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This medication comes with important safety warnings that should be understood before use. Please read the following carefully and discuss any concerns with your healthcare provider.

• Not for Weight Loss: Liothyronine (Cytomel) is not designed for weight loss. Using it for this purpose can be ineffective and potentially dangerous, especially when combined with weight loss medications like phentermine (Adipex-P). High doses may lead to severe or life-threatening effects. If weight loss is your goal, consult a healthcare professional to determine a safe and effective plan tailored to your needs.

• Heart Problems: Excessive doses of liothyronine (Cytomel) may lead to heart issues, particularly in older adults and individuals with existing heart conditions. If you are over 65 years of age or have heart disease, your initial dose may need to be lower. Consult your doctor if you are taking stimulant medications or have a history of heart problems.

• Adrenal Crisis in Individuals with Adrenal Insufficiency: If you have adrenal insufficiency, it is crucial to treat this condition with corticosteroids before starting liothyronine (Cytomel) therapy. Thyroid hormones can accelerate the metabolism of corticosteroids, potentially causing dangerously low adrenal hormone levels. Seek medical advice if you have adrenal insufficiency or Addison's disease.

• Worsening Diabetes: Liothyronine (Cytomel) may impact blood sugar control in diabetic patients, necessitating adjustments in diabetes medication dosages. Monitor your blood sugar levels when starting, adjusting, or discontinuing liothyronine (Cytomel) and follow your prescriber's guidance. Report any unusual blood sugar readings to your healthcare team.

• Effect on Bones: High doses of liothyronine (Cytomel) can lead to bone weakening over time, especially in postmenopausal individuals. Regular monitoring of thyroid hormone levels by your prescriber is essential to ensure the dose is effective yet minimal, reducing the risk of bone-related issues.

Contraindications: This medication should not be used if you have untreated adrenal insufficiency due to potential serious health risks. Always consult your healthcare provider to ensure it is safe for your specific conditions.

Common side effects:

• Shakiness
• Fast or irregular heartbeat
• Fever
• Increased sweating
• Feeling easily overheated
• Hair loss
• Increased appetite
• Diarrhea
• Weight loss
• Weak muscles
• Fatigue
• Nervousness or anxiety
• Irritability
• Trouble sleeping

Less common but important to monitor:

• Trouble breathing

Serious side effects:

• Chest pain
• Shortness of breath
• Sudden weakness
• Breaking out into a cold sweat
• Pain spreading to jaw, neck, back, shoulders, or arms

Liothyronine, a synthetic form of the thyroid hormone triiodothyronine (T3), is prescribed to treat conditions like hypothyroidism. It's important to be aware of potential interactions between liothyronine and other substances, as these can affect the medication's effectiveness or lead to adverse effects.

Medications That May Interact with Liothyronine:

• Bile Acid Sequestrants and Ion Exchange Resins: Medications such as Cholestyramine, Colesevelam, and sevelamer can bind to liothyronine in the digestive tract, reducing its absorption. To minimize this interaction, it's recommended to take liothyronine at least four hours before or after these medications.

• Iron Supplements: Iron-containing products, including iron dextran complex and iron sucrose, may decrease liothyronine levels by inhibiting its absorption in the gastrointestinal tract. It's advisable to monitor thyroid function when using these supplements concurrently with liothyronine.

• Estrogen-Containing Medications: Oral contraceptives and hormone replacement therapies that contain estrogen can increase the levels of thyroxine-binding globulin (TBG), a protein that binds thyroid hormones. This increase may necessitate a higher dose of liothyronine to maintain its effectiveness.

• Antidiabetic Agents: Starting liothyronine therapy in individuals with diabetes may worsen blood sugar control, potentially requiring adjustments in antidiabetic medications or insulin. Regular monitoring of blood glucose levels is essential during this period.

• Oral Anticoagulants: Liothyronine can enhance the effects of blood-thinning medications like Warfarin, increasing the risk of bleeding. Close monitoring of blood clotting parameters is recommended, and dosage adjustments may be necessary.

• Digitalis Glycosides: Liothyronine may reduce the effectiveness of digitalis medications used for heart conditions. Monitoring and possible dosage adjustments of digitalis may be required when initiating or changing liothyronine therapy.

• Antidepressants: Combining liothyronine with tricyclic or tetracyclic antidepressants can amplify the effects of both drugs, potentially leading to increased heart rate and nervous system stimulation. Caution and monitoring are advised when these medications are used together.

• Beta-Adrenergic Antagonists (Beta-Blockers): High doses of beta-blockers, such as Propranolol, may decrease the conversion of T4 to T3, leading to lower T3 levels. Patients should be monitored for changes in thyroid function when these medications are used concurrently.

Food and Supplement Interactions:

• Calcium and Iron Supplements: These supplements can interfere with the absorption of liothyronine. To avoid this, it's best to take liothyronine on an empty stomach, at least 30 minutes to an hour before meals, and separate from calcium or iron supplements by several hours.

Disease Interactions:

• Cardiovascular Conditions: Individuals with heart disease should use liothyronine cautiously, as it can increase heart rate and workload.

• Diabetes: Liothyronine may affect blood sugar levels, necessitating careful monitoring and possible adjustments in diabetes medications.

• Adrenal Insufficiency: Liothyronine should not be used in patients with uncorrected adrenal insufficiency, as it may exacerbate the condition.

General Recommendations:

Always inform your healthcare provider about all medications, supplements, and over-the-counter products you are taking before starting liothyronine. Regular monitoring of thyroid function and other relevant parameters is crucial to ensure the safe and effective use of liothyronine therapy.