Thyrotropin Alfa (Injection)

A thyroid stimulating hormone, Thyrotropin alfa is given in the form of an injection and can be leveraged to extract diseased tissue of the thyroid.

Overview

Thyrotropin alfa is a thyroid stimulating hormone (TSH), in the form of an injection, that is used to detect the the existence of thyroglobulin (tg) in the bodies of patients who have thyroid cancer. Thyroglobulin is a hormone that indicates the existence of thyroid disease. Typically, the health professional administering the injection can will choose whether or not radio active iodine imaging is necessary.

In addition to its primary use, Thyrotropin alfa can also be leveraged (in conjunction with radioactive iodine) to extract any diseased tissue of the thyroid that remains. This usage is typically performed on thyroid cancer patients who have had portions of or the entire thyroid gland extracted.

This drug is only administered under the direct supervision of a health care professional.

Conditions Treated

  • Thyroid disease detection
  • Thyroid tissue removal

Type of Medicine

  • Injection
  • Thyroid stimulating hormone (TSH)

Side Effects

The use of Thyrotropin alfa can cause a range of side effects, some more severe than others. While being treated with this drug, it is imperative that your doctor monitors your condition closely. Your doctor will need to detect whether or not the drug is working as intended, thus deciding whether or not treatment should be continued. Some side effects will need to be determined through blood tests.

Paralysis, such as the inability to move legs or arms on one or both sides of the body, needs immediate medical attention. Contact your heath care professional if you experience this side effect right away.

It's also important that you discuss your medical history with your doctor, including whether or not you've experienced the sudden growth of enlarged and painful thyroid tumors. If you experience breathing issues or changes to your voice, it's important to inform your doctor of this as well. Prior to the treatment of Thyrotropin alfa, your doctor may choose to treat you with glucocorticoids (steroids).

The most common side effects of Thyrotropin alfa include flushing, frequent urination, and discomfort of the stomach. The patient may also experience less common, minor side effects, which include a prickling, tingling sensation, fever, diarrhea, muscle aches or weakness, cold symptoms (sore throat or runny nose), and trouble sleeping. As your body begins to adjust to the injection, these side effects may go away in time. Your doctor may also be able to help you reduce some of these side effects or prevent them completely.

The more severe side effects that can occur while or after being treated by Thyrotropin alfa include the inability to move extremities, or paralysis on either side of your body. The patient should make their nurse or doctor aware of these side effects immediately. Rare, severe side effects also include loss of vision, hives, welts, itching, and redness of the skin or body with a feeling of warmth.

Other side effects may include difficulty breathing, speaking or swallowing, as well as dizziness, confusion, slowed speech and double vision. The patient could also experience headaches, fever, chills, as well as a hoarse voice and muscle or joint pain.

Although rare, overdoses can lead to severe side effects and must be treated with emergency care immediately. Signs of an overdose include chest pain, dizziness, faintness, or lightheadedness, a change in the heart rhythm, blurred vision, and chest pain. A patient who has overdosed may also experience increased sweating, nervousness, nausea, and irritability.

In some cases, patients who have not had their thyroid completely removed, or patients who have had cancer spread to other parts of their body, have experienced death after receiving Thyrotropin alfa. It's important to discuss your medical history with your doctor before proceeding.

Dosage

The typical strength of Thyrotropin alfa is 1.1mg, and the following information is based on this dose. Since everyone is different, different dosages and regimens may be determined by your health care professional. Be sure to discuss with them what dosages will be appropriate for your medical needs.

For patients diagnosed with thyroid cancer, Thyrotropin alfa is administered as a recommended regimen that consists of two injections. The first 0.9 mg dosage is administered intramuscularly (IM) and is followed by a second injection of the same dosage 24 hours later. After the final injection, the doctor will usually administer radioiodine 24 hours later. In the case of pediatric patients 16 years of age or older, the same regimen is typically administered.

For diagnostic purposes, Thyrotropin alfa is given as a series of medication that includes a typical regimen of two injections. For adults, the drug is usually dosed at 0.9 mg, administered as a buttock injection. After 24 hours, the patient will typically receive another 0.9 mg injection to their buttock. In the case where a doctor is retrieving testing for serum thyroglobulin (Tg), the sample of serum is typically obtained in a 72 hour time frame after the last injection the patient received. The same regimen is typically followed for pediatric patients 16 years of age or older.

Thyrotropin alfa is typically only administered intramuscularly (an injection given directly into the muscle), and not intravenously. Your doctor may consider a pre-treatment of glucocorticoids, particularly if you are a patient experiencing a compromising tumor expansion.

There are no established typical doses for children under 16 for treatment or diagnostics. Patients and their families should discuss the potential effectiveness of this drug and its safety for young patients.

Interactions

There are situations in which a patient should avoid combining two or more medications due to possible interaction side effects. In some cases, multiple medications can be taken in conjunction with one another as there are minor to no interactions. It's important to discuss your full medication regimen with your doctor prior to using this drug, as your doctor may choose to take extra precautions, or simply change the dosage or medication. Be sure to always let your health care professional know if you are consuming any over the counter medication or supplements, whether they are prescription or non-prescription.

Patients should also note that this medication and others should be avoided if eating certain types of food or alcohol, or if using tobacco. In some situations, these things can cause an interaction to occur. Always be sure to discuss the potential side effects of this interaction with your physician.

It's also important to discuss other medical conditions you have been diagnosed with or are experiencing with your physician. Certain ailments could affect how this medicine interacts with your body. An allergy to the bovine thyroid stimulating hormone, metastatic cancer, heart disease, disorders of the nervous system, and large amounts of remaining thyroid tissue, could cause your doctor to alter your treatment. A stroke or a history of strokes, as well as the usage of dialysis as a medical treatment could also cause serious side effects. Proceed with caution and discuss any potential or harmful side effects with your physician.

Warnings

It's imperative to be monitored closely by your physician while receiving treatment with this drug. Allowing your physician to be able to check to see whether or not the medication is working as intended will ensure this is the right treatment for you. It will also help determine whether or not you are experiencing side effects, and if any treatment of those side effects is needed. Your doctor may choose to alter the dosage or medication depending on progress.

If, at any time, you begin to experience paralysis on either side of the body or throughout any of your extremities, call your doctor immediately.

You will also want to quickly inform your doctor of any changes to thyroid tumors, including the sudden onset of pain or growth. If you experience noise while breathing, a struggle to breathe, or changes to your voice, also inform your doctor. This may result in them administering glucocorticoids (steroids) prior to administering the medication.

Patients that are 65 years of age or older should discuss the risks of receiving Thyrotropin alfa, as age could be a factor in the increase of side effects.

Pregnant women, or breastfeeding mothers, should also discuss the benefits and risks of taking this drug with their physician.

Storage

For patients who need to store Thyrotropin alfa at home, your nurse, pharmacist, or physician will be able to guide you on proper storage for the medication. Typically patients will not need to store this drug as it's directly administered by a physician.

Summary

Thyrotropin alfa is a drug administered through a muscle injection which is used to assist in the detection of thyroid disease for thyroid cancer patients. It works by detecting the existence of Thyroglobulin, a hormone that is a marker for thyroid disease. Thyrotropin alfa may or may not be used in conjunction with a radiology test that uses iodine. In addition, Thyrotropin alfa can also be used for assisting patients in the preparation of thyroid cancer treatment, as it can remove leftover tissue remaining after the thyroid gland has been removed. The drug is usually administered as two injections, at an interval of 24 hours.

Although Thyrotropin alfa has many benefits for patients who have thyroid cancer, it can cause side effects. These side effects range from the more common, such as headaches or nausea, to the less common and more severe, such as paralysis. In some cases, death has been reported in patients who have not had their thyroid gland entirely removed, or patients that have had their cancer spread to other parts of their body. Patients should seek medical help or contact their doctor immediately if they experience any of the more serious side effects.

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Last Reviewed:
December 23, 2017
Last Updated:
April 05, 2018
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