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12 Treatment Table 1. Thyroid Hormone Preparations Thyroid Hormone Products Available Oral Forms Doses Levothyroxine Levo-T ® , Levothroid ® , Levoxyl ® , Synthroid ® , Unithroid ® , generic Tablets 25-300 mcg Tirosint ® Gelatin capsules 13-150 mcg Liothyronine Cytomel ® , generic Tablets 5, 25, 50 mcg yroid extract Armour yroid ® , Nature roid ® , NP yroid Tablets 15-325 mg Table 2. Medications Potentially Affecting Levothyroxine Dose Requirement Examples of Drugs Potential Mechanism Possible Effect on Serum TSH Potential Effect on LT4 dose requirement Calcium carbonate, proton pump inhibitors, cholestyramine, colesevelam, selevamer, ferrous sulfate, aluminum-containing antacids, sucralfate, raloxifene, orlistat, multivitamins containing calcium and ferrous sulfate Decreased LT4 absorption Increased TSH Increased dose Estrogen, tamoxifen, raloxifene, clofibrate, opioids, mitotane, fluorouracil, capecitabine Increased LT4 transport by thyroxine- binding globulin Increased TSH Increased dose Androgens, anabolic steroids Decreased LT4 transport by thyroxine- binding globulin Decreased TSH Decreased dose Phenobarbital, phenytoin, carbamazepine, rifampin, sertraline, imatinib Increased hepatic metabolism Increased TSH Increased dose Tyrosine kinase inhibitors (e.g. imatinib, motesanib, sorafenib, sunitinib, and vandetanib) Increased conversion of T3 to reverse T3 Increased TSH Increased dose

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