Liothyronine sodium - Hypothyroidism with intolerance to levothyroxine

This entry has not yet been reviewed for inclusion on the joint formulary. However, this information has been published due to the ongoing requirement for prescribers to access the shared care agreement and other resources that were in place prior to the launch of the joint formulary.

Please refer to the list of agreed formulations and former traffic light status available on the PAD page (accessed by clicking the drug name).

See narrative below (June 2019) for recommend use.

NOTE:
Licensed, bioequivalent liothyronine CAPSULES have entered the market at a considerably reduced price and the APC recommend that:

- the most cost effective preparation should be prescribed (currently capsules) in all new patients
- prescribers should consider switching existing patients from tablets to capsules - for discussion with the patient at next review

The APC noted the additional information provided in the Liothyronine capsules - briefing paper below

The Surrey and North West Sussex APC recommends the use of liothyronine (T3) monotherapy initiated only by consultant endocrinologists in an NHS consultation for patients with an intolerance to levothyroxine (T4).
Transfer of prescribing to primary care is supported for those patients that have had a satisfactory response for at least 3 months prior to transfer to primary care.
Liothyronine for this indication will be considered as AMBER on the traffic light system. Shared-care documentation is available below.

Patients taking liothyronine (monotherapy or in combination) prior to NHS England guidance ‘Items that should not routinely be prescribed in primary care’ (Nov 2017) should have been reviewed by an NHS consultant endocrinologist.