Liothyronine

CLINICAL USE

Hypothyroidism

DOSE IN NORMAL RENAL FUNCTION

Oral:

10 to 20 &nbsp &nbsp : micrograms daily, increased to 60 micrograms in 2–3 divided dosesIV: 5–20 micrograms every 4–12 hours, or 50 micrograms initially then 25 micrograms every 8 hours, reducing to 25 micrograms twice a day

PHARMACOKINETICS

Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :673

%Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :<99

%Excreted unchanged in urine &nbsp &nbsp : 2.5

Volume of distribution (L/kg) &nbsp &nbsp &nbsp :0.1–0.2

half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :24–48/–

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 &nbsp &nbsp : Dose as in normal renal function

10 to 20 &nbsp &nbsp : Dose as in normal renal function

<10 &nbsp &nbsp &nbsp &nbsp &nbsp : Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Not dialysed. Dose as in normal renal function

HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Not dialysed. Dose as in normal renal function

HDF/high flux &nbsp :Not dialysed. Dose as in normal renal function

CAV/VVHD &nbsp &nbsp &nbsp:Not dialysed. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

Anticoagulants: effect of coumarins and phenindione enhanced

ADMINISTRATION

Reconstition

Dissolve with 1–2 mL water for injection

Route

IV, oral

Rate of Administration

Slow bolus

Comments

Alkaline solution – may cause irritation if given IM

OTHER INFORMATION

20 mcg of liothyronine is equivalent to 100 mcg of levothyroxineProtein-losing states, such as nephrotic syndrome, will result in a decrease in total T3 and T4Thyroxine (T4) is the drug of choice in hypothyroidism, but T3 can be useful due to its rapid onset of actionElderly patients should receive smaller initial doses

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