LIOTHYROMINE
Liothyronine is used to treat goitre, a condition in which the patient has an enlarged thyroid gland and to test for hyperthyroidism, a condition in which the thyroid gland produces too much thyroid hormone and myxedema coma. Liothyronine is thyroid agents whose action supply the thyroid hormones normally produced by the body. Liothyronine is the less preferred option to levothyroxine and is prescribed when there is an impaired conversion of T4 to T3 in peripheral tissues. but as synthetic form with higher concentration, the patients need much lower doses of this medicine. 25 units of liothyronine are as effective as 100 μg of levothyroxine.
Liothyronine is sold under the brand names Cytomel, Tertroxin, among others.
King Pharmaceuticals developed the exogenous liothyronine product and it was FDA approved by 1956. Since then the patent has expired and now there are several other patent holders for their own newer formulations around the world.
Usage and Dosage:
Liothyronine is available as a tablet and injectable solution in 5 mcg, 25 mcg, 50 mcg and 10 mcg/ml respectively. In the treatment of mild Hypothyroidism, the Initial recommended dose is 25 mcg, taken orally, once a day. This dose can be increased in multiples of 25 mcg every 1 or 2 weeks. While treating, Congenital Hypothyroidism, the Initial dose is 5 mcg, taken orally, once a day. This dose can be increased by 5 mcg per day increments every 3 to 4 days till a satisfactory outcome is achieved. The dose for treating Myxedema Initially is 5 mcg, taken orally, once a day. This can be increased by 5 or 10 mcg every 2 weeks. While treating for Myxedema Coma, the Initial dose is 25 to 50 mcg, taken through IV once. While doing the Thyroid Suppression Test, the patient is given 75 to 100 mcg, orally, for a week. In the treatment of Goiter, the patient is given an Initial dose of 5 mcg orally once a day, which can be increased by 5 to 10 mcg per day every 1 or 2 weeks. For TSH Suppression, the recommended initial dose is 5 mcg, taken orally once a day.
For treating Geriatric populations for Hypothyroidism, the dose is started at 5 mcg orally once a day and increase by no more than 5 mcg increments every 15 days.
The Usual Pediatric Dose for Hypothyroidism is 5 mcg orally once a day.
The price of Liothyronine:
As of 2019, in the United Kingdom, a month's supply costs about GB£247. Whereas the same supply of this medicine would cost the consumer in the United States about US$22.40.
How it works:
The thyroid hormones play a vital role in the proper development and differentiation of all cells in the body. They regulate protein, fat, and carbohydrate metabolism, which affects how cells use energetic compounds. As a salt of triiodothyronine (T3), it is chemically & pharmacologically equivalent to T3. Its actions improve basal metabolic rate, while affecting protein synthesis, and increase sensitivity to catecholamines like adrenaline by permissiveness. As mono or combination therapy with SSRIs, it can also enhance the generation of new neurons in the CNS. It works by binding to nuclear thyroid receptors. They then in turn bind to thyroid hormone response elements of target genes. This results in gene expression required for normal growth and development. Liothyronine sodium is more potent and works faster than thyroxine.
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