Medical instructions for the use of triiodothyronine. Composition and form of release. T3 general: what is

a synthetic drug natural hormone thyroid gland.

Synonyms: Liothyronine, Ttybon, Trionin.

Release form. Tablets of 20 and 50 mcg.

Pharmacokinetics. It is well absorbed in the digestive canal, the action develops quickly, as it circulates in the blood in a free form and actively penetrates into the tissues. After ingestion, the latent period lasts 4-8 hours, the maximum effect develops on the 2nd-3rd day and ends after 8-10 days. Rapidly inactivated in the liver. The half-life is 2-3 days.

Application. At extreme conditions for fast elimination thyroid insufficiency, in particular when turning off the thyroid-stimulating function of the pituitary gland, hypothyroid coma, etc. With an allergic syndrome in patients with myxedema.

Triiodothyronine is more active than thyroidin (0.1 mg of thyroidin corresponds to 25-30 μg of triiodothyronine hydrochloride). Assign it to avoid overdose at first in small doses. doses(5-10 moment), gradually selecting the optimal dose(25-100 mcg per day). Therapeutic effect when using triiodothyronine, it occurs after 24 hours, and the euthyroid state after 7-12 days.

In hypothyroid coma, 100 mcg intravenously administered every 12 hours or 20 mcg every 3-4 hours until the interrectal temperature rises. From now on dose triiodothyronine is reduced to 60 mcg. At the same time determine the pulse rate and body temperature. In patients with a history of ischemic heart disease, the initial dose triiodothyronine hydrochloride should not exceed 60-80 mcg, and in the future - 10-12 mcg 2 times a day under ECG control. Then, to prevent cardiac complications, intravenous infusions are stopped and switched to the introduction of triiodothyronine orally through a tube at a dose of 5 to 20 mcg every 12 hours. With extreme caution, triiodothyronine should be used when diabetes.

Simultaneously to combat collapse, hypoglycemia and impaired water-salt metabolism intravenously administered prednisolone or hydrocortisone, cardiac glycosides, antibiotics a wide range action and 5% glucose solution. After removal from a coma, they are prescribed in adequate doses. doses triiodothyronine inside. In secondary and tertiary hypothyroidism, triiodothyronine hydrochloride is prescribed against the background of a previously initiated treatment corticosteroids.

With hypothyroid and euthyroid sporadic goiter at the beginning treatment use triiodothyronine hydrochloride up to 75 mcg per day. With euthyroid goiter, in addition, antistrumine is prescribed. After the elimination of acute events and the restoration of the euthyroid state in subacute thyroiditis, triiodothyronine hydrochloride is prescribed at a dose of 20-100 mcg per day; simultaneously begin to gradually decrease dose glucocorticoids or salicylates at intervals of 4-6 days.

In the case of a rare hypopituitary coma, when in clinical the picture is dominated by hypothermic and hypoglycemic symptoms, along with hydrocortisone in large doses(0.7-1.2 g per day) shows very careful use of triiodothyronine, initially no more than 10-20 mg per day. Sick autoimmune thyroiditis it is recommended to prescribe triiodothyronine hydrochloride at a dose of 60-100 mcg/day. In thyroid adenoma, triiodothyronine is used at the maximum tolerated dose, with malignant tumors thyroid gland - 200-600 mcg / day.

A test with triiodothyronine (thyroidin) is produced in order to identify the autonomy of growth and functioning of thyroid nodules. The absence after a 10-14-day intake of 80-120 μg of triiodothyronine per day (or 0.1-0.15 g of thyroidin per day) of changes in the size and density of the nodes indicates the autonomy of the growth of the nodes. The use of triiodothyronine and thyroidin in the autonomous functioning of the nodes, according to scanning data, does not inhibit the capture of 181 I.

There is a test with triiodothyronine to suppress the capture of 131 I by the thyroid gland. At healthy people after the use of 80-120 mcg of triiodothyronine per day for 7-10 days, the capture of 131 I by the thyroid gland decreases by more than 50% of the initial level; in patients with diffuse toxic goiter and with hyperfunctioning nodes in thyroid gland these events are absent.

Side effect, contraindications to the appointment, interaction with other medicines. Cm. .

cbytttbxtcrbq ghtgfhft, cjjtdttctde.obq tcttctdtyyjve ujhvjye obtjdblyjq ;tktps. Cbyjybvs: Liothyronine, Ttybon, Trionin. Ajhvf dsgecrf. Tf,kttrb gj 20 b 50 vru. Afhvfrjrbyttbrf. — Instructions for medical use approved by the Pharmacological Committee of the Ministry of Health of the Russian Federation

Synthetic thyroid hormone, replenishes the deficiency of thyroid hormones. Increases the need for oxygen in tissues, stimulates their growth and differentiation, increases the level basal metabolism(proteins, fats and carbohydrates). In small doses, it has an anabolic effect, and in large doses, it has a catabolic effect. Inhibits the production of thyroid-stimulating hormone. Strengthens energy processes, renders positive influence on the function of the nervous and cardiovascular systems, liver and kidneys. Maximum pharmacological effect develops in 2-3.

Pharmacokinetics

Absorption - 95% (for 4 hours). Communication with plasma proteins is high. T1/2-2.5

Indications for use of the product

• 
  any genesis;
• 
  euthyroid goiter;
• 
  prevention of goiter recurrence after surgical treatment or therapy radioactive iodine;
• 
  : after reaching the euthyroid state with thyreostatics (as part of combination therapy).

Dosing regimen

Inside, 30 minutes before meals. At the beginning of the course of treatment, adults are recommended to prescribe 1/2 tab. Triiodothyronine 50 Berlin-Chemie per day (corresponding to 25 mcg). It is advisable to increase this dose after 2-4 weeks by 1/2-1 tablets. The average maintenance dose is from 1 to 1.5 tablets of Triiodothyronine 50 Berlin-Chemie.

Side effect

allergic reactions; progression of heart failure and angina pectoris.

Contraindications to the use of the product

• 
  high susceptibility to the product;
• 
  untreated;
• 
  (myocardium, III-IV functional class);
• 
  spicy ;
• 
  untreated;

With caution in tachycardia; tachyarrhythmias; angina I-II functional class; heart failure; ; advanced age.

Pregnancy and lactation

Triiodothyronine 50 Berlin-Chemie is not recommended for use during pregnancy as part of combination therapy in the treatment of thyrotoxicosis in combination with thyreostatic drugs, as this can lead to the development of hypothyroidism in the fetus.

special instructions

Careful selection of the dose and frequent medical supervision is required in patients of advanced age, with functional class I-II angina pectoris, heart failure and in some forms of the disorder. heart rate ().

It is necessary to avoid an overdose of liothyronine, manifested by the development of thyrotoxicosis, especially with functional class I-II angina pectoris, heart failure or tachyarrhythmia. In hypothyroidism caused by damage to the pituitary gland, it is necessary to find out whether there is an insufficiency of the adrenal cortex at the same time. In this case, the treatment of adrenal insufficiency should be started before the appointment of thyroid hormone therapy.

Overdose

In case of an overdose of the product, symptoms characteristic of thyrotoxicosis are observed: palpitations, heart rhythm disturbance, heart pain, tremor, irritability, insomnia, high sweating, increased appetite, weight loss, diarrhea, headache, .

Depending on the severity of your symptoms, your doctor may recommend reducing daily dose product, a break in treatment for several days, the appointment of beta-blockers. After the disappearance side effects treatment should be started with caution at a lower dose.

drug interaction

Reduces the effect of hypoglycemic agents, enhances - indirect anticoagulants, vasoconstrictor products.

Colestyramine reduces the absorption of liothyronine.

Oral contraceptives reduce the effect of liothyronine.

Phenytoin, salicylates, dicoumarol, (in large doses), clofibrate, antidepressants, cardiac glycosides, increase the concentration and risk of side effects of liothyronine.

HORMONES AND DRUGS REGULATING THYROID FUNCTION

The thyroid gland secretes the hormones thyroxine and triiodothyronine, which regulate fat, carbohydrate and protein metabolism, as well as the growth and development of the body. Also u thyroid gland secretes the hormone thyrocalcitonin, which is responsible for the exchange of calcium and phosphorus in the body. Hypofunction ( decreased secretion hormones) of the thyroid gland childhood leads to cretinism - a disease that is accompanied by mental and physical retardation; and in more adulthood- to myxedema, an endocrine disease that manifests itself in slowing down metabolic processes body, tissue edema, etc. A special form of insufficiency thyroid gland is an endemic goiter - a disease that occurs when there is a lack of iodine in the diet, which is essential in the body for the synthesis of thyroxine and triiodothyronine, resulting in a compensatory increase in the gland. With this disease, it is necessary to add small doses of iodine to food (in the form of sodium or potassium iodide at a dose of about 100 mcg).

hyperfunction thyroid gland appears as Graves' disease, in which there is an increase in metabolic processes (metabolism of carbohydrates, proteins, fats), weight loss, sleep disturbances, fever, enlargement of the thyroid gland puffiness appears, function is disturbed cardiovascular systems s and so on.

Treatment for hypothyroidism is replacement therapy, which is designed to compensate for the lack of hormones in the body.

THYROIDIN- a hormone that is obtained from the thyroid glands of slaughtered cattle. Thyroidin contains the hormones thyroxine and triiodothyronine. Thyreoidin is not prescribed for the treatment of hypothyroidism, as well as cretinism in children. Thyroidin p is used for thyroid cancer after removal of the tumor; very carefully - with atherosclerosis. Thyreoidin is prescribed in doses of 0.05 - 0.2 g / day - for hypothyroidism (doses are selected individually), for thyroid cancer - up to 1 g per day. Thyreoidin is contraindicated in thyrotoxicosis, diabetes mellitus and other endocrine diseases, as well as with coronary heart disease, severe exhaustion. Release form of thyroidin: powder and tablets of 0.05; 0.1 g and 0.01 g granules (in a package 2 bags of 15 g). List B.

Recipe example t ireoidina in Latin:

Rep.: Tab. Thyreoidini obductae 0.1 N 50

D.S. 1 tablet 1 time per day.

Rp.: Thyreoidini 0.02 Sacchari 0.2

M.f. pulv.

D.t. d. No. 20

S. 1 powder 3 times a day (child 2 years).

TRIIODOTHYRONINE HYDROCHLORIDE (pharmacological analogues: liothyronine) is a synthetic drug that corresponds to the natural hormone (triiodothyronine). Indications for the use of triiodothyronine hydrochloride and contraindications are similar to those for thyroidin. Release form t riodothyronine hydrochloride: tablets of 0.00002 g.

Recipe example t riodothyronine hydrochloride in latin:

Rep.: Tab. Triiodthyronini 0.00002 N. 50

D.S. 1 tablet 1-2 times a day.

LEVOTHIROXINE SODIUM SALT (pharmacological analogues:L-thyroxine) is a standardized synthetic product of thyroid hormone with prolonged action. Levothyroxine sodium salt is prescribed for hypothyroidism in adults and children, with thyroiditis, with impaired development of children due to a lack of thyroid hormones. Doses and duration of treatment with L-thyroxine are prescribed individually (in adults, the dose range of the drug is from 100 to 200 mcg per day on average). Side effects when using L-thyroxine: tachycardia, anxiety, glucosuria, tremor. Contraindications to the use of L-thyroxine: myocardial infarction, angina pectoris, arrhythmias; undesirable to appoint chronic diseases. Release form of L-thyroxine: tablets of 100 mcg.

THYROCOMB - combination drug potassium iodide and thyroid hormones. One tablet contains: thyroxine 0.07 mg, triiodothyronine 0.01 mg and potassium iodide 0.15 mg. Thyreocomb is prescribed for thyroiditis, hypothyroidism, endocrine exophthalmos, as well as for the prevention of recurrent goiter: 1-2 tablets 1-3 times a day, depending on the disease and the patient's condition. Side effects when using t ireokomba: insomnia, tachycardia, anxiety, weight loss, increased blood pressure. Release form t ireocomb: tablets.

THYREOTOM- 1 tablet contains thyroxine 0.04 mg and triiodothyronine 0.01 mg. Thyrotomy is used for euthyroid goiter and hypothyroidism. Doses of thyrotom depend on the age of the patient, the nature and course of the disease (usually the drug is prescribed 1-3 tablets per day). Thyrotomy release form: tablets of 0.05 mg. List B.

With hyperfunction of the thyroid gland (Graves' disease), antithyroid drugs are used.

THIAMAZOL(pharmacological analogues: metizol, mercazolil, tyrosol) - hormonal drug, which reduces the synthesis of thyroxine in the thyroid gland, and also helps to accelerate the release of iodides. Thiamazole is applied at different forms diffuse toxic goiter, and in preparation for thyroid surgery. Thiamazole is administered orally at 20–40 mg/day, and after normalization of thyroid function, the dose is reduced to 5–20 mg/day, the duration of treatment with the drug isup to 1/2 years. Side effects of thiamazole: leukopenia, vomiting, nausea, joint pain, rash. Contraindications to the use of t iamazol: lactation period, pregnancy, leukopenia, nodular goiter. Release form of tiamazol: tablets of 0.005 g. List B.

Recipe example t riodothyronine hydrochloride in latin:

Rep.: Tab. Mercazolili 0.005 N. 20

D.S. 1 tablet 3 times a day (during remission).

3D images

Composition and form of release

in glass bottles of 60 pieces; in a cardboard box 1 bottle.

Description of the dosage form

Flat-cylindrical tablets Pink colour, with one-sided risk.

Characteristic

Synthetic thyroid hormone.

pharmachologic effect

Increases tissue oxygen demand, stimulates their growth and differentiation, increases the level of basal metabolism (proteins, fats and carbohydrates). In small doses, it has an anabolic effect, and in large doses, it has a catabolic effect. Inhibits the production of thyroid-stimulating hormone. Enhances energy processes, has a positive effect on the state of the nervous and cardiovascular systems, liver and kidneys.

Pharmacodynamics

The maximum pharmacological effect develops after 2-3 days.

Pharmacokinetics

Absorption - 95% (within 4 hours). latent period- 4-8 hours Plasma protein binding - high. T 1/2 - 2.5 days.

Indications for Triiodothyronine ® 50 Berlin-Chemie

Hypothyroidism of any origin.
Treatment of thyroid hyperplasia: benign goiter with normal function, prevention of recurrence of goiter after surgery or after radioactive iodine therapy.
As part of the combination therapy of toxic goiter with thyreostatic agents (after achieving drug compensation of metabolic processes).

Contraindications

Hypersensitivity, hyperthyroidism (exception: as part of combination therapy for thyrostatic treatment of hyperthyroidism after reaching normal state metabolism), ischemic heart disease, myocardial infarction, angina pectoris, acute myocarditis, untreated adrenal insufficiency, diabetes mellitus, Addison's disease, cachexia.

Use during pregnancy and lactation

It is not allowed to use Triiodothyronine 50 Berlin-Chemie during pregnancy as part of combination therapy in the treatment of hyperthyroidism in combination with thyreostatic agents (drugs for the treatment of hyperthyroidism), as this can lead to the development of hypothyroidism in the fetus with all the consequences of this severe consequences.

Side effects

Hyperthyroidism: palpitations, arrhythmias, tachycardia, sweating, anxiety, irritability, weight loss, headache, dysmenorrhea, allergic reactions; progression of heart failure, angina pectoris.

Interaction

Reduces the effect of hypoglycemic agents, enhances - indirect anticoagulants, vasoconstrictor drugs. Cholestyramine reduces absorption. Oral contraceptives reduce the effect. Phenytoin, salicylates, dicoumarol, furosemide (in high doses), clofibrate, antidepressants, cardiac glycosides, ketamine increase the concentration and risk of side effects of liothyronine.

Dosage and administration

inside, 30 minutes before meals. Adults, the initial dose is 0.5 tab. per day (which corresponds to 25 mcg of liothyronine). It is advisable to increase this dose every 2-4 weeks by 0.5-1 table. Usually the average maintenance dose is from 1 to 1.5 tablets.

Precautionary measures

Use with caution in elderly patients, with lesions coronary vessels(CHD), heart failure and certain forms of heart rhythm disturbances (tachyarrhythmias).

special instructions

Even mild liothyronine-induced hyperthyroidism should be avoided, especially when insufficient blood supply hearts ( coronary insufficiency), with heart failure or tachyarrhythmias. With hypofunction of the thyroid gland caused by damage to the pituitary gland, it is necessary to find out whether there is at the same time insufficiency of the adrenal cortex. In this case, its treatment should be started before the appointment of thyroid hormone therapy.

Storage conditions of the drug Triiodothyronine ® 50 Berlin-Chemie

Keep out of the reach of children.

Shelf life of Triiodothyronine ® 50 Berlin-Chemie

Do not use after the expiry date stated on the packaging.

Synonyms of nosological groups

Release form, composition and packaging

Tablets are flat-cylindrical, pink, with one-sided risk.

Excipients: lactose, corn starch, gelatin, magnesium stearate, colloidal silicon dioxide, dye Ponceau 4R cochineal red (E124).

60 pcs. - glass bottles (1) - cardboard packs.

pharmachologic effect

[I] - Instructions for medical use approved by the Pharmacological Committee of the Ministry of Health of the Russian Federation

Synthetic thyroid hormone, replenishes the deficiency of thyroid hormones. Increases tissue oxygen demand, stimulates their growth and differentiation, increases the level of basal metabolism (proteins, fats and carbohydrates). In small doses, it has an anabolic effect, and in large doses, it has a catabolic effect. Inhibits the production of thyroid-stimulating hormone. Enhances energy processes, has a positive effect on the functions of the nervous and cardiovascular systems, liver and kidneys. The maximum pharmacological effect develops in 2-3 days.

Pharmacokinetics

Absorption - 95% (within 4 hours). Communication with plasma proteins is high. T1 / 2 - 2.5 days.

Dosage

Inside, 30 minutes before meals. At the beginning of the course of treatment, adults are recommended to prescribe 1/2 tab. Triiodothyronine 50 Berlin-Chemie per day (which corresponds to 25 mcg). It is advisable to increase this dose every 2-4 weeks by 1/2-1 tab. The average maintenance dose is from 1 to 1.5 tab. Triiodothyronine 50 Berlin-Chemie.

Overdose

With an overdose of the drug, symptoms characteristic of thyrotoxicosis are observed: palpitations, heart rhythm disturbance, tachycardia, heart pain, tremor, irritability, insomnia, excessive sweating, increased appetite, weight loss, diarrhea, headache, dysmenorrhea.

Depending on the severity of symptoms, the doctor may recommend a decrease in the daily dose of the drug, a break in treatment for several days, the appointment of beta-blockers. After the disappearance of side effects, treatment should be started with caution at a lower dose.

drug interaction

Reduces the effect of hypoglycemic agents, enhances - indirect anticoagulants, vasoconstrictor drugs.

Colestyramine reduces the absorption of liothyronine.

Oral contraceptives reduce the effect of liothyronine.

Phenytoin, salicylates, dicoumarol, furosemide (in high doses), clofibrate, antidepressants, cardiac glycosides, ketamine increase the concentration and risk of side effects of liothyronine.

Pregnancy and lactation

Triiodothyronine 50 Berlin-Chemie is not recommended for use during pregnancy as part of combination therapy in the treatment of thyrotoxicosis in combination with thyreostatic agents, since this can lead to the development of hypothyroidism in the fetus.

Side effects

allergic reactions; progression of heart failure and angina pectoris.

Terms and conditions of storage

List B.

At a temperature not higher than 25 ° C, in a place protected from light and out of the reach of children.

Shelf life - 3 years.

Do not use after the expiry date stated on the package.

Indications

- hypothyroidism of any origin;

- euthyroid goiter;

- prevention of recurrence of goiter after surgical treatment or therapy with radioactive iodine;

- diffuse toxic goiter: after reaching the euthyroid state with thyreostatics (as part of combination therapy).

Contraindications

— hypersensitivity to the drug

- untreated thyrotoxicosis;

— ischemic disease hearts (myocardial infarction, angina III-IV functional class);

- acute myocarditis;

- untreated adrenal insufficiency;

- cachexia.

With caution in tachycardia; tachyarrhythmias; angina I-II functional class; heart failure; diabetes mellitus; advanced age.

special instructions

Careful dose selection and frequent medical supervision are required in elderly patients, with functional class I-II angina pectoris, heart failure, and in some forms of cardiac arrhythmia (tachyarrhythmia).

It is necessary to avoid an overdose of liothyronine, manifested by the development of thyrotoxicosis, especially in functional class I-II angina pectoris, heart failure or tachyarrhythmia. In hypothyroidism caused by damage to the pituitary gland, it is necessary to find out whether there is an insufficiency of the adrenal cortex at the same time. In this case, the treatment of adrenal insufficiency should be started before the appointment of thyroid hormone therapy.

Use in the elderly

With caution: elderly patients.