Drug Safety update
Levothyroxine sodium is the treatment of choice for maintenance therapy. The initial dose should not exceed 100micrograms daily, preferably before breakfast, or 25 to 50 micrograms in elderly patients or those with cardiac disease, increased by 25 to 50 micrograms at intervals of at least 4 weeks.
DO NOT PRESCRIBE LIOTHYRONINE ROUTINELY OR INITIATE IN PRIMARY CARE. TO BE USED IN EXCEPTIONAL CIRCUMSTANCES ONLY ON SPECIALIST ADVICE
Liothyronine sodium has a similar action to levothyroxine but is more rapidly metabolised and has a more rapid effect; 20 - 25 micrograms is equivalent to 100 micrograms of levothyroxine. It may be used in severe hypothyroid states when a rapid response is required. In view of its short duration of action it is usually administered two or three times a day.
Liothyronine injection may be required when a patient is nil by mouth for prolonged periods and to treat hypothyroid coma.
Do not prescribe routinely to be used in exceptional circumstances only on specialist advice