Levothyroxine is a synthetic version of the thyroid hormone thyroxine. It is primarily used to treat hypothyroidism, a condition where the thyroid gland does not produce sufficient hormones¹. Here are key points about Levothyroxine:

1. Mechanism and Use: Levothyroxine works by replacing thyroxine, the hormone that the thyroid gland usually produces. It helps to normalize thyroid hormone levels in the body, thereby alleviating symptoms of hypothyroidism¹².

2. Forms and Administration: Levothyroxine is available in tablet, capsule, and liquid forms. It is typically taken once daily on an empty stomach, 30 minutes to an hour before breakfast. Consistent timing of administration is crucial for its effectiveness¹³.

3. Starting and Adjusting Dose: The initial dose is usually low and gradually increased based on regular blood tests to monitor thyroid function. This ensures the dose is suitable for maintaining normal thyroid hormone levels¹².

4. Side Effects and Interactions: Common side effects result from excessive dosing and include symptoms like irregular heartbeats, chest pain, nervousness, and excessive sweating. Levothyroxine can interact with other medications, such as iron and calcium supplements, which can affect its absorption. It's essential to discuss all medications with your healthcare provider⁴⁵⁶.

5. Special Considerations: Certain conditions, such as pregnancy or concurrent medical treatments like radioiodine therapy for thyroid cancer, require specific adjustments in levothyroxine dosing. Long-term use in subclinical hypothyroidism (SCH) is sometimes debated due to potential risks versus benefits⁵⁷.

Levothyroxine is a carefully monitored therapy to ensure effective treatment of hypothyroidism while minimizing potential adverse effects. Always follow your healthcare provider's guidance regarding its use.

Footnotes

1. NHS, "Levothyroxine: a medicine for an underactive thyroid (hypothyroidism)," NHS. ↩ ↩² ↩³ ↩⁴

2. MedlinePlus, "Levothyroxine: MedlinePlus Drug Information," MedlinePlus. ↩ ↩²

3. Sidhant Ochani, "Adverse effects of long-term Levothyroxine therapy in Subclinical Hypothyroidism," NCBI. ↩

4. Mayo Clinic, "Levothyroxine (Oral Route) Precautions," Mayo Clinic. ↩

5. Savannah A. Irving, "Drugs that interact with levothyroxine: an observational study from the Thyroid Epidemiology, Audit and Research Study (TEARS)," PubMed. ↩ ↩²

6. Leonidas H. Duntas, "Levothyroxine Dose Adjustment to Optimise Therapy Throughout a Patient’s Lifetime," NCBI. ↩

7. Bibinaz Eghtedari, "Levothyroxine - StatPearls - NCBI Bookshelf," NCBI. ↩

Finasteride is a medication primarily used to treat two conditions: benign prostatic hyperplasia (BPH), an enlarged prostate, and male pattern baldness (androgenetic alopecia). Here's an overview of its key points:

1. Mechanism of Action: Finasteride works by inhibiting the enzyme 5-alpha-reductase. This enzyme converts testosterone to dihydrotestosterone (DHT), a more potent androgen. By reducing DHT levels, finasteride helps to prevent the shrinking of hair follicles in androgenetic alopecia and reduces prostate growth in BPH¹².

2. Uses:

   • Benign Prostatic Hyperplasia (BPH): Finasteride is used to reduce symptoms of BPH, such as difficulty in urination. It can also decrease the need for surgery related to BPH¹.
   • Androgenetic Alopecia: In men, finasteride can help to slow hair loss and promote hair regrowth².

3. Dosage and Administration:

   • For BPH: Usually taken as a 5 mg tablet once daily.
   • For hair loss: Typically taken as a 1 mg tablet once daily¹².

4. Side Effects:

   • Common side effects include reduced libido, erectile dysfunction, and ejaculation disorders.
   • Rarely, it can cause breast tenderness or enlargement, and an allergic reaction which may include rash, itching, and swelling³⁴.

5. Warnings and Precautions:

   • Women, especially those who are pregnant or may become pregnant, should not handle crushed or broken finasteride tablets due to the risk of absorption and potential birth defects in a male fetus²⁵.
   • It may take several months to notice an improvement in symptoms, and continuous use is often necessary to maintain the benefits².

6. Drug Interactions: Finasteride can interact with certain drugs like other 5-alpha-reductase inhibitors and should be used cautiously under medical supervision³⁴.

7. Effectiveness:

   • Studies show significant improvement in symptoms of BPH and hair regrowth in androgenetic alopecia with consistent use¹².
   • Long-term use is generally required to maintain the benefits of treatment².

Finasteride is a well-regarded treatment for BPH and male pattern baldness, but it should be used under the guidance of a healthcare provider due to potential side effects and interactions.

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Footnotes

1. Mayo Clinic, "Finasteride (Oral Route) Description and Brand Names," Mayo Clinic. ↩ ↩² ↩³ ↩⁴

2. MedlinePlus, "Finasteride: MedlinePlus Drug Information," MedlinePlus. ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷

3. NHS, "Finasteride: a medicine for an enlarged prostate (benign prostatic hyperplasia) and male pattern baldness," NHS. ↩ ↩²

4. Cleveland Clinic, "Finasteride," Cleveland Clinic. ↩ ↩²

5. U.S. National Library of Medicine, "Finasteride," DailyMed. ↩