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Cytomel T-4

Cytomel T-4 Information

Purpose Active Ingredient

thyroid hormone replacement & Weight Loss levothyroxine sodium

Drug names

Cytomel T-4, Thyroid hormone, Euthyrox T4, Eltroxin T4, Thyreotom Forte, Levoxyl, Synthroid, Levo-T, Levotabs, Levothroid, Unithroid, T4

Cytomel T-4 warning

Levothyroxine is not for use in the treatment of obesity or for weight loss, either in isolation, or combined with diet pills, because of the threat of possible, even life-threatening, side effects. Heavy dosage of Levothyroxine, particularly with diet pills, may prompt symptoms of toxicity.


Treatment of limited thyroid function, and control or suppression of hyper activity in goiters. It is also taken with surgical procedures and other medication for treating some thyroid cancers. Levothyroxine, a thyroid hormone, is generated by the thyroid gland to regulate metabolism of the body. When the thyroid gland is unable to normally function (hypothyroidism) inadequate thyroid hormone hampers normal metabolism.


When allergic to any components in Levothyroxine.

When there is history of heart attack, chest pain (angina), adrenal gland dysfunction, or untreated increase in thyroid hormone levels.

Consult the attending doctor or health care provider immediately in case of any violation of the above conditions.

Before use of Levothyroxine:

Some medical conditions may counteract with Levothyroxine. The attending doctor or pharmacist needs to be aware of any medical conditions, particularly the following:

  • In case of existing, or intention of pregnancy, or breast-feeding,
  • In case of ongoing medication, prescribed or OTC, herbal preparation, or dietary supplement,
  • If allergic to medicines, foods, or other substances
  • In case of existing heart problems, hypertension, blood clotting, diabetes, bone degeneration (osteoporosis), indigestion or incapacity for nutrient absorption, infertility, pituitary gland problems, high thyroid levels or other thyroid problems,
  • If planning for surgery

Certain medicines may cause adverse reaction with Levothyroxine. Informing the care provider on current medication, especially the following, is imperative:

  • Aluminum salts (e.g., antacids), aminoquinolones (e.g., chloroquine), amiodarone, iron salts (e.g., ferrous sulfate), HMG-CoA reductase inhibitors (e.g., simvastatin), rifampin, raloxifene, sucralfate or sertraline, which may limit Levothyroxine’s effectiveness
  • HMG-CoA reductase inhibitors (e.g., simvastatin) or tricyclic antidepressants (e.g., amitriptyline) to avoid possible side effects like nervousness, increased or irregular heartbeat
  • Anticoagulants (e.g., warfarin) or ketamine because the related risk of side effects mayof such drugs may increase with Levothyroxine
  • Beta-blockers (e.g., metoprolol) or digitalis glycosides (e.g., digoxin) because their effectiveness may be hampered by Levothyroxine

The above are the common, but incomplete list of drug reactions that may occur, and therefore, further advice of the health care provider on Levothyroxine reaction with other medicines must be considered. Consulting with the health care provider before starting suspending, or changing the dosage of other medications is recommended.

Using Levothyroxine:

Use strictly as advised by your medical practitioner and according to the specific dosage mentioned on label of the medicine container.

Take Levothyroxine at least an hour before or 2 to 3 hours after eating, to ensure an empty stomach. It is best taken 1 hour before breakfast unless advised otherwise by the attending doctor.

Take Levothyroxine with 8oz/240mL glass of water

Keep doctor informed if consuming foods containing cottonseed meal, soybean flour (infant formula), dietary fiber or walnuts which hamper the absorption of Levothyroxine. The doctor may change dosage of Levothyroxine, as necessary.

Levothyroxine may be taken with 4 hours time-separation from iron, calcium supplements, antacids (those calcium, containing aluminum, or magnesium), cholestyramine, simethicone, sucralfate, colestipol or sodium polystyrene sulfonate as such substances may inhibit Levothyroxine absorption into the bloodstream.

Levothyroxine works best if taken in the same scheduled times daily.

Allow about 4 to 6 weeks before expecting improvement in symptoms.

Levothyroxine is a lifetime drug, except for instances of temporary low thyroid activity arising from with inflamed thyroid, and for trials.

For medication of children or patients unable to swallow, the tablet may be crushed to dissolve in 1 or 2 teaspoons (5 or 10 ml) of water, and fed with a spoon or dropper as early as possible, after preparation, the mixture being unsuitable for storage. Avoid mixing crushed tablets in soybean infant formula for administering on children. The pharmacist can advise for more information.

In case of missed a dose of Levothyroxine, take early as feasible. Ignore altogether if near time for next dose, and avoid double dosing, unless advised by the doctor.

For further clarifications on how to use Levothyroxine, refer to the health care provider.

Important safety guidelines:

Always take with adequate water as Levothyroxine tablets may disintegrate in the mouth to choke or gag the throat.

Always keep the doctor or dentist informed on existing use of Levothyroxine prior to future medical, dental, emergency or surgical prosecures.

For taking blood thinners with Levothyroxine, lab tests are necessary to adjust such other drug dosages.

As Levothyroxine may affect diabetic blood sugar status, monitor blood sugar levels and consult the doctor for changing dose of diabetes medicine.

Lab tests for monitoring Levothyroxine therapy are mandatory.

The aged should apply caution when taking Levothyroxine as such patients may be less immune to its effects.

Levothyroxine may affect growth in children and should be used with discretion.

In pregnancy and breast-feeding, the effects of Levothyroxine are unknown and may impair the fetus. Though breast milk contains Levothyroxine, if pregnant, consult the doctor on the benefits and risks of Levothyroxine during pregnancy.

Possible side effects:

Most administered drugs can cause reactions, but this would vary according to personal constitution. It is advisable to consult with the doctor on the COMMON side effects and how these may take effect, viz. Anxiety; flushing, diarrhea, muscle weakness, mood swings; sleeplessness, partial or temporary hair loss;, vomiting, stomach cramps or tiredness.

Immediate medical attention is recommended for any of these side effects, viz. severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the face, mouth, lips, or tongue), appetite changes, chest pain, changes in menstrual periods, excessive sweating, difficulty breathing, increased or irregular heartbeat, headache, fever, hyperactivity, hives or skin rash, irritability, inability to handle warm or hot indoor/outdoor conditions, nervousness, leg cramps, seizures, pounding in the chest, tremors, breathlessness, weight gain or loss.

The above is an indication of common but incomplete list of all possible adverse drug reactions that may be encountered. For further with regard to side effects, consult with the care provider or take the advice of the doctor.

Emergency arising from overdose:

Approach the available toxicity control center, or hospital emergency service. Be further aware that symptoms may also include chest pain, confusion, coma, excessive sweating, disorientation, extreme nervousness, heart attack, headache, irregular heartbeat, increased bowel motility, irritability, seizures, menstrual irregularities, shock and tremor.

Desired storage:

Preserve at room temperature, between 59 to 86 degrees F (15 to 30 degrees C), in an airtight container, and keep away from heat, light and moisture, viz. in the bathroom. Prevent children (and pets) from access to Levothyroxine.

General information:

For further queries on Levothyroxine, please consult the doctor, pharmacist, or other health care provider.

Levothyroxine is a prescription drug for use of a specific patient only.

If symptoms maintain status quo or turn adverse, consult with the doctor.

This information is a brief summarization and does not purport to contain all information on Levothyroxine. For queries on the medicine already being taken or for more information, consult with the doctor, pharmacist, or other health care provider.

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