Thyrolar
Generic Name
Liotrix (Levothyroxine Sodium and Liothyronine Sodium)
Manufacturer
AbbVie (formerly Forest Pharmaceuticals)
Country
United States
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| thyrolar 50 mcg tablet | ৳ 3.00 | ৳ 45.00 |
Description
Overview of the medicine
Thyrolar is a combination thyroid hormone replacement therapy containing synthetic levothyroxine (T4) and liothyronine (T3) in a 4:1 ratio. It is used to treat hypothyroidism.
Uses & Indications
Dosage
Adults
Initial dose typically 30 mg orally once daily, adjusted in increments of 15-30 mg every 2-3 weeks based on clinical response and lab tests (TSH, free T4). Maintenance dose usually 60-120 mg daily.
Elderly
Lower initial doses (e.g., 15 mg daily) and slower titration are recommended due to increased sensitivity and potential for cardiac events.
Renal_impairment
No specific dosage adjustment for renal impairment is usually required, but careful monitoring is advised.
How to Take
Take orally once daily, preferably on an empty stomach 30-60 minutes before breakfast to ensure consistent absorption. Do not take with antacids, iron, or calcium supplements within 4 hours.
Mechanism of Action
Thyroid hormones affect all major organs and are essential for normal metabolism, growth, and development. Thyrolar provides exogenous T3 and T4, which bind to thyroid hormone receptors in the cell nucleus, regulating gene expression and influencing various metabolic processes.
Pharmacokinetics
Onset
Clinical effects are typically observed within days to weeks, with full effect achieved over several weeks of consistent dosing.
Excretion
Excreted primarily through the kidneys (T3 and conjugated metabolites) and via bile (T4 and its metabolites).
Half life
T3 has a half-life of 1-2 days; T4 has a half-life of 6-7 days.
Absorption
T3 is almost completely absorbed from the GI tract (95%), while T4 absorption is about 48-80% and varies with GI factors. Absorption occurs primarily in the small intestine.
Metabolism
Both T3 and T4 undergo deiodination, conjugation with glucuronide and sulfate, and oxidative decarboxylation in the liver and kidneys.
Side Effects
Contraindications
- Untreated thyrotoxicosis
- Acute myocardial infarction
- Untreated adrenal cortical insufficiency
- Hypersensitivity to any component
Drug Interactions
Warfarin
May increase anticoagulant effect; monitor INR.
Estrogens
May increase thyroid hormone requirements.
Antidiabetic agents
May increase blood glucose; dose adjustment of antidiabetic agents may be needed.
Antacids, Iron, Calcium, Sucralfate, Cholestyramine
May impair absorption of thyroid hormones; administer 4 hours apart.
Storage
Store at controlled room temperature (20-25°C or 68-77°F), protected from light and moisture.
Overdose
Symptoms of overdose include signs of hyperthyroidism: headache, irritability, nervousness, sweating, diarrhea, weight loss, palpitations, arrhythmias, and heat intolerance. Management involves dose reduction/interruption and supportive therapy.
Pregnancy & Lactation
Thyroid hormone requirements may increase during pregnancy. It is essential to maintain euthyroid status for both mother and fetus. Thyrolar is generally considered safe during lactation; minimal amounts pass into breast milk.
Side Effects
Contraindications
- Untreated thyrotoxicosis
- Acute myocardial infarction
- Untreated adrenal cortical insufficiency
- Hypersensitivity to any component
Drug Interactions
Warfarin
May increase anticoagulant effect; monitor INR.
Estrogens
May increase thyroid hormone requirements.
Antidiabetic agents
May increase blood glucose; dose adjustment of antidiabetic agents may be needed.
Antacids, Iron, Calcium, Sucralfate, Cholestyramine
May impair absorption of thyroid hormones; administer 4 hours apart.
Storage
Store at controlled room temperature (20-25°C or 68-77°F), protected from light and moisture.
Overdose
Symptoms of overdose include signs of hyperthyroidism: headache, irritability, nervousness, sweating, diarrhea, weight loss, palpitations, arrhythmias, and heat intolerance. Management involves dose reduction/interruption and supportive therapy.
Pregnancy & Lactation
Thyroid hormone requirements may increase during pregnancy. It is essential to maintain euthyroid status for both mother and fetus. Thyrolar is generally considered safe during lactation; minimal amounts pass into breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months from manufacture date, refer to package insert for exact details.
Availability
Pharmacies, hospitals
Approval Status
FDA Approved
Patent Status
Patent expired
Clinical Trials
Extensive clinical data supports the efficacy and safety of thyroid hormone replacement in hypothyroidism. Specific trials for Liotrix formulations compared to levothyroxine monotherapy have been conducted.
Lab Monitoring
- Serum TSH levels (primary determinant for dose adjustment in hypothyroidism)
- Free T4 levels
- Clinical evaluation of symptoms
Doctor Notes
- Thyrolar contains both T3 and T4, which may offer benefits for some patients who do not achieve euthyroidism on levothyroxine monotherapy.
- Monitor TSH and free T4 levels closely, especially during initial titration and dose changes.
Patient Guidelines
- Take exactly as prescribed by your doctor.
- Do not stop taking this medication without consulting your doctor.
- Report any signs of overdosage immediately.
- Take on an empty stomach, 30-60 minutes before breakfast.
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it is almost time for your next dose. Do not double the dose to make up for a missed one.
Driving Precautions
Thyrolar is not expected to affect the ability to drive or operate machinery. However, if side effects like nervousness or tremors occur, caution should be exercised.
Lifestyle Advice
- Maintain a healthy diet.
- Engage in regular physical activity.
- Avoid sudden changes in diet or supplements that may affect thyroid hormone absorption.
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