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This medication carries important safety considerations which must be taken seriously to avoid potential health risks. Below are key warnings and precautions to keep in mind:

• Not for Weight Loss: This medication, particularly levothyroxine (Tirosint), is not intended for weight loss. Using it in normal doses will not facilitate weight reduction, and consuming it in large doses can result in severe, potentially fatal side effects, especially if combined with diet pills or other weight loss medications.

• Heart Issues: Excessive intake of this medication may lead to heart complications, particularly in older adults or those with pre-existing heart conditions. If you experience symptoms such as a rapid or irregular heartbeat, chest pain, or difficulty breathing, contact your healthcare provider immediately. A dose adjustment or discontinuation may be necessary if new heart problems develop.

• Adrenal Crisis: Individuals with conditions like Addison's disease, which involve low adrenal hormone levels, should inform their healthcare provider before starting this medication. Treating thyroid conditions without addressing adrenal insufficiency first can worsen adrenal hormone levels. Watch for symptoms such as persistent fatigue, stomach pain, dizziness, weakness, or vomiting, and seek medical attention if they occur.

• Diabetes Management: This medication can elevate blood sugar levels, especially at the beginning of treatment or when the dosage is increased. Those with diabetes should monitor their blood sugar levels closely and may need adjustments in their diabetes medications. Discuss any significant changes with your healthcare provider.

• Bone Health: Long-term use of levothyroxine (Tirosint), especially at high doses, can result in bone weakening, with postmenopausal women at greater risk. To mitigate this risk, your healthcare provider will regularly monitor your thyroid levels to ensure you are on the lowest effective dose. Maintaining a healthy lifestyle through exercise, a bone-friendly diet, and avoiding alcohol can also help protect bone health.

• Contraindications: Do not use this medication if you have uncorrected adrenal insufficiency, as it could pose serious health risks. Always consult your healthcare provider before starting treatment if you have any concerns related to these conditions.

In case of overdose, seek emergency medical assistance immediately.

When taking Tirosint, it's important to be aware of potential interactions with other medications and certain foods, as these can affect how well the medication works. Here are some key interactions to consider:

Medications That May Decrease Tirosint Absorption:

• Calcium and Iron Supplements: Products containing Calcium Carbonate or Ferrous Sulfate can bind to Tirosint in the stomach, reducing its absorption. To avoid this, take Tirosint at least four hours before or after these supplements.

• Bile Acid Sequestrants and Ion Exchange Resins: Medications like Cholestyramine, Colestipol, and sevelamer can interfere with Tirosint absorption. It's recommended to take Tirosint at least four hours before these drugs.

• Antacids and Sucralfate: Antacids containing aluminum or Magnesium, as well as sucralfate, may reduce Tirosint absorption. Monitor your thyroid function if you're using these medications.

Medications That May Alter Thyroid Hormone Levels:

• Antidiabetic Drugs: Starting Tirosint may affect blood sugar control, potentially requiring adjustments in diabetes medications. Regular monitoring of blood glucose levels is advised.

• Oral Anticoagulants: Tirosint can enhance the effects of blood thinners like Warfarin, increasing the risk of bleeding. Frequent monitoring of blood clotting times is necessary.

• Digitalis Glycosides: Tirosint may reduce the effectiveness of medications used for heart conditions, such as Digoxin. Your doctor may need to adjust the dosage of these drugs.

• Antidepressants: Combining Tirosint with certain antidepressants, like tricyclics or tetracyclics, can increase the effects of both medications, potentially leading to side effects like heart rhythm disturbances.

• Ketamine: Using ketamine with Tirosint may cause significant increases in blood pressure and heart rate. Close monitoring is essential if these are used together.

• Sympathomimetics: Medications that stimulate the nervous system, such as certain decongestants, can have enhanced effects when taken with Tirosint, increasing the risk of heart-related side effects.

• Tyrosine-Kinase Inhibitors: Drugs like Imatinib, used in cancer treatment, may lead to hypothyroidism when taken with Tirosint. Regular thyroid function tests are recommended.

Food Interactions:

• Certain Foods: Soybean flour (found in some infant formulas), cottonseed meal, walnuts, and high-fiber foods can decrease Tirosint absorption. It's advisable to monitor your thyroid levels if your diet includes these foods.

• Grapefruit Juice: This beverage may delay Tirosint absorption and reduce its effectiveness. To ensure optimal absorption, avoid consuming grapefruit juice close to your Tirosint dose.

To minimize these interactions, take Tirosint on an empty stomach, at least 30 minutes to one hour before breakfast. Always inform your healthcare provider about all medications and supplements you're taking, including over-the-counter products and herbal remedies, to ensure safe and effective use of Tirosint.