MTW NHS Trust West Kent CCG

Drug Status Key

  • Preferred
  • Second Line
  • Third Line
  • Specialist Initiation
  • Hospital Only
  • Not Approved for Formulary

Thyroid Hormones

Drug Safety update

May 2021: Levothyroxine: new prescribing advice for patients who experience symptoms on switching between different levothyroxine products

October 2018: Ritonavir-containing products: reports of interaction with levothyroxine leading to reduced thyroxine levels

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.

Pack Price
28 tablet £1.53
500 tablet £52.50
Pack Price
1000 tablet £51.21
28 tablet £1.30
Pack Price
1000 tablet £46.79
28 tablet £1.31

Do not prescribe routinely to be used in exceptional circumstances only on specialist advice

Pack Price
28 tablet £118.10
Pack Price
5 vial £1,567.50