Use of this site and material contained on its pages is for EDUCATIONAL USE ONLY.
 
Pharmskills Online - Counseling Topic Verification - View Detail

ELECTRONIC PRESCRIPTION
Date: 10/13/2025 at 03:02 AM
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#
2171695
Written Date
10/13/2025

Name
Georgia L. Elder
DOB
7/15/1979
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: It may take several weeks to see the full effects.
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: Hair loss may happen in some people in the first few months of using this drug. This most often goes back to normal.
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.