Liothyronine Sodium (liothyronine sodium)

The oral liothyronine dosage regimen for hypothyroidism or pituitary TSH suppression is dependent upon a variety of factors including patient age, body weight, cardiovascular status, concomitant medical conditions and medications, concurrently administered food, and nature of the treated condition. Dosage of oral liothyronine should be individualized and dosage adjustments undertaken based on periodic assessment of clinical response and laboratory parameters.

If an adequate oral liothyronine replacement dose is administered but clinical and laboratory evidence of hypothyroidism persist, the clinician should evaluate the patient for inadequate absorption, poor compliance, drug interactions, or a combination of these factors.

Liothyronine sodium is administered orally or by IV injection. Liothyronine injection should not be administered intramuscularly or subcutaneously.

Liothyronine tablets should be stored between 15-30degreesC. Liothyronine for injection should be stored under refrigeration (2-8degreesC).

No dosing information is available for this tab.

No dosing information is available for this tab.

There is no enhanced messaging for this drug.

There are no contraindication interactions for this drug.

There are no severe interactions for this drug.

There are no moderate interactions for this drug.

*Uncorrected adrenal insufficiency.

*Untreated thyrotoxicosis.

*Hypersensitivity to any of the active or extraneous ingredients of the formulation.

*Concomitant use of IV liothyronine and artificial patient rewarming.

There are no contraindication contraindications for this drug.

There are no severe contraindications for this drug.

There are no moderate contraindications for this drug.

The most common adverse reactions of oral liothyronine therapy are primarily hyperthyroidism-related due to therapeutic overdosage and include arrhythmias, myocardial infarction, dyspnea, headache, nervousness, irritability, insomnia, tremors, muscle weakness, increased appetite, weight loss, diarrhea, heat intolerance, menstrual irregularities, and skin rash. Hypersensitivity reactions (e.g., urticaria, pruritus, skin rash, angioedema, GI symptoms, fever, arthralgia, serum sickness, wheezing) to inactive ingredients in oral thyroid hormone products have been reported.

The most common adverse reactions of IV liothyronine therapy include arrhythmia (6%) and tachycardia (3%). Approximately 2% of patients experience cardiopulmonary arrest, hypotension, and myocardial infarction. Angina, congestive heart failure, fever, hypertension, phlebitis, and twitching have been reported in approximately <=1% of patients.

There are no severe adverse reactions for this drug.

There are no less severe adverse reactions for this drug.

No enhanced messaging available.

In pediatric patients with congenital hypothyroidism, oral thyroid hormone therapy should be initiated immediately upon diagnosis in order to prevent adverse effects on intellectual development, growth, and maturation; therapy is generally lifelong in these patients. During the first 2 weeks of thyroid agent therapy, infants should be closely monitored for cardiac overload, arrhythmias, and aspiration resulting from avid suckling.

Pediatric patients with congenital or acquired hypothyroidism should be monitored closely to avoid undertreatment or overtreatment. Undertreatment may result in negative effects on intellectual development and growth while overtreatment may result in craniosynostosis in infants and accelerate the aging of bones, resulting in premature epiphyseal closure and compromised adult stature.

In pediatric patients with acquired hypothyroidism administered oral thyroid hormone therapy, a period of catch-up growth may occur, which may be adequate in some cases to achieve normal adult height. In children with severe or long-standing hypothyroidism, catch-up growth may not be adequate to achieve normal adult height.

If a diagnosis of permanent hypothyroidism has not been established in a pediatric patient, oral thyroid hormone therapy should be discontinued for a trial period, but only after the patient is >=3 years of age. Clinicians should obtain various laboratory tests (e.g., serum TSH, T4, T3) at the end of the trial period and use results to guide diagnosis and treatment.

Pseudotumor cerebri and slipped capital femoral epiphysis have been reported in pediatric patients receiving oral thyroid agent therapy.

The efficacy and safety of IV liothyronine have not been established in pediatric patients.

The required oral liothyronine dosage may increase during pregnancy in patients with pre-existing hypothyroidism. For patients with serum TSH above the normal trimester-specific range, clinicians should increase the liothyronine dosage and measure TSH every 4 weeks until a stable dose is achieved and serum TSH is within the normal trimester-specific range.

The oral liothyronine dosage should be reduced to pre-pregnancy levels immediately after delivery. Serum TSH levels should be measured 4 to 8 weeks postpartum to ensure an appropriate liothyronine dosage.

In pregnant women, data from postmarketing studies have not reported increased rates of fetal malformations, miscarriages, or other adverse maternal or fetal outcomes with liothyronine therapy. No animal studies evaluating use of liothyronine during pregnancy have been conducted.

Untreated hypothyroidism during pregnancy is associated with risks to the mother and fetus; liothyronine therapy should not be discontinued during pregnancy. If hypothyroidism is diagnosed during pregnancy, clinicians should promptly treat the condition. Thyroid stimulating hormone (TSH) levels may increase during pregnancy and should be monitored, with liothyronine dosage adjusted as appropriate. The liothyronine dose should be returned to the pre-pregnancy dose immediately after delivery since postpartum TSH levels are similar to preconception values.

Liothyronine is present in human milk. There is insufficient information available to determine the effects of the drug on the breastfeeding infant or milk production. The developmental and health benefits of breastfeeding should be considered along with the clinical need for liothyronine and any potential adverse effects on the breastfed infant or from the underlying maternal condition.

Geriatric patients should be initiated on less than the full replacement dose of oral liothyronine due to the increased prevalence of cardiovascular disease in this patient population.

Hypothyroidism: in elderly patients, start with 5 mcg once daily and increase by 5 mcg increments at the recommended intervals.

Liothyronine oral therapy should be initiated at less than the full replacement dose in geriatric patients due to the increased prevalence of cardiovascular disease in this patient population. The most common arrhythmia observed among geriatric patients with thyroid hormone overtreatment is atrial fibrillation.

Clinical studies of IV liothyronine therapy did not include a sufficient number of patients >=65 years of age to determine whether they respond differently from younger patients; however, other clinical experience has not reported differences in response between geriatric and younger patients. In geriatric patients, the dose of IV liothyronine should be initiated at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy in this patient population.

Since IV liothyronine is excreted by the kidneys, clinicians should monitor renal function in geriatric patients.