Instruction for use: Levothyroxine sodium + Liothyronine (Levothyroxinum natrium+ Liothyroninum)

Pharmacological group of substance Calcitonin

Hormones of the thyroid and parathyroid glands, their analogs and antagonists (including antithyroid agents) / 67 /

Nosological classification (ICD-10)

C73 Malignant neoplasm of thyroid

Thyroid cancer, Thyrotropin-Dependent Thyroid Carcinoma, Anaplastic thyroid cancer, Thyroid carcinoma, Medullary thyroid cancer, Thyroid tumors, Papillary thyroid cancer

E03 Other forms of hypothyroidism

hypothyroidism, Hypothyroid conditions, Thyroid hypothyroidism, Diagnosis of hypothyroidism, Myxedema, Primary hypothyroidism, Simple goitre,Spontaneous hypothyroidism, Iatrogenic hypothyroidism

E03.9 Unspecified hypothyroidism

Hypothyroidism, Hypothyroid conditions, Thyroid hypothyroidism, Diagnosis of hypothyroidism, Simple goiter, Hypothyroid edema,Wolf-Chaikoff effect, Congenital hypothyroidism, Secondary hypothyroidism, Hypothyroid obesity, Hypothyroid status, Obstructive hypothyroidism

E04.9 Non-toxic goiter, unspecified

The sporadic goiter, Non-toxic goiter

Pharmacotherapy

Substitution therapy, contains L-isomers of T4 and T3, replenishes the deficiency of thyroid hormones. It has anabolic and catabolic action, activates fat metabolism, increases the functional activity of CCC and CNS. In large doses, the production of TTPF by the hypothalamus and TTG by the pituitary is inhibited. More effective than levothyroxine. The latent period of action of levothyroxine is 24-48 h, lyotyronine - 4-8 hours. The optimal combination of drugs is 4: 1 or 5: 1.

Indication

Hypothyroidism (of various genesis), thyroid hormone deficiency, goitre recurrence (prophylaxis after resection), euthyroid benign goiter, additional thyrotoxicosis therapy with thyreostatic drugs after reaching the euthyroid status (not during pregnancy). Thyroid cancer (suppressive therapy, after removal of the thyroid gland - replacement).

Contraindications

Hypersensitivity; Myocardial infarction (acute, in anamnesis); Goiter in old age, acute myocarditis, cardiopathy; angina; Adrenal insufficiency; CHF, CHD, severe atherosclerosis; Arrhythmias; arterial hypertension.

Dosing

Individual, inside, in the morning 30 minutes before breakfast (without chewing, with a small amount of liquid). Adults take 40-100 μg of levothyroxine with 10-20 μg of lyotyronine once a day, increasing the dose at intervals of 2-4 weeks to a maintenance dose (usually 2-2.5 times the initial dose). Children under 14 years - in a dose, 2 times less than adults.

Side effect

Thyrotoxicosis (tremor of fingers, tachycardia, increased sweating, insomnia, glucosuria, stenocardia, arrhythmias, diarrhea, weight loss, anxiety, tremor), weight gain, alopecia, renal dysfunction, in children - increased convulsive readiness.

Interaction

Strengthens the effect of indirect anticoagulants, weakens - hypoglycemic drugs.

Kolestyramin reduces the absorption of thyroid hormones.

Rapid intravenous injection of phenytoin increases the concentration in the plasma of free levothyroxine and lyotyronine and, in some cases, contributes to the disturbance of the heart rhythm.

Salicylates, dicoumarol, furosemide (in high doses), clofibrate increase the effect of the drug.