Аллергические реакции на разные препараты тироксина описаны, например:
Drug Rash Induced by Levothyroxine Tablets - Thyroid.Oct 2012.ahead of printhttp://doi.org/10.1089/thy.2011.0462, [
Ссылки доступны только зарегистрированным пользователям ] Здесь аллергию связали с тартразином 3, 4; антигистаминные не давали эффекта, но после приёма преднизолона и замены препарата тироксина на безтартразиновый аллергия купировалась. Не знаю, есть ли эти компоненты в обсуждаемых тироксинах, но исключить этого с ходу [
Ссылки доступны только зарегистрированным пользователям ], надо детально смотреть состав таблетки и плёнки.
Drug rash induced by levothyroxine and oral desensitization - World Allergy Organ J. 2015; 8(Suppl 1): A21. - Published online 2015 Apr 8. doi: 10.1186/1939-4551-8-S1-A21 - [
Ссылки доступны только зарегистрированным пользователям ]. Тут применили десенсибилизацию, но в это надо вчитываться.
Собственно:
Цитата:
What is the appropriate management of perceived allergy to the constituents of levothyroxine or intolerance to levothyroxine?
■ Recommendation
Perceived allergy or intolerance to levothyroxine can be managed by changing the dose or product, including consideration of gel capsules, and possibly by treating concomitant iron-deficiency anemia. In selected cases, a consultation with an allergist may be appropriate.
Weak recommendation. Low-quality evidence.
Discussion of the clinical literature
The vast majority of patients taking LT4 tolerate the medication without adverse effects. Since LT4 is identical to the molecule produced by the body, it is difficult to understand how patients can be “allergic” to the medication, but occasional patients perceive adverse reactions from the medication, including headaches, palpitations, anxiety, and other nonspecific symptoms even when their thyroid hormone levels are still low and serum TSH levels are elevated. A reasonable approach in such instances would be to reduce the LT4 dose and advance it slowly. One report of symptoms with institution of LT4 therapy documented resolution of the symptoms when concomitant iron deficiency was corrected (240), highlighting that the correct attribution of the cause of symptoms is not always easy. Allergy to the dye in the tablet may rarely occur (241) and can be managed using 50 μg tablets, which are colorant-free. A recent report of an allergy in the form of a rash that developed in a patient taking an LT4 preparation manufactured in Korea and containing tartrazine yellow no. 4 and red no. 3, was circumvented by treating the patient with a different levothyroxine product (242). Purported intolerance to other excipients in LT4 tablets (e.g., lactose, acacia, or even gluten) is anecdotal. However, some brands of LT4 contain lactose and/or acacia, and others do not, so trying an alternate product, including gel capsules, to see if allergic symptoms resolve is a reasonable strategy. If problems persist, a referral to an allergist may be helpful to rule out other allergens in food or in the home, reactions to which may have been attributed to the patient's thyroid medication
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- из Guidelines for the Treatment of Hypothyroidism: Prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement [
Ссылки доступны только зарегистрированным пользователям ] 2014 года.