For emergency treatment of hypothyroid coma, OR in patients exhibiting signs and symptoms of hypothyroidism following failure to administer/absorb usual oral replacement therapy (typically after 5-7 days).
Please note this this a high cost medicine
Prescribers in primary care should not initiate liothyronine for any new patient
Please note - only the 20 microgram strength is on formulary. For lower doses the tablet can be dispersed in water. See SPC for details.
Liothyronine is non formulary for monotherapy, it should be used with levothyroxine (T4).
Please note this is a high cost medicine
The British Thyroid Association (BTA) advise that a small proportion of patients treated with levothyroxine continue to suffer with symptoms despite adequate biochemical correction.
In these circumstances, where levothyroxine has failed and in line with BTA guidance, endocrinologists providing NHS services may recommend liothyronine for individual patients after a carefully audited trial of at least 3 months duration of liothyronine.
Liothyronine is used for patients with thyroid cancer, in preparation for radioiodine ablation, iodine scanning, or stimulated thyroglobulin test. In these situations it is appropriate for patients to obtain their prescriptions from the centre undertaking the treatment and not be routinely obtained from primary care prescribers.
RED - Hospital only – to be prescribed by a specialist and supplied from secondary care ONLY throughout treatment.
Amber medicines are considered suitable for GP prescribing following specialist initiation or recommendation.
Shared Care - these medicines require specialist initiation and stabilisation. Ongoing division of responsibility for drug and disease monitoring between specialist and GP by a Shared Care Guideline (SCG). If no SCG in place status reverts to red.
These medicines are appropriate for initiation in both primary and secondary care. Prescribing is appropriate within licensed or local recommendations.
Suitable for patient to be directed to buy themselves
Not currently used. We intend to include this TLS in future to highlight where a decision to use this medicine is under review.
(In use from Oct 2020) Used where a decision has been made by the BSW APC not to routinely commission this preparation for its licensed indications. Do not prescribe.
Not currently used. We intend to include this TLS in future to highlight where this medicine and indication is ONLY available through a Specialist Centre according to a NICE Highly Specialised Technology or NHSE Specialised Commission Circular / Policy.