CYTOMEL (liothyronine sodium)

There are 0 contraindications.

Drug contraindication overview.

*Uncorrected adrenal insufficiency. *Untreated thyrotoxicosis. *Hypersensitivity to any of the active or extraneous ingredients of the formulation. *Concomitant use of IV liothyronine and artificial patient rewarming.

Adverse reaction overview.

The most common adverse reactions of oral liothyronine therapy are primarily hyperthyroidism-related due to therapeutic overdosage and include arrhythmias, myocardial infarction, dyspnea, headache, nervousness, irritability, insomnia, tremors, muscle weakness, increased appetite, weight loss, diarrhea, heat intolerance, menstrual irregularities, and skin rash. Hypersensitivity reactions (e.g., urticaria, pruritus, skin rash, angioedema, GI symptoms, fever, arthralgia, serum sickness, wheezing) to inactive ingredients in oral thyroid hormone products have been reported. The most common adverse reactions of IV liothyronine therapy include arrhythmia (6%) and tachycardia (3%).

Approximately 2% of patients experience cardiopulmonary arrest, hypotension, and myocardial infarction. Angina, congestive heart failure, fever, hypertension, phlebitis, and twitching have been reported in approximately <=1% of patients.

In pediatric patients with congenital hypothyroidism, oral thyroid hormone therapy should be initiated immediately upon diagnosis in order to prevent adverse effects on intellectual development, growth, and maturation; therapy is generally lifelong in these patients. During the first 2 weeks of thyroid agent therapy, infants should be closely monitored for cardiac overload, arrhythmias, and aspiration resulting from avid suckling. Pediatric patients with congenital or acquired hypothyroidism should be monitored closely to avoid undertreatment or overtreatment.

Undertreatment may result in negative effects on intellectual development and growth while overtreatment may result in craniosynostosis in infants and accelerate the aging of bones, resulting in premature epiphyseal closure and compromised adult stature. In pediatric patients with acquired hypothyroidism administered oral thyroid hormone therapy, a period of catch-up growth may occur, which may be adequate in some cases to achieve normal adult height. In children with severe or long-standing hypothyroidism, catch-up growth may not be adequate to achieve normal adult height.

If a diagnosis of permanent hypothyroidism has not been established in a pediatric patient, oral thyroid hormone therapy should be discontinued for a trial period, but only after the patient is >=3 years of age. Clinicians should obtain various laboratory tests (e.g., serum TSH, T4, T3) at the end of the trial period and use results to guide diagnosis and treatment. Pseudotumor cerebri and slipped capital femoral epiphysis have been reported in pediatric patients receiving oral thyroid agent therapy. The efficacy and safety of IV liothyronine have not been established in pediatric patients.

Contraindicated

None

Severe Precaution

None

Management or Monitoring Precaution

None