Who can administer
  
                  May be administered by registered competent doctor or nurse/midwife
      
  
        Available preparations
  
                  Liothyronine 20 micrograms (Mercury) powder for solution for injection
Triiodothyronine 20 micrograms powder for solution for injection
      
  
        Reconstitution
  
                  Reconstitute with 1 or 2mL of water for injection
      
  
        Infusion fluids
  
                  Not applicable
For Organ donation indication - see below
      
  
        Methods of intravenous administration
  
                  Slow intravenous injection 
- Administer over at least 3 minutes (ref 1)
 
- May dilute to 5mL with Sodium choride 0.9% to aid slow administration
 
      
  
        Dose in adults
  
                  Myxedema coma
- Give 5 to 20 micrograms, repeated every 12 hours, or less if required.
 
- The minimum interval between doses is four hours
 
- An initial dose of 50 micrograms is used by some physicians, followed by further injections of 25 micrograms every eight hours until improvement occurs. The dosage may then be reduced to 25 micrograms twice daily
 
- In elderly patients with severe long-standing hypothyroidism, treatment with liothyronine sodium should be introduced with doses at the lower end of the dose range, with smaller increments and longer intervals between increases as necessary
 
- With regular dosing the peak therapeutic effect is usually achieved within 2 to 3 days; on withdrawal its effects may persist for 1 to 2 days (ref 2)
 
- As each vial is 20 micrograms and they are generally in short supply please consider a dosage regimen that minimises wastage of drug as well as efficacy and safety
 
Organ donation (ref 1,3)
- Dilute 20 micrograms (1ml) with 5ml Sodium chloride 0.9%
 
- Administer 4 microgram bolus dose, followed by a continuous infusion of 3 micrograms per hour
 
Equivalent doses (ref 2,4)
- Liothyronine sodium 10.3microgram is equivalent to about 10micrograms of liothyronine.
 
- Liothyronine sodium 20 to 25 micrograms is generally considered to be equivalent in activity to about 100micrograms of levothyroxine sodium
 
      
  
        Storage
  
                  Store below 250C
      
  
        References
  
                  SPC March 2019
1. Injectable Medicines Guide Medusa, downloaded 15/04/2025
2: Martindale accessed online 15/04/2025
3: Organ Donation Transplant Ireland guidelines
4: BNF accessed online 08/04/2025
      
  
        Therapeutic classification
  
                  Thyroid/Endocrine (Search term thyroxine)