ADVERSE REACTIONS
Adverse reactions associated with levothyroxine therapy are primarily those of hyperthyroidism due to therapeutic overdosage (see PRECAUTIONS and OVERDOSAGE). They include the following:
General
fatigue, increased appetite, weight loss, heat intolerance, fever, excessive sweating;
Central nervous system
headache, hyperactivity, nervousness, anxiety, irritability, emotional lability, insomnia;
Musculoskeletal
tremors, muscle weakness;
Cardiovascular
palpitations, tachycardia, arrhythmias, increased pulse and blood pressure, heart failure, angina, myocardial infarction, cardiac arrest;
Respiratory
dyspnea;
Gastrointestinal
diarrhea, vomiting, abdominal cramps and elevations in liver function tests;
Dermatologic
hair loss, flushing;
Endocrine
decreased bone mineral density;
Reproductive
menstrual irregularities, impaired fertility.
Pseudotumor cerebri and slipped capital femoral epiphysis have been reported in children receiving levothyroxine therapy. Overtreatment may result in craniosynostosis in infants and premature closure of the epiphyses in children with resultant compromised adult height.
Seizures have been reported rarely with the institution of levothyroxine therapy.
Inadequate levothyroxine dosage will produce or fail to ameliorate the signs and symptoms of hypothyroidism.
Hypersensitivity reactions to inactive ingredients have occurred in patients treated with thyroid hormone products. These include urticaria, pruritus, skin rash, flushing, angioedema, various GI symptoms (abdominal pain, nausea, vomiting and diarrhea), fever, arthralgia, serum sickness and wheezing. Hypersensitivity to levothyroxine itself is not known to occur.
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