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In patients with nontoxic diffuse goiter or nodular thyroid diseaseparticularly the elderly or those with underlying cardiovascular diseaselevothyroxine sodium therapy is contraindicated if the serum TSH level is already suppressed due to the risk of precipitating overt thyrotoxicosissee CONTRAINDICATIONSIf the serum TSH level is not suppressedSYNTHROID should be used with caution in conjunction with careful monitoring of thyroid function for evidence of hyperthyroidism and clinical monitoring for potential associated adverse cardiovascular signs and symptoms of hyperthyroidism.

The patient should be monitored closely to avoid undertreatment or overtreatmentUndertreatment may have deleterious effects on intellectual development and linear growthOvertreatment has been associated with craniosynostosis in infantsand may adversely affect the tempo of brain maturation and accelerate the bone age with resultant premature closure of the epiphyses and compromised adult stature.

During the first 2 weeks of SYNTHROID therapyinfants should be closely monitored for cardiac overloadarrhythmiasand aspiration from avid suckling.

Tell all of your health care providers that you take Synthroidlevothyroxine tabletsThis includes your doctorsnursespharmacistsand dentistsDo not run out of Synthroidlevothyroxine tabletsIt may take several weeks to see the full effectsIf you have high blood sugardiabetesyou will need to watch your blood sugar closelyHave blood work checked as you have been told by the doctorTalk with the doctorThis medicine may cause weak bonesosteoporosiswith long-term useTalk with your doctor to see if you have a higher chance of weak bones or if you have any questionsThis medicine may affect how much of some other drugs are in your bodyIf you are taking other drugstalk with your doctorYou may need to have your blood work checked more closely while taking Synthroidlevothyroxine tabletswith your other drugsIf you are 65 or olderuse Synthroidlevothyroxine tabletswith careYou could have more side effectsTell your doctor if you are pregnant or plan on getting pregnantYou will need to talk about the benefits and risks of using Synthroidlevothyroxine tabletswhile you are pregnantTell your doctor if you are breast-feedingYou will need to talk about any risks to your baby.

Levothyroxineat doses individualized according to patient responseis effective as replacement or supplemental therapy in hypothyroidism of any etiologyexcept transient hypothyroidism during the recovery phase of subacute thyroiditis.

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