Cytomel 25 Tab

CYTOMEL

Liothyronine Sodium Tablets USP

COMPOSITION:

Each film-coated tablet contains:

Liothyronine Sodium USP

eq. to liothyronine 25mcg

Excipients q.s.

Colour: Approved colour used in coang

PHARMACOLOGICALCLASSIFICATION:

Thyroid preparaon

CLINICAL PHARMACOLOGY

The mechanisms by which thyroid hormones exert their physiologic acon are not well understood. As such, it acts on the body to increase the basal metabolic rate, enhance oxygen consumpon by most ssues of the body, effect protein synthesis and increase the body's sensivity to catecholamines (such as adrenaline) by permissiveness, Thus, it exert a profound influence on every organ system in the body and are of parcular importance in the development of the central nervous system.

PHARMACOKINETICS:

Since liothyronine sodium (T3) is not firmly bound to serum protein, it is readily available to body ssues. The onset of acvity of liothyronine sodium is rapid, occurring within a few hours. Maximum pharmacologic response occurs within 2 or 3 days, providing early clinical response. The biological half-life is about 2- 1/2 days. T3 is almost totally absorbed, 95 percent in 4 hours. Liothyronine sodium has a rapid cut off of acvity which permits quick dosage adjustment and facilitates control of the effects of over dosage, should they occur

INDICATIONS:

It is used to treat myxoedema and other forms of hypothyroidism. It is used as diagnosc aid in a test of the thyroid gland to determine if the thyroid is funconing normally. It is used in the treatment of various types of euthyroid goiters

DOSAGE: Adults:

Mild Hypothyroidism: Recommended dosage is 25mcg daily. Daily dosage may be increased by up to 25 mcg every 1 or 2 weeks. Usual maintenance dose is 25-75 mcg daily.

Myxedema: Recommended starng dosage is 5mcg daily. It may increase by 5 to 10 mcg daily every 1 or 2 weeks. When 25 mcg daily is reached, dosage may be increased by 5 to 25 mcg every 1 or 2 weeks unl a sasfactory therapeuc response is aained. Usual maintenance dose is 50 to 100 mcg daily. Simple (non-toxic) Goiter: Recommended starng dosage is 5 mcg daily. Dosage may be increased by5 to 1 O mcg daily every 1 or 2 weeks. When 25 mcg daily is reached, dosage may be increased every week or two by 12.5 or 25 mcg, usual maintenance dosage Is 75 mcg daily.

For children and elderly paents:

The inial dosage should be5 mcg daily. Cytomel-T3 should be given in divided doses two or three mes daily.

OVER DOSAGE:

Gastric lavage or emesis is required if paent is seen within a few hours of taking the dose. In addion to exaggeraon of side effects the following symptoms may be seen: agitaon, confusion, irritability, hyperacvity, headache, sweang, mydriasis, tachycardia, arrhythmias, tachypnoea, pyrexia, increase bowel movements and convulsions. Treatment is symptomac.

SIDE EFFECTS:

Allergic reacon (difficulty breathing, losing of the throat, swelling of the lips, tongue, or face), voming, chest pain, irregular heartbeat, or shortness of breath

Other, less serious side effects may be tremor, nervousness, or irritability, headache, insomnia, diarrhea, weight loss, leg cramps, menstrual irregularies, fever, sweang, or heat sensivity.

WARNINGS:

Thyroid hormone should not be used to treat obesity in paents with normal thyroid funcon. Liothyronine is ineffecve for weight reducon in normal thyroid paents and may cause serious or life threatening toxicity, especially when taken with amphetamines.

DRUG INTERACTIONS:

Oral Ancoagulants: Cytomel-T3 tablet may potenate the effect of ancoagulants.

Anconvulsants: Such as carbamazepine and phenytoin enhance the metabolism of thyroid hormones and may displace them from plasma proteins. Insulin or oral hypoglycemic: Iniang thyroid replacement therapy may cause increases in insulin or oral hypoglycemic requirements. Estrogen, oral contracepves: Co-administraon of oral contracepves may result in an increased dosage requirement of liothyronine sodium. Tricyclic andepressants: Concurrent administraon with imipramine and other tricyclic andepressants may increases receptor sensivity, enhances andepressants acvity and thyroid hormone acvity. Digitalis: Thyroid preparaons may potenate the toxic effects of digitalis. Ketamine: Concurrent administraon of liothyronine with parenteral anaesthec ketamine may cause hypertension and tachycardia.

PRECAUTIONS:

In severe and prolonged hypothyroidism, adrenocorcal acvity may be decreased which can lead to adrenocorcal insufficiency. Supplemental adrenocorcal steroids may be necessary. Thyroid replacement therapy may aggravate diabetes mellitus and result in an increase in dosage requirement of insulin or other andiabec therapy. In myxoedema, care must be taken to avoid imposing excessive burden on cardiac muscle affected by prolonged severe thyroid depleon.

CONTRA-INDICATIONS:

Thyrotoxicosis. Hypersensivity to any component of the tablet. Cauon should be taken when Cytomel-T3 is administered to lactang mothers.

PRESENTATION:

4 blister strips of 25 tablets are packed in a printed carton along with a leaflet.

OR

100 Tablets in Plasc Bole.

STORAGE INSTRUCTIONS:

Store at room temperature <25° C, Protect from sunlight. Keep out of reach of children!