Hypothyroid Treatment

Levothyroxine (Synthroid®)

Liothyronine (Cytomel®)

Liotrix (Thyrolar®)

Thyroglobulin (Proloid®)

Thyroid, dissected (Armour® Thyroid)

MOA: Provides the body with thyroid hormone (T4 or T3) to replace the lack of thyroid hormone in hypothyroidism

SE: Palpitations, increased appetite, tachycardia, nervousness, tremor, weight loss, sweating, diarrhea, insomnia, alopecia, heat intolerance, anxiety, nausea, headache, fever

Levothyroxine

Levoxyl®, Synthroid®, Levothroid®

Preferred drug for hypothyroidism 

Dose: 100-150 mcg po daily

 Hypothyroid Treatment

Liothyronine

Cytomel®, Triostat®

Hypothyroid Treatment

Liotrix

Thyrolar®

Hypothyroid Treatment

Thyroglobulin

Proloid®

Hypothyroid Treatment

Thyroid, dissected

Armour® Thyroid

Hypothyroid Treatment

Hyperthyroid Treatment

Iodide

Propyithiouracil (PTU)

Methimazole (Tapazole®)

Radioactive Iodine (I₁₃₁)

Propranolol (Inderal®)

Diltiazem (Cardizem®)

Verapamil (Calan®)

Prednisone (Deltasone®)

Iodide

No Brand Name

MOA: Inhibits thyroid hormone release, block iodotyrosine and iodothyronine synthesis, decrease vascularity of the thyroid gland; can rapidly decrease serum T4 concentration

Hyperthyroid Adjunct Treatment

Propyithiouracil

PTU

MOA: Inhibits hormone synthesis but does not affect existing hormone levels, also inhibits the conversion of T3 or T4. It is the drug of choice for thyroid storm.

Dose: 100-150 mg q8 hours, then reduce to 50 mg 2-3 times daily after euthyroid state is reached

SE: Abnormal sense of taste, itching, rash, fever, arthralgias

Thioamides (Hyperthyroid Treatment)

Methimazole

Tapazole®

MOA: Inhibits hormone synthesis, but does not affect existing stores of thyroid hormone; preferred over PTU because it is dosed once daily to enhance compliance

Dose: 5-15 mg BID up to 30 mg BID; MD: 5-10 mg daily

SE: Abnormal sense of taste, itching, rash, fever, arthralgia

Thioamide (Hyperthyroid Treatment)

Radioactive Iodine

I₁₃₁

SE: Hypothyroidism, worsening of ophthalmopathy, fear of radiation induced leukemia, genetic damage, malignancy, radiation sickness

Hyperthyroid Treatment

Propranolol

Inderal®

MOA: Blocks effects of thyroid hormone peripherally, no effect on underlying disease, blocks T4 to T3 conversion

Dose: 10-40 mg q6 hour to prn to decrease HR <100 bpm

SE: Bradycardia, CHF, bronchospasms, blocks symptoms of hypoglycemia

Beta Blocker (Hyperthyroid Treatment)

Diltiazem

Cardizem®

MOA: Blocks effect of thyroid hormone peripherally, no effect on underlying disease

Dose: 120 mg 3 to 4 times daily

SE: Bradycardia, peripheral edema, CHF, headache, flushing, hypotension, dizziness

Calcium Channel Blocker (Hyperthyroid Treatment)

Verapamil 

Calan®

MOA: Blocks effects of thyroid hormone peripherally, no effect on underlying disease

Dose: 80-120 mg 3 to 4 times daily

SE: Bradycardia, peripheral edema, CHF, headache, flushing, hypotension, dizziness

Calcium Channel Blocker (Hyperthyroid Treatment)

Prednisone

Deltasone®

MOA: Decreases thyroid receptor antibodies, supresses inflammatory process, blocks conversion of T4 to T3

Corticosteroid (Hyperthyroid Treatment)