LIOTHYRONINE SODIUM

Posology Adults Starting dose of 10 or 20 micrograms every 8 hours, increasing after one week, if necessary, to the usual recommended daily dose of 60 micrograms in two or three divided doses. Myxoedema Coma 60 micrograms given by stomach tube, then 20 micrograms every 8 hours.

It is more usual to start treatment with intravenous liothyronine. Adjunct to carbimazole treatment of thyrotoxicosis 20 micrograms every 8 hours. Elderly and Paediatric Population 5 micrograms daily. Method of administration For oral use only.

For patients who have difficulty in swallowing a whole tablet, such as the elderly and young children, a whole tablet may be crushed and allowed to dissolve in a minimum of 20 mL of water. The entire volume of liquid should be consumed to ensure ingestion of the full dose.

The solubility of liothyronine in water enables this as a method of administration.

The following effects are indicative of excessive dosage and usually disappear on reduction of dosage or withdrawal of treatment for a day or two. The undesirable effects are listed below by organ class and the following frequency convention: very common (≥ 1/10), common (≥ 1/100 to < 1/10), uncommon (≥ 1/1,000 to < 1/100), rare (≥ 1/10,000 to < 1/1,000), not known (frequency cannot be estimated from the available data).

System organ class Frequency Undesirable effects Immune system disorders Not Known hypersensitivity reactions including rash, pruritus and oedema Metabolism and nutrition Not Known excessive loss of weight disorders Nervous system disorders Not Known restlessness, excitability, tremor, insomnia Cardiac disorders Not Known Anginal pain, cardiac arrhythmias, palpitations, tachycardia.

Gastrointestinal disorders Not Known Diarrhoea, vomiting Musculoskeletal and connective tissue disorder Not Known muscle cramps, muscular weakness, General disorders and administration site conditions Not Known headache, flushing, sweating, fever, heat intolerance Skin and subcutaneous tissue disorders Not Known Transient hair loss in children Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important.

It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme. uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.

In severe and prolonged hypothyroidism, adrenocortical activity may be decreased. When thyroid replacement therapy is started, metabolism increases more than adrenocortical activity and this can lead to adrenocortical insufficiency requiring supplemental adrenocortical steroids.

Liothyronine rather than levothyroxine would be the replacement therapy of choice during block and replace treatment of thyrotoxicosis with propylthiouracil (PTU) due to the inhibition by PTU of the peripheral conversion of T4 to T3.

Liothyronine sodium treatment may result in an increase in insulin or anti-diabetic drug requirements. Care is required for patients with diabetes mellitus and diabetes insipidus. Panhypopituitarism or predisposition to adrenal insufficiency (initiate corticosteroid therapy before starting liothyronine), pregnancy, breast-feeding (see section

1. Patients with angina of effort or cardiovascular diseases and thyrotoxicosis.