Таблетки белого или белого с кремоватым оттенком цвета, плоскоцилиндрические, с фаской с двух сторон и риской с одной стороны.
Фармакотерапевтическая группа
тиреоидное средство
Фармакологические свойства
Фармакодинамика:
Синтетический левовращающий изомер тироксина. После частичного превращения в трийодтиронин (в печени и почках) и перехода в клетки организма оказывает влияние на развитие и рост тканей на обмен веществ.
В малых дозах оказывает анаболическое действие на белковый и жировой обмен.
В средних дозах стимулирует рост и развитие повышает потребность тканей в кислороде стимулирует метаболизм белков жиров и углеводов повышает функциональную активность сердечно-сосудистой системы и центральной нервной системы.
В больших дозах угнетает выработку тиреотропин-рилизинг гормона гипоталамуса и тиреотропного гормона гипофиза.
Терапевтический эффект наблюдается через 7-12 дней в течение этого же времени сохраняется действие после отмены препарата. Клинический эффект при гипотиреозе проявляется через 3-5 сут. Диффузный зоб уменьшается или исчезает в течение 3-6 мес.
Фармакокинетика:
При приеме внутрь левотироксин натрия всасывается почти исключительно в верхнем отделе тонкой кишки. Всасывается до 80% принятой дозы препарата. Прием пиши снижает всасываемость левотироксина натрия. Максимальная концентрация в сыворотке крови достигается примерно через 5-6 часов после приема внутрь.
После всасывания более 99% препарата связывается с белками сыворотки (тироксин-связывающим глобулином тироксин-связывающим преальбумином и альбумином). В различных тканях происходит монодейодирование примерно 80% левотироксина натрия с образованием трийодтиронина (Т3) и неактивных продуктов.
Тиреоидные гормоны метаболизируются главным образом в печени почках головном мозге и в мышцах. Небольшое количество препарата подвергается дезаминированию и декарбоксилированию а также конъюгированию с серной и глюкуроновыми кислотами (в печени).
Метаболиты выводятся почками и через кишечник. Период полувыведения препарата составляет 6-7 дней. При тиреотоксикозе период полувыведения укорачивается до 3-4 дней а при гипотиреозе удлиняется до 9-10 дней.
Показания к применению
- Гипотиреоз;
- эутиреоидный зоб;
- в качестве заместительной терапии и для профилактики рецидива зоба после резекции щитовидной железы;
- рак щитовидной железы (после оперативного лечения);
- диффузный токсический зоб: после достижения эутиреоидного состояния тиреостатиками (в виде комбинированной или монотерапии);
- в качестве диагностического средства при проведении теста тиреоидной супрессии.
Противопоказания
- Повышенная индивидуальная чувствительность к препарату;
- нелеченый тиреотоксикоз;
- острый инфаркт миокарда острый миокардит;
- нелеченая недостаточность надпочечников;
- наследственная непереносимость галактозы недостаточность лактазы или нарушение всасывания глюкозы и лактозы.
С осторожностью
С осторожностью следует назначать препарат при заболеваниях сердечно-сосудистой системы: ишемической болезни сердца (атеросклероз стенокардия инфаркт миокарда в анамнезе) артериальной гипертензии аритмии; при сахарном диабете тяжелом длительно существующем гипотиреозе синдроме мальабсорбции (может потребоваться коррекция дозы).
Применение при беременности и в период грудного вскармливания
В период беременности и грудного вскармливания терапия препаратом назначенным по поводу гипотиреоза должна продолжаться. В период беременности требуется увеличение дозы препарата из-за повышения уровня содержания тироксин-связывающего глобулина.
Количество тиреоидного гормона секретируемого с грудным молоком при лактации (даже при проведении лечения высокими дозами препарата) не достаточно для того чтобы вызвать какие-либо нарушения у ребенка.
Применение при беременности препарата в комбинации с антитиреоидными препаратами противопоказано так как прием левотироксина натрия может потребовать увеличение дозы антитиреоидных препаратов. Поскольку антитиреоидные препараты в отличие от левотироксина натрия могут проникать через плаценту то у плода может развиться гипотиреоз.
В период грудного вскармливания препарат следует принимать с осторожностью строго в рекомендуемых дозах под наблюдением врача.
Способ применения и дозы
Суточная доза определяется индивидуально в зависимости от показаний.
L-тироксин в суточной дозе принимают внутрь утром натощак по крайней мере за 30 минут до приема пищи запивая таблетку небольшим количеством жидкости (полстакана воды) и не разжевывая.
При проведении заместительной терапии гипотиреоза у больных моложе 55 лет при отсутствии сердечно-сосудистых заболеваний L-тироксин назначают в суточной дозе 16-18 мкг/кг массы тела; у больных старше 55 лет или с сердечно-сосудистыми заболеваниями - 09 мкг/кг массы тела. При выраженном ожирении (ИМТ ≥ 30 кг/м2) расчёт следует делать на "идеальный вес".
Начальный этап заместительной терапии при гипотиреозе:
Больные без сердечно-сосудистых заболеваний моложе 55 лет
- Начальная доза:
женщины - 75-100 мкг/сут
мужчины - 100-150 мкг/сут
Больные с сердечно-сосудистыми заболеваниями или старше 55 лет
- Начальная доза - 25 мкг в день
- Увеличивать по 25 мкг с интервалом 2 месяца до нормализации показателя ТТГ в крови
- При появлении или усугублении симптомов со стороны сердечно-сосудистой системы провести коррекцию терапии сердечно-сосудистых заболеваний
Рекомендуемые дозы левотироксина для лечения врождённого гипотиреоза:
Возраст/Суточная доза левотироксина (мкг)/Доза левотироксина в расчете на массу тела (мкг/кг)
Профилактика рецидива после хирургического лечения эутиреоидного зоба/75-200
В комплексной терапии тиреотоксикоза/50-100
Супрессивная терапия рака щитовидной железы/150-300
Грудным детям и детям младше 3 лет суточную дозу L-тироксина дают в один прием за 30 минут до первого кормления. Таблетку растворяют в воде до тонкой взвеси которую готовят непосредственно перед приемом препарата.
При гипотиреозе L-тироксин принимают как правило в течение всей жизни.
При тиреотоксикозе L-тироксин используют в комплексной терапии с антитиреоидными средствами после достижения эутиреоидного состояния. Во всех случаях длительность лечения препаратом определяет врач.
Побочное действие
При правильном применении L-тироксина под контролем врача побочные эффекты не наблюдаются.
При повышенной чувствительности к препарату могут наблюдаться аллергические реакции.
Развитие других побочных эффектов обусловлено передозировкой препарата (см. раздел "Передозировка)").
Передозировка
При передозировке препарата наблюдаются симптомы характерные для тиреотоксикоза: сердцебиение нарушение ритма сердца боли в сердце беспокойство тремор нарушение сна повышенная потливость повышение аппетита снижение массы тела диарея. В зависимости от выраженности симптомов врачом может быть рекомендовано уменьшение суточной дозы препарата перерыв в лечении на несколько дней назначение бета-адреноблокаторов. После исчезновения побочных эффектов лечение следует начинать с осторожностью с более низкой дозы.
Взаимодействие с другими лекарственными средствами
Левотироксин натрия усиливает действие непрямых антикоагулянтов что может потребовать снижения их дозы.
Применение трициклических антидепрессантов с левотироксином натрия может привести к усилению действия антидепрессантов.
Тиреоидные гормоны могут увеличивать потребность в инсулине и пероральных гипогликемических препаратах. Более частый контроль концентрации глюкозы в крови рекомендуется проводить в периоды начала лечения левотироксином натрия а также при изменении его режима дозирования.
Левотироксин натрия снижает действие сердечных гликозидов.
При одновременном применении колестирамин колестипол и алюминия гидроксид уменьшают плазменную концентрацию левотироксина натрия за счет торможения всасывания его в кишечнике.
При одновременном применении с анаболическими стероидами аспарагиназой тамоксифеном возможно фармакокинетическое взаимодействие на уровне связывания с белком.
При одновременном применении с фенитоином салицилатами клофибратом фуросемидом в высоких дозах повышается содержание не связанного с белками плазмы крови левотироксина натрия и тироксина (Т4) .
Прием эстрогенсодержащих препаратов увеличивает содержание тироксин-связывающего глобулина что может повысить потребность в левотироксине натрия у некоторых пациентов.
Соматотропин при одновременном применении с левотироксином натрия может ускорить закрытие эпифизарных зон роста.
Прием фенобарбитала карбамазепина и рифампицина может увеличивать клиренс левотироксина натрия и потребовать повышения дозы.
На распределение и метаболизм препарата оказывают влияние амиодарон аминоглутетимид ПАСК этионамид антитиреоидные лекарственные средства бета-адреноблокаторы карбамазепин хлоралгидрат диазепам леводопа допамин метоклопрамид ловастатин соматостатин.
При одновременном применении с фенитоином салицилатами фуросемидом (в высоких дозах) клофибратом повышается концентрация препарата в крови.
Фенитоин снижает количество левотироксина связанного с белком и концентрацию Т4 на 15 и 25% соответственно.
Особые указания
При гипотиреозе обусловленном поражением гипофиза необходимо выяснить имеется ли одновременно недостаточность коры надпочечников. В данном случае заместительную терапию глюкокортикостероидами следует начинать до начала лечения гипотиреоза тиреоидными гормонами во избежание развития острой надпочечниковой недостаточности.
Рекомендуется периодически определять в крови концентрацию тиреотропного гормона (ТТГ) повышение которого указывает на недостаточность дозы.
Влияние на способность управлять автомобилем и движущимися механизмами
Препарат не оказывает влияния на деятельность связанную с вождением транспортных средств и управлением механизмами.
Форма выпуска
Таблетки 50 и 100 мкг.
Условия хранения
Хранить в сухом защищенном от света месте при температуре не выше 25 °С.
Хранить в недоступном для детей месте.
Срок годности
3 года.
Не применять по истечении срока годности.
Условия отпуска
По рецепту
Производитель
Общество с ограниченной ответственностью "Озон" (ООО "Озон"), 445351, Самарская обл., г. Жигулёвск, ул. Гидростроителей, д. 6, Россия
Организация, принимающая претензии потребителей
ООО "Озон"
Для описания товара использована информация от партнера 36.6
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мг, целлюлоза микрокристаллическая - 17,0 мг."}}]},{"id":5,"name":"Описание","slug":"common_description","body":[{"type":"paragraph","data":{"text":"Таблетки белого или белого с кремоватым оттенком цвета, плоскоцилиндрические, с фаской с двух сторон и риской с одной стороны."}}]},{"id":6,"name":"Фармакотерапевтическая группа","slug":"","body":[{"type":"paragraph","data":{"text":"тиреоидное средство"}}]},{"id":7,"name":"Фармакологические свойства","slug":"pharmacologic_effects","body":[{"type":"header","data":{"text":"Фармакодинамика:","level":3}},{"type":"paragraph","data":{"text":"Синтетический левовращающий изомер тироксина. После частичного превращения в трийодтиронин (в печени и почках) и перехода в клетки организма оказывает влияние на развитие и рост тканей на обмен веществ."}},{"type":"paragraph","data":{"text":"В малых дозах оказывает анаболическое действие на белковый и жировой обмен."}},{"type":"paragraph","data":{"text":"В средних дозах стимулирует рост и развитие повышает потребность тканей в кислороде стимулирует метаболизм белков жиров и углеводов повышает функциональную активность сердечно-сосудистой системы и центральной нервной системы."}},{"type":"paragraph","data":{"text":"В больших дозах угнетает выработку тиреотропин-рилизинг гормона гипоталамуса и тиреотропного гормона гипофиза."}},{"type":"paragraph","data":{"text":"Терапевтический эффект наблюдается через 7-12 дней в течение этого же времени сохраняется действие после отмены препарата. Клинический эффект при гипотиреозе проявляется через 3-5 сут. Диффузный зоб уменьшается или исчезает в течение 3-6 мес."}},{"type":"header","data":{"text":"Фармакокинетика:","level":3}},{"type":"paragraph","data":{"text":"При приеме внутрь левотироксин натрия всасывается почти исключительно в верхнем отделе тонкой кишки. Всасывается до 80% принятой дозы препарата. Прием пиши снижает всасываемость левотироксина натрия. Максимальная концентрация в сыворотке крови достигается примерно через 5-6 часов после приема внутрь."}},{"type":"paragraph","data":{"text":"После всасывания более 99% препарата связывается с белками сыворотки (тироксин-связывающим глобулином тироксин-связывающим преальбумином и альбумином). В различных тканях происходит монодейодирование примерно 80% левотироксина натрия с образованием трийодтиронина (Т\u003csub\u003e3\u003c/sub\u003e) и неактивных продуктов."}},{"type":"paragraph","data":{"text":"Тиреоидные гормоны метаболизируются главным образом в печени почках головном мозге и в мышцах. Небольшое количество препарата подвергается дезаминированию и декарбоксилированию а также конъюгированию с серной и глюкуроновыми кислотами (в печени)."}},{"type":"paragraph","data":{"text":"Метаболиты выводятся почками и через кишечник. Период полувыведения препарата составляет 6-7 дней. При тиреотоксикозе период полувыведения укорачивается до 3-4 дней а при гипотиреозе удлиняется до 9-10 дней."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"- Гипотиреоз;"}},{"type":"paragraph","data":{"text":"- эутиреоидный зоб;"}},{"type":"paragraph","data":{"text":"- в качестве заместительной терапии и для профилактики рецидива зоба после резекции щитовидной железы;"}},{"type":"paragraph","data":{"text":"- рак щитовидной железы (после оперативного лечения);"}},{"type":"paragraph","data":{"text":"- диффузный токсический зоб: после достижения эутиреоидного состояния тиреостатиками (в виде комбинированной или монотерапии);"}},{"type":"paragraph","data":{"text":"- в качестве диагностического средства при проведении теста тиреоидной супрессии."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"- Повышенная индивидуальная чувствительность к препарату;"}},{"type":"paragraph","data":{"text":"- нелеченый тиреотоксикоз;"}},{"type":"paragraph","data":{"text":"- острый инфаркт миокарда острый миокардит;"}},{"type":"paragraph","data":{"text":"- нелеченая недостаточность надпочечников;"}},{"type":"paragraph","data":{"text":"- наследственная непереносимость галактозы недостаточность лактазы или нарушение всасывания глюкозы и лактозы."}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"С осторожностью следует назначать препарат при заболеваниях сердечно-сосудистой системы: ишемической болезни сердца (атеросклероз стенокардия инфаркт миокарда в анамнезе) артериальной гипертензии аритмии; при сахарном диабете тяжелом длительно существующем гипотиреозе синдроме мальабсорбции (может потребоваться коррекция дозы)."}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"В период беременности и грудного вскармливания терапия препаратом назначенным по поводу гипотиреоза должна продолжаться. В период беременности требуется увеличение дозы препарата из-за повышения уровня содержания тироксин-связывающего глобулина."}},{"type":"paragraph","data":{"text":"Количество тиреоидного гормона секретируемого с грудным молоком при лактации (даже при проведении лечения высокими дозами препарата) не достаточно для того чтобы вызвать какие-либо нарушения у ребенка."}},{"type":"paragraph","data":{"text":"Применение при беременности препарата в комбинации с антитиреоидными препаратами противопоказано так как прием левотироксина натрия может потребовать увеличение дозы антитиреоидных препаратов. Поскольку антитиреоидные препараты в отличие от левотироксина натрия могут проникать через плаценту то у плода может развиться гипотиреоз."}},{"type":"paragraph","data":{"text":"В период грудного вскармливания препарат следует принимать с осторожностью строго в рекомендуемых дозах под наблюдением врача."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Суточная доза определяется индивидуально в зависимости от показаний."}},{"type":"paragraph","data":{"text":"L-тироксин в суточной дозе принимают внутрь утром натощак по крайней мере за 30 минут до приема пищи запивая таблетку небольшим количеством жидкости (полстакана воды) и не разжевывая."}},{"type":"paragraph","data":{"text":"При проведении заместительной терапии гипотиреоза у больных моложе 55 лет при отсутствии сердечно-сосудистых заболеваний L-тироксин назначают в суточной дозе 16-18 мкг/кг массы тела; у больных старше 55 лет или с сердечно-сосудистыми заболеваниями - 09 мкг/кг массы тела. При выраженном ожирении (ИМТ ≥ 30 кг/м\u003csup\u003e2\u003c/sup\u003e) расчёт следует делать на \"идеальный вес\"."}},{"type":"paragraph","data":{"text":"Начальный этап заместительной терапии при гипотиреозе:"}},{"type":"paragraph","data":{"text":"Больные без сердечно-сосудистых заболеваний моложе 55 лет"}},{"type":"paragraph","data":{"text":"- Начальная доза:"}},{"type":"paragraph","data":{"text":"женщины - 75-100 мкг/сут"}},{"type":"paragraph","data":{"text":"мужчины - 100-150 мкг/сут"}},{"type":"paragraph","data":{"text":"Больные с сердечно-сосудистыми заболеваниями или старше 55 лет"}},{"type":"paragraph","data":{"text":"- Начальная доза - 25 мкг в день"}},{"type":"paragraph","data":{"text":"- Увеличивать по 25 мкг с интервалом 2 месяца до нормализации показателя ТТГ в крови"}},{"type":"paragraph","data":{"text":"- При появлении или усугублении симптомов со стороны сердечно-сосудистой системы провести коррекцию терапии сердечно-сосудистых заболеваний"}},{"type":"paragraph","data":{"text":"Рекомендуемые дозы левотироксина для лечения врождённого гипотиреоза:"}},{"type":"paragraph","data":{"text":"Возраст/Суточная доза левотироксина (мкг)/Доза левотироксина в расчете на массу тела (мкг/кг)"}},{"type":"paragraph","data":{"text":"0-6 месяцев/25-50/10-15"}},{"type":"paragraph","data":{"text":"6-12 месяцев/50-75/6-8"}},{"type":"paragraph","data":{"text":"1-5 лет/75-100/5-6"}},{"type":"paragraph","data":{"text":"6-12 лет/100-150/4-5"}},{"type":"paragraph","data":{"text":"> 12 лет/100-200/2-3"}},{"type":"paragraph","data":{"text":"Показания/Рекомендуемые дозы (L-Тироксин мкг/сут):"}},{"type":"paragraph","data":{"text":"Лечение эутиреоидного зоба/75-200"}},{"type":"paragraph","data":{"text":"Профилактика рецидива после хирургического лечения эутиреоидного зоба/75-200"}},{"type":"paragraph","data":{"text":"В комплексной терапии тиреотоксикоза/50-100"}},{"type":"paragraph","data":{"text":"Супрессивная терапия рака щитовидной железы/150-300"}},{"type":"paragraph","data":{"text":"Грудным детям и детям младше 3 лет суточную дозу L-тироксина дают в один прием за 30 минут до первого кормления. Таблетку растворяют в воде до тонкой взвеси которую готовят непосредственно перед приемом препарата."}},{"type":"paragraph","data":{"text":"При гипотиреозе L-тироксин принимают как правило в течение всей жизни."}},{"type":"paragraph","data":{"text":"При тиреотоксикозе L-тироксин используют в комплексной терапии с антитиреоидными средствами после достижения эутиреоидного состояния. Во всех случаях длительность лечения препаратом определяет врач."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"При правильном применении L-тироксина под контролем врача побочные эффекты не наблюдаются."}},{"type":"paragraph","data":{"text":"При повышенной чувствительности к препарату могут наблюдаться аллергические реакции."}},{"type":"paragraph","data":{"text":"Развитие других побочных эффектов обусловлено передозировкой препарата (см. раздел \"Передозировка)\")."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"При передозировке препарата наблюдаются симптомы характерные для тиреотоксикоза: сердцебиение нарушение ритма сердца боли в сердце беспокойство тремор нарушение сна повышенная потливость повышение аппетита снижение массы тела диарея. В зависимости от выраженности симптомов врачом может быть рекомендовано уменьшение суточной дозы препарата перерыв в лечении на несколько дней назначение бета-адреноблокаторов. После исчезновения побочных эффектов лечение следует начинать с осторожностью с более низкой дозы."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Левотироксин натрия усиливает действие непрямых антикоагулянтов что может потребовать снижения их дозы."}},{"type":"paragraph","data":{"text":"Применение трициклических антидепрессантов с левотироксином натрия может привести к усилению действия антидепрессантов."}},{"type":"paragraph","data":{"text":"Тиреоидные гормоны могут увеличивать потребность в инсулине и пероральных гипогликемических препаратах. Более частый контроль концентрации глюкозы в крови рекомендуется проводить в периоды начала лечения левотироксином натрия а также при изменении его режима дозирования."}},{"type":"paragraph","data":{"text":"Левотироксин натрия снижает действие сердечных гликозидов."}},{"type":"paragraph","data":{"text":"При одновременном применении колестирамин колестипол и алюминия гидроксид уменьшают плазменную концентрацию левотироксина натрия за счет торможения всасывания его в кишечнике."}},{"type":"paragraph","data":{"text":"При одновременном применении с анаболическими стероидами аспарагиназой тамоксифеном возможно фармакокинетическое взаимодействие на уровне связывания с белком."}},{"type":"paragraph","data":{"text":"При одновременном применении с фенитоином салицилатами клофибратом фуросемидом в высоких дозах повышается содержание не связанного с белками плазмы крови левотироксина натрия и тироксина (Т\u003csub\u003e4\u003c/sub\u003e) ."}},{"type":"paragraph","data":{"text":"Прием эстрогенсодержащих препаратов увеличивает содержание тироксин-связывающего глобулина что может повысить потребность в левотироксине натрия у некоторых пациентов."}},{"type":"paragraph","data":{"text":"Соматотропин при одновременном применении с левотироксином натрия может ускорить закрытие эпифизарных зон роста."}},{"type":"paragraph","data":{"text":"Прием фенобарбитала карбамазепина и рифампицина может увеличивать клиренс левотироксина натрия и потребовать повышения дозы."}},{"type":"paragraph","data":{"text":"На распределение и метаболизм препарата оказывают влияние амиодарон аминоглутетимид ПАСК этионамид антитиреоидные лекарственные средства бета-адреноблокаторы карбамазепин хлоралгидрат диазепам леводопа допамин метоклопрамид ловастатин соматостатин."}},{"type":"paragraph","data":{"text":"При одновременном применении с фенитоином салицилатами фуросемидом (в высоких дозах) клофибратом повышается концентрация препарата в крови."}},{"type":"paragraph","data":{"text":"Фенитоин снижает количество левотироксина связанного с белком и концентрацию Т\u003csub\u003e4\u003c/sub\u003e на 15 и 25% соответственно."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"При гипотиреозе обусловленном поражением гипофиза необходимо выяснить имеется ли одновременно недостаточность коры надпочечников. В данном случае заместительную терапию глюкокортикостероидами следует начинать до начала лечения гипотиреоза тиреоидными гормонами во избежание развития острой надпочечниковой недостаточности."}},{"type":"paragraph","data":{"text":"Рекомендуется периодически определять в крови концентрацию тиреотропного гормона (ТТГ) повышение которого указывает на недостаточность дозы."}}]},{"id":17,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"Препарат не оказывает влияния на деятельность связанную с вождением транспортных средств и управлением механизмами."}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Таблетки 50 и 100 мкг."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"Хранить в сухом защищенном от света месте при температуре не выше 25 °С."}},{"type":"paragraph","data":{"text":"Хранить в недоступном для детей месте."}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"3 года."}},{"type":"paragraph","data":{"text":"Не применять по истечении срока годности."}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"По рецепту"}}]},{"id":22,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"Общество с ограниченной ответственностью \"Озон\" (ООО \"Озон\"), 445351, Самарская обл., г. Жигулёвск, ул. Гидростроителей, д. 6, Россия"}}]},{"id":23,"name":"Организация, принимающая претензии потребителей","body":[{"type":"paragraph","data":{"text":"ООО \"Озон\""}}]}],"source":null},"description_toggle":false,"short_description":"Синтетический левовращающий изомер тироксина. После частичного превращения в трийодтиронин (в печени и почках) и перехода в клетки организма оказывает влияние на развитие и рост тканей на обмен веществ. В малых дозах оказывает анаболическое действие на белковый и жировой обмен. В средних дозах стимулирует рост и развитие повышает потребность тканей в кислороде стимулирует метаболизм белков жиров и углеводов повышает функциональную активность сердечно-сосудистой системы и центральной нервной системы. В больших дозах угнетает выработку тиреотропин-рилизинг гормона гипоталамуса и тиреотропного гормона гипофиза. Терапевтический эффект наблюдается через 7-12 дней в течение этого же времени сохраняется действие после отмены препарата. Клинический эффект при гипотиреозе проявляется через 3-5 сут. Диффузный зоб уменьшается или исчезает в течение 3-6 мес. При приеме внутрь левотироксин натрия всасывается почти исключительно в верхнем отделе тонкой кишки. Всасывается до 80% принятой дозы препарата. Прием пиши снижает всасываемость левотироксина натрия. Максимальная концентрация в сыворотке крови достигается примерно через 5-6 часов после приема внутрь. После всасывания более 99% препарата связывается с белками сыворотки (тироксин-связывающим глобулином тироксин-связывающим преальбумином и альбумином). В различных тканях происходит монодейодирование примерно 80% левотироксина натрия с образованием трийодтиронина (Т3) и неактивных продуктов. Тиреоидные гормоны метаболизируются главным образом в печени почках головном мозге и в мышцах. Небольшое количество препарата подвергается дезаминированию и декарбоксилированию а также конъюгированию с серной и глюкуроновыми кислотами (в печени). Метаболиты выводятся почками и через кишечник. Период полувыведения препарата составляет 6-7 дней. При тиреотоксикозе период полувыведения укорачивается до 3-4 дней а при гипотиреозе удлиняется до 9-10 дней.","substance":[{"id":276,"title":"Левотироксин натрия","title_latin":"Levothyroxinum natrium","slug":"levotiroksin_natriya_276"}],"branding":null,"valid_for_quick_buy":true,"is_available_to_delivery":false,"comments":null,"image_alt":"L-Тироксин Озон - фото упаковки","image_share":{"isTouch":{"default":"https://vseapteki.ru/cropping/thumbnails/101/4675/share_default/"},"isFromTablet":{"default":"https://vseapteki.ru/cropping/thumbnails/101/4675/share_default/"}},"diseases":[{"id":"258","title":"Злокачественное новообразование щитовидной железы","slug":"258-zlokachestvennoe_novoobrazovanie_schitovidnoy_zhelezy"},{"id":"359","title":"Диффузный (эндемический) зоб, связанный с йодной недостаточностью","slug":"359-diffuznyy_endemicheskiy_zob_svyazannyy_s_yodnoy_nedostatochnostyu"},{"id":"360","title":"Многоузловой (эндемический) зоб, связанный с йодной 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