia, feeling hot, weight loss, increased weakness, muscle cramps .

The appearance of the above symptoms is a reason to reduce the dose of L-Thyroxine or stop treatment with the drug for several days.

Cases of sudden death have been recorded due to cardiac disorders in patients using levothyroxine in high doses for a long time.

After the disappearance of side effects, therapy is continued, carefully selecting the optimal dose. Whenever allergic reactions (bronchospasm , laryngeal edema and - in some cases -) the use of the drug is stopped.

L-Thyroxine: instructions for use

The daily dose of the drug is determined individually depending on the indications. The tablets are taken on an empty stomach with a small amount of liquid (without chewing), at least half an hour before meals.

Patients under 55 years of age with healthy heart and blood vessels during replacement therapy are advised to take the drug at a dose of 1.6 to 1.8 mcg/kg. Persons who have been diagnosed with certain heart/vascular diseases , as well as for patients over 55 years of age, the dose is reduced to 0.9 mcg/kg.

For persons whose body mass index exceeds 30 kg/sq.m, the calculation is made based on “ ideal weight”.

At the initial stages of treatment hypothyroidism The dosage regimen for different patient groups is as follows:

75-100 mcg/day/100-150 mcg/day. - respectively, for women and men, provided that their heart and vascular system are functioning normally.
25 mcg/day. - persons over 55 years of age, as well as persons diagnosed with cardiovascular diseases. After two months, the dose is increased to 50 mcg. The dose should be adjusted by increasing it by 25 mcg every next 2 months until the indicators normalize thyrotropin in blood. If cardiac or vascular symptoms occur or worsen, a change in treatment regimen is required. heart/vascular diseases .

In accordance with the instructions for use of levothyroxine sodium, patients with congenital hypothyroidism the dose should be calculated depending on age.

For children from birth to six months, the daily dose varies from 25 to 50 mcg, which corresponds to 10-15 mcg/kg/day. when converted to body weight. Children from six months to one year are prescribed 50-75 mcg/day, children from one to five years old - from 75 to 100 mcg/day, children over 6 years old - from 100 to 150 mcg/day, adolescents over 12 years old - from 100 to 200 mcg/day.

The instructions for L-Thyroxine indicate that infants and children under 36 months of age should be given the daily dose in one dose, half an hour before the first feeding. Immediately before administration, the L-Thyroxine tablet is placed in water and dissolved until a thin suspension is formed.

At hypothyroidism El-Thyroxine is usually taken throughout life. At thyrotoxicosis after it is reached euthyroid state , levothyroxine sodium is prescribed to be taken in combination with antithyroid drugs . The duration of treatment is determined by the doctor in each specific case.

Regimen for taking L-Thyroxine for weight loss

In order to lose extra pounds, the drug should be taken at a dose of 50 mcg/day, dividing the indicated dose into 2 doses (both doses should be taken in the first half of the day).

Therapy is supplemented with the use β-blockers, the dose of which is adjusted depending on the pulse rate.

Subsequently, the dose of levothyroxine is gradually increased to 150-300 mcg/day, dividing it into 3 doses until 18:00. At the same time, the daily dose is increased β-blocker . It is recommended to select it individually, so that the resting heart rate does not exceed 70 beats per minute, but at the same time is greater than 60 beats per minute.

The appearance of pronounced side effects is a prerequisite for reducing the dose of the drug.

The duration of the course is from 4 to 7 weeks. The medication should be stopped gradually, reducing the dose every 14 days until complete discontinuation.

If during use there is diarrhea , the course is supplemented with a prescription, which is taken 1 or 2 capsules per day.

Between courses of taking levothyroxine, intervals of at least 3-4 weeks should be maintained.

Overdose

Symptoms of overdose are:

increased heart rate and pulse;
increased anxiety;
feeling of heat;
hyperthermia ;
hyperhidrosis (excessive sweating);
insomnia;
arrhythmia ;
increased frequency of attacks angina pectoris ;
weight loss;
anxiety;
tremor ;
diarrhea ;
vomit;
muscle weakness and convulsions ;
pseudotumor cerebri;
menstrual cycle irregularities .

Treatment involves stopping taking L-Thyroxine and conducting follow-up examinations.

With the development of severe tachycardia to reduce its severity, the patient is prescribed β - adrenergic blockers . Due to the fact that the thyroid function is completely suppressed, use thyreostatic drugs not advisable.

When taking levothyroxine in extreme doses (during a suicide attempt), it is effective to plasmapheresis .

Interaction

The use of levothyroxine reduces the effectiveness antidiabetic agents . At the beginning of treatment with the drug, as well as each time the dose is changed, monitoring should be carried out more frequently. blood glucose level .

Levothyroxine potentiates effects anticoagulants (in particular, the coumarin series), thereby increasing risk of cerebral hemorrhage (dorsal or head), as well as gastrointestinal intestinal bleeding (especially in older people).

Therefore, if it is necessary to take these drugs in combination, it is recommended to carry out regular blood clotting tests and, if appropriate, reduce the dose anticoagulants.

The effect of levothyroxine may be impaired when taken concomitantly with protease inhibitors. In this regard, it is necessary to constantly monitor the concentration of thyroid hormones. In some situations, it may be necessary to review the dose of L-Thyroxine.

Cholestyramine And colestipol slow down the absorption of levothyroxine, so L-Thyroxine must be taken at least 4-5 hours before taking these medications.

Drugs containing aluminum or iron may reduce the severity of the effects of levothyroxine, so take L-Thyroxine at least 2 hours before taking them.

The absorption of levothyroxine is reduced when taken in combination with lanthanum carbonate or sevelamer , therefore, it should be taken one hour before or three hours after using these remedies.

When taking drugs in combination, monitoring the level of thyroid hormones is necessary at the initial and final stages of their simultaneous use. The dose of levothyroxine may need to be adjusted.

The effectiveness of the drug decreases when taken simultaneously with tyrosine kinase inhibitors, therefore, changes in thyroid function should be kept under control during the initial and final stages of the simultaneous use of these drugs.

Proguanil/chloroquine And reduce the effectiveness of the drug and provoke an increase plasma concentration of thyrotropin .

Drug-induced enzymes (eg. carbamazepine or barbiturates ) may increase the concentration of levothyroxine.

Women taking hormonal contraceptives , which contains estrogenic component , as well as for women taking postmenopausal age hormone replacement drugs , the dose of levothyroxine may need to be increased.

Thyroxine and L-Thyroxine

Which is better: Eutirox or L-Thyroxine?

The drugs are generics, that is, they have the same indications for use, the same range of contraindications and are dosed similarly.

Difference Euthyroxa and L-Thyroxine is that it contains Euthyroxa Levothyroxine sodium is present in slightly different concentrations than in L-Thyroxine.

Combination with alcohol

A single intake of a small dose of alcohol that is not too strong, as a rule, does not provoke any negative consequences for the body, therefore the instructions for the drug do not categorically prohibit such a combination.

However, it is permissible only for patients with healthy heart and blood vessels.

Drinking alcohol during treatment with L-Thyroxine often provokes a number of undesirable reactions from the central nervous system and liver, which in turn can affect the effectiveness of treatment.

L-Thyroxine for weight loss

According to its effectiveness thyroxine significantly superior to most fat burning products (including pharmacological ones). According to the instructions, it speeds up , increases calorie expenditure, enhances heat production, stimulates the central nervous system, suppresses appetite, reduces the need for sleep and increases physical performance.

In this regard, there are many positive reviews about the use of levothyroxine sodium for weight loss. However, those who want to lose excess weight should remember that the drug increases heart muscle contraction frequency , causes a feeling of anxiety and excitement, thereby having a negative effect on the heart.

To prevent the development of side effects, experienced bodybuilders advise using el-thyroxine for weight loss in combination with antagonists (blockers) β-adrenergic receptors . This allows you to normalize your heart rate and reduce the severity of some other side effects that accompany taking thyroxine.

The advantages of L-Thyroxine for weight loss are the high efficiency and availability of this drug, the disadvantage is a large number of side effects. Despite the fact that many of them can be eliminated or even prevented, it is recommended to consult a specialist before using the drug in order to lose extra pounds.

Use during pregnancy

Treatment with thyroid hormones should be carried out consistently, especially during pregnancy and lactation. Despite the fact that L-Thyroxine is used quite widely during pregnancy, there is no exact data on its safety for the developing fetus.

The amount of thyroid hormones penetrating into breast milk (even if therapy is carried out using high doses of the drug) is insufficient to provoke in an infant inhibition of thyrotropin secretion or development thyrotoxicosis .