thyroxine od or om?

[morerightsneeded]

Hi.....another question for the more experienced pharmacists.

This may be a silly question so be warned. I have noticed that many Rxs which request two strengths of levothyroxine seem to deliberately specify an OM dosage for one dose and an OD dosage for the other as if to differentiate between the two. I am under the impression that levothyroxine should normally be taken as a single dose in the morning, but I have seen this variation so much I am beginning to think there may be more to this than i may think.

Does anyone know something that I don't???

[Fleegle]

A single daily dose, taken at the same time each day is perfectly adequate. Just another case of total ignorance, and lack of attention to detail in the generation of repeat prescriptions by the surgery computer-bimbettes aka 'receptionists'. Just the usual, really.

Fleeg.

[Pharmanaut]

A single daily dose, taken at the same time each day is perfectly adequate. Just another case of total ignorance, and lack of attention to detail in the generation of repeat prescriptions by the surgery computer-bimbettes aka 'receptionists'. Just the usual, really.

Fleeg.

Also a panic caused once when the 25mcg was temporarily not available.
Suggestion that 50mcg Alternate days would be adequate due to long half-life was met with disbelief.

Once spent a good few minutes waiting at the receptionists counter to collect prescriptions while they discussed the weekend, then all looked at an engagement ring and then on to the cost of school uniform. Meanwhile the queue is building up to check in to the doctors, and back at my pharmacy, my work was piling up.
They only broke off when Pharmanaut said "I can see you are busy, shall I come back later?"

Yet when the same people call us or visit the pharmacy we treat them top priority as a professional courtesy.

[PHARMAC1ST]

Yes with half life of thyroxine which is about a week i think it is best to take it in mornings before breakfast as a single dose. I too have noticed those prescriptions.

Also i have heard if taken at night can potentially keep the patient awake.

Morerights needed i like the questions you ask

[kemzero]

OM before brekkie definitely

Calcium and IRon reduces thyroxine absorption which can lead to therapeutic failure particularly with Iron so I always advise patients to take it 30-40mins before breakfast and warn them about having it with cereal ( for those who take their cereal with milk!)

[Sir_Dispensalot]

Also a panic caused once when the 25mcg was temporarily not available.
Suggestion that 50mcg Alternate days would be adequate due to long half-life was met with disbelief.

Once spent a good few minutes waiting at the receptionists counter to collect prescriptions while they discussed the weekend, then all looked at an engagement ring and then on to the cost of school uniform. Meanwhile the queue is building up to check in to the doctors, and back at my pharmacy, my work was piling up.
They only broke off when Pharmanaut said "I can see you are busy, shall I come back later?"

Yet when the same people call us or visit the pharmacy we treat them top priority as a professional courtesy.

I just walk round into the receptionists area when they do that. When they challenge me i just tell them i haven't got the time to spare buggering about as i've got patients to get back to. Mind you, me stepping out of the shop these days is about as rare as rocking-horse poo....