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Pharmskills Online - Counseling Topic Verification - View Detail

ELECTRONIC PRESCRIPTION
Date: 08/19/2026 at 08:31 PM
Patient: Georgia L. Elder
Address: 940 Popular
Drug: Synthroid 150 mcg Tablet
Dispense: 30
SIG: i po QD for low thyroid
Refills: prn
DAW: substitution permitted
Prescriber: James T. Warren
Address: 3-G Medical Arts Building
DEA#: AW1351977
Rx#
3667345
Written Date
08/19/2026

Name
Georgia L. Elder
DOB
7/15/1980
Age
46
Address
940 Popular
Phone
(316) 555-2751
Allergies
Cefuroxime (rash)

Prescriber
James T. Warren
Practice
Hometown Family Medicine
Address
3-G Medical Arts Building
Fax
(785) 555-5567
DEA
AW1351977
NPI
6379131958
Phone
(785) 555-5566

Dispensed
Levothyroxine 150 mcg Tablet
NDC #
00378-1815-10
Mfg
Mylan
Pres Qty
30
Dis Qty
30
Day Supply
30
Refills
1 Year
DAW
0
Origin Code
3

Instructions
Take 1 tablet by mouth once daily for low thyroid.

Dispensing Notes

 
New Rx - Mandatory Counseling
Document Patient Counseling Topics To Be Given Verbally
Used For: It is used to add thyroid hormone to the body.
Need to Know: This drug may cause weak bones (osteoporosis) with doses that are too high. The risk may be higher after menopause.
Need to Know: This drug may cause dark patches of skin on your face. Avoid sun, sunlamps, and tanning beds. Use sunscreen and wear clothing and eyewear that protects you from the sun.
Side Effects: Signs of a pancreas problem (pancreatitis) like very bad stomach pain, very bad back pain, or very bad upset stomach or throwing up.
Side Effects: Signs of gallbladder problems like pain in the upper right belly area, right shoulder area, or between the shoulder blades; yellow skin or eyes; fever with chills; bloating; or very upset stomach or throwing up.
Best Taken: Take with food.
Best Taken: Take in the evening.
Med Guide: This drug does not require a medication guide but I will be providing you a drug information handout with more details about this medication.