Liothyronine

Brands

DEA Class; Rx

Common Brand Names; Cytomel, Triostat, Liothyronine T3, Thyroid Hormone

  • Thyroid Products

Oral and parenteral synthetic form of the thyroid hormone triiodothyronine (T3); faster onset of action (no need to peripherally convert T4 to T3) vs. levothyroxine
Used for myxedema coma in combination with levothyroxine; monitor for cardiostimulatory effects
Levothyroxine (T4) alone is preferred for routine therapy of hypothyroidism; however, partial replacement with T3 is used in selected patients after T4 dose stabilization

Indicted for the treatment of hypothyroidism of any etiology, except during the recovery phase of subacute thyroiditis; used as a replacement in primary (thyroidal), secondary (pituitary), tertiary (hypothalamic), congenital (cretinism), or acquired hypothyroidism.

For the treatment of myxedema coma.
For diagnostic use in thyroid suppression testing (T3 suppression test) to differentiate a suspected mild hyperthyroidism diagnosis or thyroid gland autonomy.
As an adjunct to surgery and radioiodine (RAI) therapy in the management of well-differentiated thyroid cancer.
For use as triiodothyronine replacement therapy for organ preservation of heart transplantation donors prior to procurement.

Hypersensitivity to thyroid hormone

Acute MI uncomplicated by hypothyroidism, thyrotoxicosis, untreated adrenal insufficiency

Treatment of obesity or infertility

  • Tachycardia (3%)
  • Hypotension (2%)
  • Myocardial infarction (2%)
  • Cardiopulmonary arrest (2%)
  • Congestive heart failure
  • Hypertension
  • Twitching
  • Phlebitis
  • Angina
  • Fever

Caution in angina, cardiovascular disease, hypopituitarism, DM

May use judiciously in acute MI caused/complicated by hypothyroidism

Perform periodic assessment of thyroid status when using as thyroid replacement

Myxedematous patients are very sensitive to thyroid hormone; start at very low dose

Pregnancy category: A

Lactation: Excreted into breast milk; use caution

Liothyronine has a narrow therapeutic index; dosage must be individualized.

Adults

There is limited clinical experience with more than 100 mcg/day PO or IV.

Geriatric

There is limited clinical experience with more than 100 mcg/day PO or IV.

Adolescents

Adolescents in whom growth and puberty are complete: There is limited clinical experience with more than 100 mcg/day PO or IV.

Children

Oral dosage must be individualized to age, weight, growth, and clinical status; if more than 3 years of age, adult dosages may be required (adult usual Max: 100 mcg/day PO). There is limited experience with IV use; safety and efficacy of IV use in pediatric patients have not been established.

Infants

Individualize dosage.

Neonates

Individualize dosage.

Liothyronine Sodium

injectable solution

  • 10mcg/mL

tablet

  • 5mcg
  • 25mcg
  • 50mcg
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