Each vial contains 20 micrograms liothyronine sodium

Intravenous injection Packed as a freeze dried white plug, in a glass vial for reconstitution with 1 or 2ml water for injection.

Liothyronine Sodium Injection is indicated for the treatment of myxoedema coma, usually in conjunction with other measures including the intravenous injection of a corticosteroid. For the treatment of less severe forms of myxoedema and for maintenance therapy, orally administered liothyronine should be used.

5 to 20 micrograms given by slow intravenous injection, and repeated at intervals of 12 hours or less if required. The minimal interval between dosing is 4 hours. An initial dose of 50 micrograms intravenously is used by some physicians, followed by further intravenous injections of 25 micrograms every 8 hours until improvement occurs. The dosage may then be reduced to 25 micrograms intravenously twice daily.

Method of Administration:

Usually given by intravenous injection, as the alkalinity of the solution may cause irritation of the tissues if given by deep intramuscular injection. The solution is prepared by adding 1 or 2ml water of injection to the ampoule, and shaking gently until the solution has dissolved.

Hypersensitivity to any components of the preparation. Liothyronine sodium is contraindicated in patients with cardiovascular disorders or angina of effort.

Liothyronine must be given with extreme caution in myxoedema coma because too large a dose can precipitate heart failure, especially in elderly patients and those with ischaemic heart disease. ECG monitoring can give a useful indication of impending ishcaemia, however, changes in ST segment can be confused with similar changes occurring in hypothyroidism.

In severe and prolonged hypothyroidism, there may be decreased adrenocortical activity. When thyroid replacement therapy is started, metabolism is raised at a greater rate that adrenocortical activity, and this can result in adrenocortical insufficiency. This insufficiency may require supplemental adrenocoritcal steroids. Thyroid replacement therapy may cause an increase in the dosage requirement of insulin or other anti-diabetic treatment. Care is needed in patients with diabetes mellitus and diabetes insipidus.

Liothyronine sodium therapy may potentiate the action of anticoagulants.

Anticonvulsant, such as carbamazepine and phenytoin-enhance the metabolism of thyroid hormones and may displace thyroid hormones from plasma proteins.

Initiation or discontinuation of anticonvulsant therapy may alter liothyronine dose requirements. Phenytoin levels may be increased by liothyronine.

Liothyronine raises blood sugar levels and this may upset the stability of patients receiving antidiabetic agents. If co-administered with cardiac glycosides, adjustment of dosage of cardiac glycoside may be necessary.

Liothyronine increases receptor sensitivity to catecholamines thus, accelerating the response to tricyclic antidepressants. A number of drugs may affect thyroid function tests and this should be borne in mind when monitoring patients on liothyronine therapy.

Co-administration with oral contraceptives may result in an increased dosage requirement of liothyronine sodium

The following are indicative of overdosage, and disappear after reduction of dosage or stopping treatment for a day or more:

Anginal pain, cardiac arrhythmias, palpitations, cramps, tachycardia, diarrhoea, restlessness, excitability, headache, flushing, sweating, excessive loss of weight and muscular weakness.

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