|•Tablets Mild hypothyroidism.
Adults, individualized, initial: 25 mcg/day. Increase by 12.5-25 mcg q 1-2 weeks until satisfactory response has been obtained. Usual maintenance: 25-75 mcg/day (100 mcg may be required in some clients). Use lower initial dosage (5 mcg/day) for the elderly, children, and clients with CV disease. Increase only by 5-mcg increments.
Adults, initial: 5 mcg/day increased by 5-10 mcg/day q 1-2 weeks until 25 mcg/day is reached; then, increase q 1-2 weeks by 12.5-50 mcg. Usual maintenance: 50-100 mcg/day.
Simple (nontoxic) goiter.
Adults, initial: 5 mcg/day; then, increase q 1-2 weeks by 5-10 mcg until 25 mcg/day is reached; then, dose can be increased by 12.5-25 mcg/week until the maintenance dose of 50-100 mcg/day is reached (usual is 75 mcg/day).
T3 suppression test.
75-100 mcg/day for 7 days followed by a repeat of the I131 thyroid uptake test (a 50% or greater suppression of uptake indicates a normal thyroid-pituitary axis).
Adults and children, initial: 5 mcg/day; then, increase by 5 mcg/day q 3-4 days until the desired effect is achieved. Approximately 20 mcg/day may be sufficient for infants a few months of age while children 1 year of age may require 50 mcg/day. Children above 3 years may require the full adult dose.
•IV Only Myxedema coma, precoma.
Adults, initial: 25-50 mcg. Base subsequent doses on continuous monitoring of client's clinical status and response. Doses should be given at least 4 hr, and no more than 12 hr, apart. Total daily doses of 65 mcg in initial days of therapy are associated with a lower incidence of mortality. In cases of known CV disease, give an initial dose of 10-20 mcg.