Greenstone

Liothyronine

Generic

Generic for Cytomel

ID: 59762120601

NaN

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📜 Prescription Required

FORM

Tablet

STRENGTH

5 mcg

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TL;DR — Quick Summary

Key facts from the full medication guide below

BOXED WARNING SECTION RECENT MAJOR CHANGES SECTION 1 INDICATIONS AND USAGE 1.1 Hypothyroidism 1.2 Pituitary Thyroid-Stimulating Hormone (TSH) Suppression

🩺What it's for

Liothyronine sodium is an L-triiodothyronine (T3) indicated for: Hypothyroidism: As replacement in primary (thyroidal), secondary (pituitary), and tertiary (hypothalamic) congenital or acquired hypothyroidism (1.1) Pituitary Thyroid-Stimulating Hormone (TSH) Suppression: As an adjunct to surgery and radioiodine therapy in the management of well-differentiated thyroid cancer (1.2) Thyroid Suppression Test: As a diagnostic agent in suppression tests to differentiate suspected mild hyperthyroidism…

💊How to take it

Administer liothyronine sodium orally once daily and individual dosage according to patient response and laboratory findings (2.1) See full prescribing information for recommended dosage for hypothyroidism (2.2) TSH suppression in well-differentiated thyroid cancer (2.3) and for thyroid suppression test (2.4) When switching a patient to liothyronine sodium, discontinue levothyroxine therapy and initiate liothyronine sodium at a low dosage.

ℹ️Common side effects

Overtreatment with thyroid hormone may cause an increase in heart rate, cardiac wall thickness, and cardiac contractility and may precipitate angina or arrhythmias, particularly in patients with cardiovascular disease and in elderly patients. Initiate liothyronine sodium therapy in this population at lower doses than those recommended in younger individuals or in patients without cardiac disease [see Dosage and Administration (2.3) and Use in Specific Populations (8.5)].

⚠️Serious risks

Thyroid hormones, including LIOTHYRONINE SODIUM, either alone or with other therapeutic agents, should not be used for the treatment of obesity or for weight loss. In euthyroid patients, doses within the range of daily hormonal requirements are ineffective for weight reduction.

📋Interactions & cautions

See full prescribing information for drugs that affect thyroid hormone pharmacokinetics and metabolism (e.g., absorption, synthesis, secretion, catabolism, protein binding, and target tissue response) and may alter the therapeutic response to liothyronine sodium (7)

📦Storage & missed dose

Liothyronine sodium tablets (round, white to off-white) are supplied as follows: Strength Tablet Markings NDC bottles of 100 5 mcg Debossed with KPI on one side and 115 on the other side 59762-1206-1 25 mcg Scored on one side and debossed with KPI and 116 on the other side 59762-1207-1 50 mcg Scored on one side and debossed with KPI and 117 on the other side 59762-1208-1

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Many drugs can exert effects on thyroid hormone pharmacokinetics (e.g. absorption, synthesis, secretion, catabolism, protein binding, and target tissue response) and may alter the therapeutic response to liothyronine sodium (see Tables 1 4). Table 1: Drugs That May Decrease T3 Absorption (Hypothyroidism) Potential impact: Concurrent use may reduce the efficacy of liothyronine sodium by binding and delaying or preventing absorption, potentially resulting in hypothyroidism. Drug or Drug Class Effect Bile Acid Sequestrants-Colesevelam-Cholestyramine-ColestipolIon Exchange Resins-Kayexalate-Sevelamer Bile acid sequestrants and ion exchange resins are known to decrease thyroid hormones absorption. Administer liothyronine sodium at least 4 hours prior to these drugs or monitor TSH levels. Table 2: Drugs That May Alter Triiodothyronine (T3) Serum Transport Without Affecting Free Thyroxine (FT4) Concentration (Euthyroidism) Drug or Drug Class Effect ClofibrateEstrogen-containing oral contraceptivesEstrogens (oral)Heroin/Methadone5-FluorouracilMitotaneTamoxifen These drugs may increase serum thyroxine-binding globulin (TBG) concentration. Androgens/Anabolic SteroidsAsparaginaseGlucocorticoidsSlow-Release Nicotinic Acid These drugs may decrease serum TBG concentration. Salicylates (>2 g/day) Salicylates inhibit binding of T4 and T3 to TBG and transthyretin. An initial increase in serum FT4 is followed by return of FT4 to normal levels with sustained therapeutic serum salicylate concentrations, although total T4 levels may decrease by as much as 30%. Other drugs:CarbamazepineFurosemide (>80 mg IV)HeparinHydantoinsNon-Steroidal Anti-inflammatory DrugsFenamates These drugs may cause protein binding site displacement. Furosemide has been shown to inhibit the protein binding of T4 to TBG and albumin, causing an increased free-T4 fraction in serum. Furosemide competes for T4-binding sites on TBG, prealbumin, and albumin, so that a single high dose can acutely lower the total T4 level. Phenytoin and carbamazepine reduce serum protein binding of thyroid hormones, and total and FT4 may be reduced by 20% to 40%, but most patients have normal serum TSH levels and are clinically euthyroid. Closely monitor thyroid hormone parameters. Table 3: Drugs That May Alter Hepatic Metabolism of Thyroid hormones Potential impact: Stimulation of hepatic microsomal drug-metabolizing enzyme activity may cause increased hepatic degradation of thyroid hormones, resulting in increased liothyronine sodium requirements. Drug or Drug Class Effect PhenobarbitalRifampin Phenobarbital has been shown to reduce the response to thyroxine. Phenobarbital increases L-thyroxine metabolism by inducing uridine 5'-diphospho-glucuronosyltransferase (UGT) and leads to a lower T4 serum levels. Changes in thyroid status may occur if barbiturates are added or withdrawn from patients being treated for hypothyroidism. Rifampin has been shown to accelerate the metabolism of thyroid hormones. Table 4: Drugs That May Decrease Conversion of T4 to T3 Potential impact: Administration of these enzyme inhibitors decreases the peripheral conversion of T4 to T3, leading to decreased T3 levels. However, serum T4 levels are usually normal but may occasionally be slightly increased. Drug or Drug Class Effect Beta-adrenergic antagonists(e.g., Propranolol >160 mg/day) In patients treated with large doses of propranolol (>160 mg/day), T3 and T4 levels change, TSH levels remain normal, and patients are clinically euthyroid. Actions of particular beta-adrenergic antagonists may be impaired when a hypothyroid patient is converted to the euthyroid state. Glucocorticoids (e.g., Dexamethasone 4 mg/day) Short-term administration of large doses of glucocorticoids may decrease serum T3 concentrations by 30% with minimal change in serum T4 levels. However, long-term glucocorticoid therapy may result in slightly decreased T3 and T4 levels due to decreased TBG production (see above). Other drugs:Amiodarone Amiodarone inhibits peripheral conversion of levothyroxine (T4) to triiodothyronine (T3) and may cause isolated biochemical changes (increase in serum free-T4, and decreased or normal free-T3) in clinically euthyroid patients.