Liotrix

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Liotrix
Combination of
LevothyroxineThyroid hormone
TriiodothyronineThyroid hormone
Names
Trade namesThyrolar
Clinical data
Pregnancy
category
  • US: A (No risk in human studies)
Routes of
use		By mouth
External links
AHFS/Drugs.comMonograph
Legal
Legal status

Levothyroxine/liothyronine, also known as liotrix and sold under the brand name Thyrolar, is a medication used to treat low thyroid; though is less preferred than levothyroxine.[1][2] Other uses may include goiter with normal thyroid function and thyroid cancer.[1] It is taken by mouth.[1]

Common side effects from excessive doses include sweating, headache, trouble sleeping, and chest pain.[1] Other side effects may include irregular heartbeat, anxiety, and trouble adjusting to hot temperatures.[3] Use is not recommended for obesity by itself as it is not effective and could result in side effects.[3] It is a 4:1 mixture of manufactured levothyroxine (T4) and triiodothyronine (T3).[1]

As of 2024 it is not longer commercially available in the United States; though it may still be purchased from a compounding pharmacy.[1][4] In the United States 3 months of medication used to cost around 90 USD.[5] The combination is not recommended routinely by the American Thyroid Association.[6]

Medical uses

The most common usage is hypothyroidism treatment, via supplementation.[7][8] Other uses include:

As of 2021 there is no evidence that the combination is better than levothyroxine alone.[9]

Side effects

Adverse effects are mainly due to chronic accidental overdose. Symptoms mimic those of hyperthyroidism and include headache, chest pain, irregular heartbeat, dyspnea, trembling, sweating, diarrhea, and weight loss. These effects can be reduced through titration of the dose levels, but this should be done by the prescribing physician.[10] Sympathomimetic cardiovascular effects including: heart palpitations, chest pain, arrhythmia, sweating, chest pain, and anxiety, require urgent medical attention.[11] Particularly if these signs occur in patients who are at an increased risk for cardiovascular complications i.e. familial or patient history of myocardial infarction, cardiovascular disease, stroke, arteriosclerosis.[7] Hair loss occasionally occurs in the first few months of treatment, but is reversible. The condition is usually self-limiting without altering treatment.[11]

Contraindications

Thyroid agents should not be used to treat obesity, particularly in euthyroid patients. Regular doses in hypothyroid patients are acceptable, but only in the context of treating hypothyroidism. Excessive doses (and regular doses in euthyroid patients) can result in life-threatening cardiovascular events. Patients should be advised against taking sympathomimetic agents, including stimulants and diet pills, while undergoing hypothyroid treatment, as these agents increase the risk of cardiovascular events.[12]

Society and culture

In 2013, Forest Laboratories has released the following statement regarding the limited availability of liotrix: "U.S. Pharmacopeia, an official public standards-setting authority for prescription and over-the-counter medicines and other health care products manufactured or sold in the United States, has mandated new specifications for a component used in the manufacturing of Thyrolar. As a result, all strengths of Thyrolar are currently on long-term back order while modifications necessary to meet these new specifications are made."[13]

References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 1.5 "Liotrix Monograph for Professionals". Drugs.com. Archived from the original on 18 May 2021. Retrieved 23 November 2021.
  2. ↑ "Thyrolar (Brand No Longer Available)". GoodRx. Archived from the original on 10 January 2024. Retrieved 9 January 2024.
  3. ↑ 3.0 3.1 "Liotrix: MedlinePlus Drug Information". medlineplus.gov. Archived from the original on 27 March 2023. Retrieved 9 January 2024.
  4. ↑ Zaidi, Sarfraz (4 September 2013). Hypothyroidism And Hashimoto's Thyroiditis: A Groundbreaking, Scientific And Practical Treatment Approach. Sarfraz Zaidi. p. PT97. ISBN 978-1-4909-1596-8. Archived from the original on 10 January 2024. Retrieved 9 January 2024.
  5. ↑ "Thyrolar-2 Prices, Coupons, Copay & Patient Assistance". Drugs.com. Archived from the original on 10 January 2024. Retrieved 9 January 2024.
  6. ↑ Chun, Ji Hyun (28 November 2016). Endocrinology, An Issue of Physician Assistant Clinics. Elsevier Health Sciences. p. 57. ISBN 978-0-323-48287-5. Archived from the original on 10 January 2024. Retrieved 9 January 2024.
  7. ↑ 7.0 7.1 "Liotrix (Professional Patient Advice)". Archived from the original on 2020-10-20. Retrieved 2021-10-09.
  8. ↑ Skidmore-Roth L (2015). "Liotrix". Mosby's 2015 nursing drug reference (Twenty-eight ed.). Saint Louis, Missouri: Elsevier Health Sciences. p. 713. ISBN 978-0-323-28693-0. Archived from the original on 2021-10-09. Retrieved 2021-10-09.
  9. ↑ Jonklaas, J; Bianco, AC; Cappola, AR; Celi, FS; Fliers, E; Heuer, H; McAninch, EA; Moeller, LC; Nygaard, B; Sawka, AM; Watt, T; Dayan, CM (March 2021). "Evidence-Based Use of Levothyroxine/Liothyronine Combinations in Treating Hypothyroidism: A Consensus Document". European thyroid journal. 10 (1): 10–38. doi:10.1159/000512970. PMID 33777817.
  10. ↑ "LIOTRIX - ORAL (Thyrolar) side effects, medical uses, and drug interactions". MedicineNet. Archived from the original on 2021-04-21. Retrieved 2021-10-09.
  11. ↑ 11.0 11.1 "Thyrolar (Liotrix) dosing, indications, interactions, adverse effects, and more". MedScape. Archived from the original on 2021-02-26. Retrieved 2021-10-09.
  12. ↑ "Thyrolar (Liotrix) dosing, indications, interactions, adverse effects, and more". MedScape. Archived from the original on 2021-02-26. Retrieved 2021-10-09.
  13. ↑ "Thyrolar". Forest Pharmaceuticals, Inc. Archived from the original on 11 August 2008.

External links

Identifiers:
Retrieved from "https://mdwiki.org/w/index.php?title=Liotrix&oldid=1394268"