UPDATE ON TEVA T3 LIOTHYRONINE DOSING

[paulaelizabeth]

Hi All

I wrote to TEVA asking them why their 20mcg tablets are not scored and how to dose if taking less than 20mcg quantities and this was their response...

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Thank you for your enquiry regarding Teva UK Limited’s liothyronine sodium 20 microgram tablets PL 00289/2116.

Teva only have a license for the 20 mcg tablets, this is the same as the other generic companies who also market the tablets.

The product does not have a score line as the quantity of the active substance is too small to be able to ensure that each half of the tablet will have the equal quantity of the active substance, therefore you would not be able to guarantee the dose you would be receiving.

Where a dose of 5 micrograms or 10 micrograms is required, the following procedure is recommended to ensure that the active substance liothyronine is adequately dispersed. Note that the excipients do not dissolve as readily and therefore the suspension will remain cloudy.

Recommended dose 5 micrograms:

1) Crush one Liothyronine sodium 20 microgram tablet.

2) Transfer the crushed tablet to a 30 ml graduated medicine (dosing) cup containing 20 ml of water and leave to disperse for 5 minutes.

3) Gently stir the suspension for 15 seconds and then withdraw 5 ml of the suspension with an oral medicine (dosing) syringe.

4) The contents of the syringe may be emptied directly into the mouth by slowly pushing down the plunger of the syringe.

Recommended dose 10 micrograms:

1) Crush one Liothyronine sodium 20 microgram tablet.

2) Transfer the crushed tablet to a 30 ml graduated medicine (dosing) cup containing 20 ml of water and leave to disperse for 5 minutes.

3) Gently stir the suspension for 15 seconds and then withdraw 10 ml of the suspension with an oral medicine (dosing) syringe.

4) The contents of the syringe may be emptied directly into the mouth by slowly pushing down the plunger of the syringe.

Any remaining liquid should be discarded immediately.

The Code of Practice for the Pharmaceutical Industry (produced by the ABPI), does not allow us to discuss personal medical matters, offer advice or information on issues relating to an individual patient’s care as we cannot be seen to interfere in the relationship between a patient and their doctor. We recommend, that you consult your doctor directly regarding any concerns around the administration of the liothyronine as they are the best person to advise you about your treatment and care.

I hope this is sufficient for your present needs, but if there is further information we can provide please do not hesitate to contact us again.

Kind regards

Susannah

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So there you have it!

I would be very interested to hear from anyone currrently taking Teva T3 and to know how they are getting on with it. It would be good to hear of some positive outcomes .....

P.

[SeasideSusie Remembering]

Someone posted about this recently. I wonder what Teva expects the patient to do with the excess liquid, how should it be disposed of? A good question to ask them I think as it surely shouldn't be put down the sink or flushed away, that would mean it eventually would get into our drinking water supply.

[helvella Administrator Thyroid UK]

paulaelizabeth,

Some time ago in communication with a pharmaceutical manufacturer, they insisted that a score line does NOT mean a tablet is suitable for splitting in order to take a half dose. They insisted it was so that a tablet can be broken in case of difficulties in swallowing a whole tablet.

I am sure many people assume a score line indicates suitability for splitting a dose. Doesn't help that the Patient Information Leaflets are silent on this issues. (Though some insist a tablet is taken whole - especially enteric coated products.)

[Hennerton]

I had the same ludicrous reply to my query and wrote back asking why they were suggesting a method that involved throwing away half of every tablet, especially at the extortionate cost they were demanding. I have never received a reply. Well, nothing they can say, is there? The whole industry is flawed.

I then asked my very helpful pharmacist and his view was that dissolving a tablet and suctioning up half of the liquid is as inaccurate as cutting a tablet in half, (or quarters, as I do). I have carried on with the cutting procedure...

[Marz]

I once read of a member here who nibbled on her T3 tablet throughout the day 😊 No doubt as accurate as any other suggestions .... !

[EbonyEvans in reply to Marz]

Nibbled?!? 😷 that must have tasted awful.

[Hennerton in reply to EbonyEvans]

No, it actually tastes fine. If I am out and about without access to water and need to take a 1/4 dose, I just let it dissolve on my tongue. It disappears in less than a minute and I find no difference taking it this way than with water. May not be recommended but works well enough for me!

[Marz in reply to EbonyEvans]

Wash it down with a glass of water - you won't notice it 😊

[paulaelizabeth]

I wrote to Teva again asking them how the remaining drug in the syringe should be disposed of and this was their response: Priceless!!

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Yes, we completely agree, medicines should never be disposed of via wastewater or household waste. We would recommend that any excess liquid is disposed of in a bottle clearly labelled and kept out of site and reach of children. The liquid inside the bottle can also be mixed with a substance such as coffee or cat litter to ensure the liquid is not accidently ingested. The bottle can be taken to your local pharmacy, at a time convenient to you and the pharmacy will dispose of the medication as per their guidelines.

Kind regards

Susannah

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