Thyropearl 25 Tablet (Thyroxine Sodium 25 mcg)

Composition

Each uncoated tablet contains:

Thyroxine Sodium IP — 25 mcg
Excipients: q.s.

 Therapeutic Category

Thyroid Hormone Replacement / Hormonal Therapy.

Dosage & Administration

Route: Oral administration

Typical adult starting dose: 25–50 mcg once daily.

Elderly or cardiac patients: Start at 12.5–25 mcg/day, increase gradually at 2–4 week intervals.

Maintenance dose: 25–200 mcg/day depending on patient’s thyroid status and TSH levels.

Administration:

Take once daily on an empty stomach, ideally 30–60 minutes before breakfast.

Swallow whole with water.

Consistent timing and same brand recommended to maintain stable thyroid levels.

 Warnings & Precautions

Regular monitoring of serum TSH and free T₄ levels required.

Use with caution in cardiac disorders — excessive dosing can worsen angina or arrhythmia.

Diabetic patients: Thyroxine may alter insulin/glucose control.

Adrenal insufficiency: Must be corrected before initiating therapy.

Avoid abrupt discontinuation.

Switching brands without medical advice is discouraged due to possible differences in bioavailability.

 Adverse Effects

Usually due to excessive dosage or over-replacement:

Common: Palpitations, tremor, insomnia, anxiety, heat intolerance, weight loss.

Less common: Tachycardia, arrhythmia, diarrhoea, menstrual irregularities, muscle cramps.

Rare: Hypersensitivity skin reactions, headache, fatigue.

Use in Special Populations

Pregnancy: Safe and necessary; monitor and adjust dose as required.

Lactation: Compatible; minimal excretion in breast milk.

Pediatric use: Dose individualized per age and weight.

Geriatric use: Start at low doses; titrate slowly to avoid cardiac stress.

 Overdosage

Symptoms: Tachycardia, tremors, irritability, hyperthermia, sweating, cardiac arrhythmias.
Management:

Temporarily discontinue therapy.

Symptomatic treatment with β-blockers (e.g., propranolol).

Cholestyramine may be given to enhance thyroxine elimination in severe cases.

 Storage

Store below 25°C, in a cool, dry place, protected from light and moisture.
Keep out of reach of children.