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Symptoms: Overdose may cause symptoms of a significant increase in the metabolic rate. For typical symptoms, see "Adverse Reactions".
In predisposed patients isolated cases of seizures have been reported when the individual dose tolerance limit was exceeded. Overdose of levothyroxine may result in hyperthyroidism and could lead to symptoms of acute psychosis, especially in patients at risk of psychotic disorders.
Several cases of sudden cardiac death have been reported in patients with long years of levothyroxine abuse.
Management: An elevated T3 level is a reliable indicator of overdose, more than elevated T4 or fT4 levels.
Depending on the extent of the overdose it is recommended that treatment is interrupted and that tests are carried out.
Beta-sympathomimetic effects such as tachycardia, anxiety, agitation or hyperkinesia can be relieved by betablockers. After extreme doses plasmapheresis may be indicated.
