식사 전 적어도 30-60 분, 오전 공복 상태에서 지속적으로 투약합니다. 반대로 마지막 식사 후 밤 3-4시간 후에 지속적으로 투약하기로 합니다.
Oral: Administer consistently in the morning on an empty stomach, at least 30 to 60 minutes before food. Alternatively, may consistently administer at night 3 to 4 hours after the last meal (AACE/ATA [Garber 2012]; ATA [Jonklaas 2014]). Do not administer within 4 hours of calcium- or iron-containing products or bile acid sequestrants.
Capsule: Must be swallowed whole; do not cut, crush, or chew.
Solution (Tirosint): May administer undiluted or diluted in water only (do not dilute with any other liquid); if administering undiluted, squeeze contents of single unit-dose ampule into mouth or onto a spoon and administer immediately. If diluting with water, squeeze contents of ampule into a glass or cup, stir, and then administer entire contents immediately. Rinse glass or cup with additional water and administer contents to ensure entire dose is consumed.
Tablet: Administer with a full glass of water (choking, gagging, and dysphagia have been reported with some formulations). May be crushed and suspended in 5 to 10 mL of water; suspension should be used immediately.
Nasogastric tube: Bioavailability of levothyroxine (crushed tablets suspended in water) is reduced if administered with enteral tube feeds. Since holding feedings for at least 1 hour before and after levothyroxine administration may not completely resolve the interaction, an increase in dose (eg, additional 25 mcg) may be necessary (Dickerson 2010). Tirosint oral solution product labeling does not provide recommendations regarding nasogastric administration.
REF. UpToDate 2019.07.23
