Formulary
Liothyronine sodium: Indications, Dosing, Side Effects and Interactions
Liothyronine sodium clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Liothyronine sodium: Indications, Dosing, Side Effects and Interactions
Liothyronine sodium clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Hypothyroidism**
- **Adult** (By Mouth): Initially 10-20 micrograms daily; increased to 60 micrograms daily in 2-3 divided doses, dose should be increased gradually, smaller initial doses given for the elderly.
**Hypothyroid coma**
- **Adult** (By Slow Intravenous Injection): 5-20 micrograms every 12 hours, increased to 5-20 micrograms every 4 hours if required, alternatively initially 50 micrograms for 1 dose, then 25 micrograms every 8 hours, reduced to 25 micrograms twice daily.
**Hypothyroidism for liothyronine sodium**
- **Child 12-17 years** (By mouth): Initially 10-20 micrograms daily; increased to 60 micrograms daily in 2-3 divided doses.
**Hypothyroid coma for liothyronine sodium**
- **Child 12-17 years** (By slow intravenous injection): 5-20 micrograms every 12 hours, increased to 5-20 micrograms every 4 hours if required, alternatively initially 50 micrograms for 1 dose, then 25 micrograms every 8 hours, reduced to 25 micrograms twice daily.
**Hypothyroidism (replacement for oral levothyroxine) for liothyronine sodium**
- **Child** (By slow intravenous injection): Convert daily levothyroxine dose to liothyronine and give in 2-3 divided doses, adjusted according to response.
Cautions
Cardiovascular disorders; diabetes insipidus; diabetes mellitus (dose of antidiabetic drugs including insulin may need to be increased); elderly; hypertension; long-standing hypothyroidism; myocardial infarction; myocardial insufficiency; panhypopituitarism (initiate corticosteroid therapy before starting liothyronine); predisposition to adrenal insufficiency (initiate corticosteroid therapy before starting liothyronine) Cautions, further information Cardiovascular disorders Baseline ECG is valuable because changes induced by hypothyroidism can be confused with ischaemia.
Contraindications
Thyrotoxicosis
Side effects
General side-effects: Frequency not known Angina pectoris; anxiety; arrhythmias; diarrhoea; fever; flushing; headache; hyperhidrosis; insomnia; muscle cramps; muscle weakness; palpitations; tremor; vomiting; weight decreased Specific side-effects: Frequency not known With intravenous use Menstruation irregular With oral use Heat intolerance Side-effects, further information Initial dosage in patients with cardiovascular disorders If metabolism increases too rapidly (causing diarrhoea, nervousness, rapid pulse, insomnia, tremors and sometimes anginal pain where there is latent myocardial ischaemia), reduce dose or withhold for 1-2 days and start again at a lower dose.
Interactions
**Other interactions (9):**
- Liothyronine sodium therapy may potentiate the action of anticoagulants.
- Phenytoin levels may be increased by liothyronine sodium.
- Anticonvulsants, such as carbamazepine and phenytoin enhance the metabolism of thyroid hormones and may displace thyroid hormones from plasma proteins.
- Colestyramine and colestipol given concurrently reduces gastrointestinal absorption of liothyronine sodium.
- Liothyronine sodium raises blood sugar levels and this may upset the stability of patients receiving antidiabetic agents.
- Liothyronine sodium increases receptor sensitivity to catecholamines thus accelerating the response to tricyclic antidepressants.
Pregnancy
Does not cross the placenta in significant amounts. Excessive or insufficient maternal thyroid hormones can be detrimental to fetus. Liothyronine requirement may increase during pregnancy. Monitoring in pregnancy Assess maternal thyroid function before conception (if possible), at diagnosis of pregnancy, at antenatal booking, during both the second and third trimesters, and after delivery (more frequent monitoring required on initiation or adjustment of liothyronine).
Breast feeding
Amount too small to affect tests for neonatal hypothyroidism.
Medicinal forms
Tablet,Tablet,Capsule,Solution,Solution
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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