Pharmacy Guide
Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
Pharmacy Guide
Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
Liothyronine sodium 20 micrograms Hard Capsules
⚠ This medicine appears to have been discontinued
The electronic medicines compendium (emc) no longer publishes a Summary of Product Characteristics for this product, which usually means it is no longer marketed in the UK. The patient leaflet below is kept for reference, but the product may not be available.
If you were prescribed this medicine, other products containing Liothyronine sodium may still be available. Do not stop your treatment — ask your pharmacist or GP what to use instead.
What it is and what it is used for
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What you need to know before you take it
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How to take it
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Possible side effects
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How to store it
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Contents of the pack and other information
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Frequently asked questions about Liothyronine sodium 20 micrograms Hard Capsules
How do I take Liothyronine sodium 20 micrograms Hard Capsules?
Liothyronine sodium 20 micrograms Hard Capsules comes as capsule containing 20mcg. Always follow the dose your doctor or pharmacist has given you, and read the leaflet that comes with the medicine.
What is the active substance in Liothyronine sodium 20 micrograms Hard Capsules?
The active substance in Liothyronine sodium 20 micrograms Hard Capsules is liothyronine sodium.
Where does this information come from?
This leaflet reproduces the patient information leaflet approved for Liothyronine sodium 20 micrograms Hard Capsules, as published on the electronic medicines compendium (emc). The version printed inside your medicine’s packaging is the one that applies to you.
Can I get Liothyronine sodium 20 micrograms Hard Capsules without a prescription?
Whether a medicine is available over the counter or on prescription only depends on its licence. Check the leaflet, or ask your pharmacist — they can tell you straight away.
About this leaflet
The text above reproduces the patient information leaflet approved for this medicine, restructured for easier reading.
- Source: electronic medicines compendium (emc), Datapharm
- Active substance: liothyronine sodium
- Official document: view the original leaflet on emc →
⚕For healthcare professionals — Summary of Product Characteristics (SmPC)Full SmPC: dosage, interactions, contraindications, warnings+
4.1. Therapeutic indications
Liothyronine is indicated in adults and children for the treatment of coma of myxoedema, the management of severe chronic thyroid deficiency and hypothyroid states occurring in the treatment of thyrotoxicosis.
Liothyronine sodium can be used also in the treatment of thyrotoxicosis as an adjunct to carbimazole to prevent sub-clinical hypothyroidism developing during treatment.
Liothyronine sodium may be preferred for treating severe and acute hypothyroid states because of its rapid and more potent effect, but thyroxine sodium is normally the drug of choice for routine replacement therapy.
4.2. Posology and method of administration
Posology
Adults
Starting dose of 10 or 20 micrograms every 8 hours, increasing after one week, if necessary, to the usual recommended daily dose of 60 micrograms in two or three divided doses.
Myxedema Coma
60 micrograms given by stomach tube, then 20 micrograms every 8 hours. It is more usual to start treatment with intravenous liothyronine.
Adjunct to carbimazole treatment of thyrotoxicosis
20 micrograms every 8 hours.
Elderly and Paediatric population
5 micrograms daily.
Method of administration
Oral use.
In patients who have difficulty in swallowing a whole capsule, the contents of a capsule should be emptied into a minimum of 20 ml of water. The entire liquid should be consumed after swirling the mixture to ensure ingestion of the full dose. The solubility of liothyronine in water enables this as a method of administration.
For doses lower than 20 micrograms, Liothyronine sodium 5 micrograms Hard Capsules and Liothyronine sodium 10 micrograms Hard Capsules are also available.
4.3. Contraindications
Hypersensitivity to any components of Liothyronine sodium hard capsules.
Patients with angina of effort or cardiovascular diseases and thyrotoxicosis.
4.4. Special warnings and precautions for use
In severe and prolonged hypothyroidism, adrenocortical activity may be decreased. When thyroid replacement therapy is started, metabolism increases more than adrenocortical activity and this can lead to adrenocortical insufficiency requiring supplemental adrenocortical steroids.
Liothyronine sodium treatment may result in an increase in insulin or anti- diabetic drug requirements. Care is required for patients with diabetes mellitus and diabetes insipidus.
Panhypopituitarism or predisposition to adrenal insufficiency (initiate corticosteroid therapy before starting liothyronine), pregnancy, breast-feeding (see section 4.6 Pregnancy and lactation).
In myxoedema, care must be taken to avoid imposing excessive burden on cardiac muscle affected by prolonged severe thyroid depletion. Particular care is needed in the elderly who have a greater risk of occult cardiovascular disease. Baseline ECG is recommended prior to commencement of liothyronine treatment in order to detect changes consistent with ischaemia. Patients should undergo cardiovascular monitoring, including periodic ECGs, during liothyronine treatment. Liothyronine is contraindicated in established myocardial ischaemia (see section 4.3) in which case, levothyroxine, with cautious dose escalation, is recommended instead.
Liothyronine rather than levothyroxine would be the replacement therapy of choice during block and replace treatment of thyrotoxicosis with propylthiouracil (PTU) due to the inhibition by PTU of the peripheral conversion of T4 to T3.
If metabolism increases too rapidly (causing diarrhoea, nervousness, rapid pulse, insomnia, tremors and sometimes anginal pain where there is latent myocardial ischaemia), reduce dose or withhold for 1-2days and start again at a lower dose. TSH levels should be monitored during treatment to reduce the risk of over- or undertreatment. The risks of over-treatment include atrial fibrillation, osteoporosis and bone fractures.
Interferences with laboratory test:
Biotin may interfere with thyroid immunoassays that are based on a biotin/streptavidin interaction, leading to either falsely decreased or falsely increased test results. The risk of interference increases with higher doses of biotin.
When interpreting results of laboratory tests, possible biotin interference has to be taken into consideration, especially if a lack of coherence with the clinical presentation is observed.
For patients taking biotin-containing products, laboratory personnel should be informed when a thyroid function test is requested. Alternative tests not susceptible to biotin interference should be used, if available (see section 4.5).
This medicine contains less than 1 mmol sodium (23 mg) per 5micrograms, 10micrograms and 20 micrograms hard capsule, that is to say essentially 'sodium-free'.
4.5. Interaction with other medicinal products and other forms of interaction
Liothyronine sodium therapy may potentiate the action of anticoagulants. Phenytoin levels may be increased by liothyronine. Anticonvulsants, 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.
If co-administered with cardiac glycosides, adjustment of dosage of cardiac glycoside may be necessary. Colestyramine and colestipol given concurrently reduces gastrointestinal absorption of liothyronine.
Liothyronine raises blood sugar levels and this may upset the stability of patients receiving antidiabetic agents.
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 of oral contraceptives may result in an increased dosage requirement of liothyronine sodium.
Amiodarone may inhibit the deiodination of thyroxine to triiodothyronine resulting in a decreased concentration of triiodothyronine with a rise in the concentration of inactive reverse triiodothyronine.
As with other thyroid hormones, Liothyronine may enhance effects of amitriptyline and effects of imipramine.
Metabolism of thyroid hormones accelerated by barbiturates and primidone (may increase requirements for thyroid hormones in hypothyroidism).
Requirements for thyroid hormones in hypothyroidism may be increased by oestrogens.
Interferences with laboratory test:
Biotin may interfere with thyroid immunoassays that are based on a biotin/streptavidin interaction, leading to either falsely decreased or falsely increased test results (see section 4.4).
4.6. Fertility, pregnancy and lactation
Pregnancy
Safety during pregnancy is not known. The risk of foetal congenital abnormalities should be weighed against the- risk to the foetus of untreated maternal hypothyroidism.
Lactation
Liothyronine sodium is excreted into breast milk in low concentrations.
This may interfere with neonatal screening programmes.
Fertility
There are no fertility data available.
4.7. Effects on ability to drive and use machines
None.
4.8. Undesirable effects
The following effects are indicative of excessive dosage and usually disappear on reduction of dosage or withdrawal of treatment for a day or two.
The undesirable effects are listed below by organ class and the following frequency convention:
Not known (cannot be estimated from the available data)
System Organ Class
Frequency
Adverse events
Immune system disorders
Not known
Hypersensitivity reactions including rash, pruritus and oedema also reported.
Metabolism and nutrition disorders
Not known
Excessive loss of weight
Psychiatric disorders
Not known
Restlessness, excitability, insomnia
Nervous system disorders
Not known
Headache, tremor
Cardiac disorders
Not known
Anginal pain, cardiac arrhythmias, palpitations, tachycardia
Vascular disorders
Not known
Flushing
Gastrointestinal disorders
Not known
Diarrhoea, vomiting
Skin and subcutaneous tissue disorders
Not known
Sweating
Musculoskeletal and connective tissue disorders
Not known
Muscle cramps, muscular weakness
General disorders and administration site conditions
Not known
Fever, flushing and heat intolerance
Paediatric population
• Transient hair loss in children (Not Known)
Reporting of suspected adverse reactions
Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via Yellow Card Scheme, Website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.
4.9. Overdose
If patient is seen within a few hours of overdosage: gastric lavage or emesis. There may be exaggeration of the side effects as well as agitation, confusion, irritability, hyperactivity, headache, sweating, mydriasis, tachycardia, arrhythmias, tachypnoea, pyrexia, increased bowel movements and convulsions.
Treatment is symptomatic. Tachycardia in adults may be controlled with 40mg propranolol every 6 hours.
🇷🇴 Known in Romania as
Medicines sold in Romania with the same active substance: Cunoscut în România ca
⚠ Not the same combination. This medicine contains Liothyronine sodium. The products below do not contain exactly the same set of active substances — they are not direct substitutes.
- NOVOTHYRAL 100/20 micrograme prescription partial — not the same combinationCOMBINATII (LEVOTHYROXINUM+LIOTHYRONINUM) · taken by mouth
Some of these do not contain exactly the same active substances — check each one. The strength, the form and whether you need a prescription can differ. Always ask a pharmacist before you switch. Romanian medicines in the UK →
🇵🇱 Known in Poland as
Medicines sold in Poland with the same active substance: W Polsce znany jako
⚠ Not the same combination. This medicine contains Liothyronine sodium. The products below do not contain exactly the same set of active substances — they are not direct substitutes.
- Novothyral partial — not the same combinationLevothyroxinum natricum + Liothyroninum natricum · taken by mouth
- Novothyral 75 partial — not the same combinationLevothyroxinum natricum + Liothyroninum natricum · taken by mouth
Some of these do not contain exactly the same active substances — check each one. The strength, the form and whether you need a prescription can differ. Always ask a pharmacist before you switch. Polish medicines in the UK →
💬 Ask about this leaflet
Ask anything about Liothyronine sodium 20 micrograms Hard Capsules. The assistant answers only from this leaflet — if the leaflet does not cover it, it will say so. It does not give medical advice.
Answers come from the patient leaflet published on the electronic medicines compendium (emc). They are not medical advice. Ask a pharmacist or your GP if you are unsure. For urgent help call NHS 111, or 999 in an emergency.
Medicines containing Liothyronine sodium
- Enolio 10 micrograms / ml Oral Solution
- Liothyronine sodium 10 micrograms Hard Capsules
- Liothyronine Sodium 10 micrograms Tablets
- Liothyronine Sodium 20 micrograms Powder for Solution for Injection
- Liothyronine Sodium 20 micrograms Tablets
- Liothyronine sodium 5 micrograms Hard Capsules
- Liothyronine Sodium 5 micrograms Tablets
- Liothyronine Sodium BP 20micrograms Tablets