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ZDS-LIOTHYRONINE is a brand name for Liothyronine, supplied as a tablet. The medicine, its uses, side effects and dosage are the same regardless of brand.
Used for: AND CLINICAL USES ZDS-Liothyronine is indicated in conditions of inadequate endogenous thyroid production. These: include: a. HYPOTHYROIDISM: As replacement or supplemental therapy in patients with hypothyroidism of any etiology except transient hypothyroidism during the recovery phase of subacute thyroiditis b.…
Verbatim from this product's HC label. Tap a section to expand.
Serious Warnings and Precautions The use of ZDS-Liothyronine or other thyroid preparations in the therapy of obesity is unjustified and dangerous. In euthyroid patients, doses within the range of daily hormonal requirements are ineffective for weight reduction.
Larger doses may produce serious or even life-threatening manifestations of toxicity, particularly when given in association with sympathomimetic amines such as those used for anorectic effects. General Liothyronine sodium has a narrow therapeutic index and has a relatively short half-life compared to levothyroxine.
Regardless of the indication for use, careful dosage titration is necessary to avoid the consequences of over or under treatment. These consequences include, among others, effects on growth and development, cardiovascular function, bone metabolism, reproductive function, emotional state and gastrointestinal function.
Many drugs interact with liothyronine sodium, necessitating adjustments in dosing to maintain therapeutic response (See DRUG INTERACTIONS). Cardiovascular Since Liothyronine sodium is a metabolic stimulant, it is not recommended for use in patients with compromised cardiovascular systems, particularly the coronary arteries.
These include patients with angina pectoris, ischemic states, and the elderly (in whom there is a greater likelihood of occult cardiac disease). However, if it is used in such patients, caution should be exercised and the starting dosage should never be more than 5 mcg daily.
If the dosage is increased, it should be in increments of no more than 5 mcg daily at two-week intervals. (See DOSAGE and ADMINISTRATION). Endocrine and Metabolism Patients with Nontoxic Diffuse Goiter or Nodular Thyroid Disease Exercise caution when administering liothyronine sodium to patients with nontoxic diffuse goiter or nodular thyroid disease in order to prevent precipitation of thyrotoxicosis.
Not medical advice. Always read the patient information leaflet and follow your prescriber or pharmacist.
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Based on shared pharmacological effect of thyroid hormones, the below caution may apply to liothyronine: In those patients, particularly the elderly or those with underlying cardiovascular disease, levothyroxine therapy is contraindicated if the serum TSH level is already suppressed due to the risk of precipitating overt thyrotoxicosis.
If the serum TSH level is not suppressed, levothyroxine should be used with caution in conjunction with careful monitoring of thyroid function for evidence of hyperthyroidism and clinical monitoring for potential associated adverse cardiovascular signs and symptoms of hyperthyroidism.
Myxedematous patients are sensitive to thyroid substances; dosage should be started at a very low level and increased gradually (See DOSAGE and ADMINISTRATION). ZDS- Liothyronine Product Monograph Page 5 of 19 Diabetes Patients with diabetes mellitus may require upward adjustments of their antidiabetic therapeutic regimens when treated with liothyronine sodium (see DRUG INTERACTIONS).
Hypothalamic/Pituitary Hormone Deficiencies In patients with secondary or tertiary hypothyroidism, additional hypothalamic/pituitary hormone deficiencies should be considered, and, if diagnosed, treated (see WARNINGS AND PRECAUTIONS, Autoimmune Polyglandular Syndrome for adrenal insufficiency).
Severe and prolonged hypothyroidism can lead to a decreased level of adrenocortical activity commensurate with the lowered metabolic state. When thyroid replacement therapy is administered, the metabolism increases at a greater rate than adrenocortical activity.
This can precipitate adrenocortical insufficiency. Therefore, in severe and prolonged hypothyroidism, supplemental adrenocortical steroids may be necessary. In rare instances, the administration of thyroid hormone may precipitate a hyperthyroid state or may aggravate existing hyperthyroidism.
In infants, excessive doses of thyroid hormone preparations may produce cradiosynostosis. Morphologic hypogonadism and nephrosis should be ruled out before the drug is administered. If hypopituitarism is present, the adrenal deficiency must be corrected before liothyronine sodium therapy is started.
Bone Mineral Density In women, long-term thyroid hormones therapy has been associated with increased bone resorption, thereby decreasing bone mineral density, especially in post-menopausal women on greater than replacement doses or in women who are receiving suppressive doses of thyroid hormones.
Therefore, it is recommended that patients receiving thyroid hormones be given the minimum dose necessary to achieve the desired clinical and biochemical response. Immune Autoimmune Polyglandular Syndrome Occasionally, chronic autoimmune thyroiditis may occur in association with other autoimmune disorders such as adrenal insufficiency, pernicious anemia, and insulin dependent diabetes mellitus.
Patients with concomitant adrenal insufficiency should be treated with replacement glucocorticoids prior to initiation of treatment with liothyronine sodium. Failure to do so may precipitate an acute adrenal crisis when thyroid hormone therapy is initiated, due to increased metabolic clearance of glucocorticoids by thyroid hormone.
Special Populations Pregnancy:
Thyroid hormones do not readily cross the placental barrier. The clinical experience to date does not indicate any adverse effect on fetuses when thyroid hormones are administered to pregnant women. Thyroid replacement therapy to hypothyroid women should ZDS- Liothyronine Product Monograph Page 6 of 19 not be discontinued during pregnancy.
Pregnant women who are maintained on liothyronine sodium should have their TSH measured periodically and liothyronine sodium dose adjusted as necessary. Serum TSH level should be obtained six to eight weeks postpartum to adjust dosage.
There are no available animal data informing the drug-associated risk.
Breast-feeding:
Thyroid hormones are excreted in human milk in minimal amounts. Because liothyronine is excreted in human milk, caution should be exercised.
Pediatrics:
Clinical assessment of growth, development, […]