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dextrothyroxine

C10AX01

Forms & Strengths

Oral tablets: 1 mg, 2 mg, 4 mg (historical/withdrawn in many markets)

Adult Dosing

Initial dose: 1 to 2 mg orally once daily
Maintenance dose: 4 to 8 mg orally once daily, adjusted based on serum cholesterol response
Maximum daily dose: 8 mg daily

Pediatric Dosing

Safety and efficacy not established in pediatric patients; generally not recommended

Indications

Adjunctive therapy for reduction of elevated serum cholesterol in patients with primary hypercholesterolemia (historical use)

Mechanism of Action

Dextrorotatory isomer of thyroxine that stimulates the liver to catabolize and excrete cholesterol into the bile
Exhibits lower metabolic and calorigenic activity compared to levothyroxine, though retaining some thyroid hormone receptor agonism

Contraindications

Known hypersensitivity to dextrothyroxine or thyroid analogues
Euthyroid patients with history of myocardial infarction or angina pectoris
Organic heart disease
Hypertension (severe)
Advanced hepatic or renal impairment
Pregnancy and lactation

Adverse Reactions

Increased frequency and severity of anginal pain
Myocardial infarction
Cardiac arrhythmias
Palpitations
Insomnia
Nervousness
Weight loss
Diarrhea
Gastrointestinal distress
Visual disturbances

Drug Interactions

Anticoagulants (warfarin): potentiates hypoprothrombinemic effect, increasing bleeding risk
Digitalis glycosides: increased risk of cardiac arrhythmias
Sympathomimetics and other cardiotoxic agents: additive cardiovascular stimulation
Oral hypoglycemics/insulin: may alter diabetic control due to metabolic effects

Curated Content: Needs Vetting Before Put to Clinical Use