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Medication
Oroxine & Eutroxsig (synthetic T4/Thyroxine)
Thyroxine (Oroxine/Eutroxsig) is prescribed for patients who have had a total thyroidectomy, or who suffer from an underactive thyroid gland, either as a result of hemi-thyroid surgery, radioactive iodine or due to hypothyroidism.
Oroxine/Eutroxsig is a synthetic form of the hormone, thyroxine. It is the closest form of thyroxine to what your body produces.
If your thyroid is underactive, your doctor will prescribe a small dose to start your treatment and increase the dose as your thyroid gland becomes progressively inactive. If this medication is prescribed as a result of a total thyroidectomy, your treating doctor will determine the initial dose. It is unusual for patients to cease these medications once it is begun.
Time to take Medication
Recent research supports The ATF’s recommendation to take Oroxine/Eutroxsig first thing in the morning (as soon as your eyes are open) with a glass of water only, on an empty stomach. Wait at least 60 minutes before breakfast. Other medications, vitamin/mineral supplements and herbal extracts should not be taken at the same time to avoid interactions with Oroxine/Eutroxsig. An interval of 4 hours is recommended by Prof. Jim Stockigt (Thyroid News No. 7 Sept/Oct 2001). This is due to possible interactions and lower absorption.
Storage of Oroxine and Eutroxsig:
It is essential to refrigerate blister strips not yet in use of Oroxine/Eutroxsig between 2 – 8oC. Blister Strips in use, should not be allowed to reach 25oC for a minimum of 40 days. After 40 days of storage below 25oC, discard any remaining tablet. Therefore it is suggested to also refrigerate blister strips in use. This is to safeguard against spoilage in high temperature areas, room temperature increases, due to seasonal change, or room heating during colder months or whilst travelling.
Laboratory tests have shown that if not stored correctly, there is a reduction in potency of the active ingredient thyroxine sodium.
Do not store Oroxine/Eutroxsig, or any other medicines in a bathroom or near a sink.
Do not leave it in the car or on windowsills.
If tablets become soft and/or discoloured, or you believe they are not effective, please contact The ATF info@thyroidfoundation.com.au and Sigma Pharmaceuticals – Medical Affairs Department (03) 9839 2800. Email sigmamedical@signet.com.au
Travel Information for Oroxine and Eutroxsig:
Ensure your medication will not spoil from being exposed to heat or light whilst travelling. The ATF suggest using an Esky or cooler bag with an ice brick to protect it against temperature change.
Many ATF members have sourced a “Doggy Treat Bag” from the Dog Food Section of Bi Lo and Coles stores. This bag can hold a small ice brick and sections of blister strips. It is small enough to place in your handbag or carry-on luggage.
Remember to ensure you keep your medication in your hand luggage whilst travelling, so it arrives with you! The ATF are presently investigating a Medication Travel Pouch to overcome travel concerns. These will be available for members to purchase once production is complete.
Your treating doctor will regularly test your thyroxine (T4) level by blood test.
T3/T4 combination therapy (Oroxine/Tertroxine)
T4/T3 combination therapy is not recommended for hypothyroid replacement drug therapy. In rare cases, doctors may prescribe a combination therapy if patients are having problems with their absorption of thyroxine alone.
This therapy would be done with close monitoring by pathology testing under the supervision of your treating doctor.
Tertroxine (synthetic T3 therapy)
Tertroxine or triiodothyronine is a hormone produced in small amounts by the thyroid gland. It is also produced after thyroxine is absorbed and it acts on every cell of the body. It is not usually prescribed by doctors, as it can have a negative effect on the patient's heart and bones.
Neomercazole (Carbimazole)
Neomercazole is an anti-thyroid drug treatment used in the treatment of hyperthyroidism. Some patients will experience some side effects from this medication. The treatment is used to stop the thyroid gland over-producing thyroxine and triiodothyronine.
The initial dose of this medication is usually between two and six tablets per day. Your dose is usually reduced, once the medication takes effect. The length of time of this treatment is determined by the severity of the condition.
The treatment is usually effective in controlling hyperthyroidism. If this treatment produces side effects or the hyperthyroidism does not go into remission within one to two years of treatment then your doctor may recommend definitive treatment by way of thyroidectomy or radioactive Iodine.
Propylthiouracil – PTU (Carbimazole)
PTU, as it is referred, is an alternative to Neomercazole. PTU works in the same way as Neomercazole. Your treating doctor will monitor you closely whilst undertaking either treatment. The length of time for treatment is usually the same. Both these drugs have side effects, however most patients will find one will suit them better.
Calcium supplementation
Calcium Supplementation is used when the parathyroid glands under-produce the hormone which controls the absorption of calcium, or because one or more of these glands have been surgically removed due to hyperparathyroidism.
Calcium may also be prescribed for a period of time after thyroid surgery due to bruising or repositioning of the parathyroid glands.
As calcium can cause interactions with Oroxine/Eutroxsig, your thyroxine level (T4) should be monitored closely when calcium replacement begins. You should not take calcium tablets at the same time as you take your thyroxine.