LiothyronineLiothyronine Sodium

About Liothyronine

Levothyroxine supplies T4, which the body converts into T3, the form that acts on cells; liothyronine supplies T3 directly. It starts working within a few hours and reaches its full effect in two to three days. It is approved for hypothyroidism, to suppress TSH alongside surgery and radioactive iodine in some thyroid cancers, and for a diagnostic thyroid suppression test.

It is usually taken once a day. The label starts adults on a low dose and raises it every week or two, and starts older adults and people with heart disease lower still, because extra thyroid hormone strains the heart. Someone switching from levothyroxine stops it and starts liothyronine low, since the old drug’s effect lingers for weeks. TSH blood tests guide the dose, and pregnancy may raise the dose needed.

Too much causes the symptoms of an overactive thyroid: a fast or irregular heartbeat, chest pain, nervousness, tremor, poor sleep, sweating, heat intolerance, diarrhea and weight loss. The boxed warning says thyroid hormone must not be used for obesity or weight loss, because doses large enough to affect weight can be life-threatening. It is not used with uncorrected adrenal insufficiency, it can worsen blood sugar control in diabetes, and over-replacement thins the bones.

Taking Liothyronine

How to take it

Usually once a day, exactly as prescribed, with your normal diet unless told otherwise. Take it at least 4 hours before cholestyramine or similar resins. Do not stop it without talking to the prescriber; treatment is usually lifelong.

If you miss a dose

Take it as soon as you remember, unless it is almost time for the next dose; in that case skip the missed dose and carry on as usual. Never take two doses at once to make up.

Storage

At room temperature in the original container, tightly closed, away from heat and moisture.

Interactions to know about

It can strengthen the effect of warfarin and weaken digoxin, and diabetes medicines may need adjusting as thyroid levels change. With ketamine it can sharply raise blood pressure and heart rate, and stimulant medicines add to its effect on the heart. Some cancer drugs called tyrosine kinase inhibitors can lower thyroid function. Report chest pain or a racing or irregular heartbeat.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Liothyronine differs from pharmacy to pharmacy

Pharmacies buy generic liothyronine from different makers at different costs, and because the Cytomel brand is still sold, a prescription that does not allow substitution is filled with the brand at a brand price. Cytomel comes in bottles of 100, so pharmacies differ in whether they price by the tablet or by the bottle, and when a dose is built from several 5 mcg tablets while it is being adjusted, the tablet count, and that difference, grows.

Ways to pay less for Liothyronine without insurance

• Ask the prescriber to allow generic substitution.
• Once the dose is stable, ask whether it can be written in the fewest tablets and as a ninety-day supply, if the prescriber agrees.
• Ask whether liothyronine is on the pharmacy’s flat-price generic list.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Liothyronine

1. 1.Is this the generic or Cytomel, and is it the same maker as last time?
2. 2.If I also take levothyroxine, how should the two fit together?
3. 3.Which symptoms mean my dose may be too high?
4. 4.Does it change how my warfarin, digoxin or diabetes medicine works?
5. 5.When should my thyroid blood test be repeated?

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