Liothyronine (Oral)

Liothyronine is used to treat hypothyroidism, which is when the thyroid gland does not make enough thyroid hormone. It is also used to reduce the size of enlarged thyroid glands (goiter) and to treat thyroid cancer.

Liothyronine is also used in certain medical tests to help diagnose issues with the thyroid gland.

This medicine is available only with your doctor's prescription.

It is very important that your doctor check your or your child's progress at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it. Blood tests will be needed to check for unwanted effects.

Liothyronine should not be used for the treatment of obesity or for the purpose of losing weight. This medicine is ineffective for weight reduction and when taken in larger amounts, may cause more serious unwanted effects.

Call your doctor right away if you start to have chest pain, fast or irregular heartbeat, excessive sweating, difficulty with breathing, heat intolerance, nervousness, leg cramps, headache, irritability, sleeplessness, tremors, change in appetite, weight gain or loss, vomiting, diarrhea, fever, changes in menstrual periods, hives, or skin rash. These could be symptoms of too much medicine in your body.

This medicine may cause severe hypothyroidism, called myxedema coma, which may be life-threatening and requires immediate medical attention. Check with your doctor right away if you have the following symptoms: weakness, confusion or non-responsiveness, feeling cold, low body temperature, swelling of the body, especially the face, tongue, and lower legs, or difficulty breathing.

For patients with diabetes: It is very important that you keep track of your blood or urine sugar levels as instructed by your doctor. Check with your doctor right away if you notice any changes in your sugar levels.

If you think you have become pregnant while using this medicine, tell your doctor right away. You may need a larger dose of liothyronine while you are pregnant.

Women who are post-menopausal or who use this medicine for a long time may have some bone loss, which could lead to osteoporosis. Talk with your doctor if you have questions or concerns about this.

A temporary loss of hair may occur during the first few months of liothyronine treatment. Ask your doctor about this if you have any concerns.

Make sure any doctor or dentist who treats you knows that you or your child are using this medicine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

In deciding to use a medicine, you and your doctor need to consider the risks of taking the medicine against the benefits it may provide. The following points should be taken into account for this medicine:

Allergies

Inform your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also, let your healthcare professional know if you have any other allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Studies conducted so far have not shown any specific problems in children that would limit the use of liothyronine. Recommended doses should not be exceeded, and the patient should be closely monitored during treatment.

Geriatric

Studies conducted so far have not indicated any specific problems in the elderly that would limit the use of liothyronine. However, older patients are more likely to have age-related kidney, heart, or blood vessel issues, which may require caution and a dose adjustment for those taking liothyronine.

Breast Feeding

There are no adequate studies in women to determine the risk to infants when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before using this medication while breastfeeding.

Interactions with Medicines

Some medicines should not be used together, while others may be used together with caution. In these cases, your doctor may need to adjust the dose or take other precautions. When taking this medicine, it is very important that your healthcare professional knows if you are taking any of the following medicines. The interactions listed below are significant but not exhaustive.

Using this medicine with any of the following medicines is generally not recommended, but may be necessary in some situations. If both medicines are prescribed, your doctor may adjust the dose or frequency of use for one or both medicines.

• Furosemide
• Iopromide
• Midodrine

Using this medicine with any of the following medicines may increase the risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Ethinyl Estradiol
• Kelp
• Sevelamer
• Sodium Polystyrene Sulfonate

Interactions with Food/Tobacco/Alcohol

Some medicines should not be taken around the time of eating food or certain types of food due to possible interactions. Using alcohol or tobacco with some medicines can also lead to interactions. Discuss with your healthcare professional about using your medicine with food, alcohol, or tobacco.

Other Medical Problems

Having other medical problems may affect how this medicine works for you. Be sure to inform your doctor if you have any other medical issues, especially:

• Adrenal insufficiency (underactive adrenal gland), uncorrected—Should not be used in patients with this condition.

• Adrenal gland problems or
• History of angina (chest pain) or
• Blood clotting problems or
• Diabetes or
• History of heart or blood vessel disease (e.g., coronary artery disease, heart failure) or
• History of heart rhythm problems (e.g., arrhythmia, atrial fibrillation)—Use with caution. May worsen these conditions.

• Severe hypoproteinemia (low levels of protein in the blood) or
• Kidney disease (e.g., nephrosis) or
• Severe liver disease (e.g., hepatitis) or
• Pituitary gland problems (e.g., acromegaly) or
• Porphyria (enzyme problem)—Use with caution. May need to adjust the dose of liothyronine in patients with these conditions.

Along with its needed effects, a drug may cause some unwanted effects. Although not all of these adverse effects may occur, if they do occur they may require medical attention.

Verify with your physician right away if any of the following side effects occur:

Incidence not known

• Anxiety
• arm, back, or jaw pain
• blurred or double vision
• chest pain or discomfort
• chest tightness or heaviness
• crying
• decreased bone mineral density
• decreased urine output
• delusions of persecution, mistrust, suspiciousness, or combativeness
• diarrhea
• difficulty breathing
• dilated neck vein
• dizziness
• excessive
• sweating
• extreme fatigue or weakness
• eye pain
• fainting
• false or unusual sense of well-being
• fast, pounding, or irregular heartbeat or pulse
• feeling of discomfort
• feeling of unreality
• fever
• headache
• heat intolerance
• impaired fertility
• increased appetite
• increased blood pressure
• irregular breathing
• irritability
• itchiness, skin rash
• joint swelling
• limp pain in the hip or knee
• menstrual changes
• mental depression
• muscle aches, weakness, or cramps
• nausea
• nervousness
• pain or discomfort in the arms, jaw, back, or neck
• quick to react or overreact emotionally
• rapidly changing moods
• restlessness
• sense of detachment from self or body
• serious headache
• slow heartbeat
• stomach cramps
• swelling of the face, fingers, feet, or lower legs
• swollen lymph glands
• tremors
• trouble sitting still
• trouble sleeping
• vomiting
• weight gain or loss

Get emergency assist immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

• Cold, clammy skin
• confusion about identity, place, and time
• difficulty in speaking
• light-headedness
• double vision
• fast, weak pulse
• headache
• inability to move the arms, legs, or facial muscles
• inability to speak
• lightheadedness
• loss of consciousness
• nervousness
• seizure
• sensitivity to heat
• slow speech
• sweating
• trouble sleeping
• weight loss

Some adverse effects may occur that usually do not require medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be capable to inform you about ways to prevent or lower some of these side effects. Verify with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known

• Feeling of warmth
• hair loss
• redness of the face, neck, arms, and occasionally, upper chest

Other side effects not listed may additionally occur in some patients. If you notice any other effects, verify with your healthcare professional.

Call your physician for medical advice about adverse effects. You may report side effects to the FDA at 1-800-FDA-1088.

In the U.S.

• Cytomel

Available Dosage Forms:

• Tablet

Therapeutic Class: Thyroid Supplement

This medicine will need to be taken for the rest of your life of your child's life. Do not stop taking this medicine or change your doses without first checking with your doctor. It may take several weeks before you start to notice an improvement in your symptoms.

If you use medicine to treat high cholesterol (including cholestyramine, colesevelam, colestipol), Kayexalate®, or sevelamer, take liothyronine at least 4 hours before you take any of these medicines.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage form (tablet): For hypothyroidism: Adults—At first, 25 micrograms (mcg) once a day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 75 mcg once a day. Older adults—At first, 5 mcg once a day. Your doctor may adjust your dose as needed. Children—At first, 5 mcg once a day. Your doctor may adjust your dose as needed. For thyroid cancer:Adults and children—Use and dose must be determined by your doctor. For thyroid problem diagnosis: Adults— 75 to 100 micrograms (mcg) once a day for 7 days. Your doctor will give you a radioactive iodine before and after the 7-day liothyronine. Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.