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6.2 Thyroid and antithyroid drugs

6.2.1 Thyroid hormones

GREEN       Levothyroxine tablets 25, 50, 100 microgram
BLACK       Levothyroxine liquid (all strengths)
RED           Liothyronine injection 20 microgram  (hospital use only in thyroid emergencies)  
 Liothyronine tablets:  RED Traffic Light for use in: 
 > Monotherapy treatment in refractory hypothyroidism 
 > Add-on treatment for refractory hypothyroidism [Not to be used alone or in combination with levothyroxine]
 RED           Liothyronine tablets [tertroxin]
 link to RCP - Diagnosis and management of primary hypothyroidism
BLACK       Thyroid extracts [unlicensed liothyronine and thyroid extra products] e.g. Armour Thyroid   
                   RMOC liothyronine guidance
BLACK       Liothyronine tablets/capsules
 Liothyronine tablets:  BLACK Traffic Light for use in: 
 > Monotherapy for the management of chronic hyperthyroidism [primary and secondary care]
 > Liothyronine therapy commenced in the private sector
 > Management of resistant depression


6.2.2 Antithyroid drugs

Carbimazole is the drug of choice, with propylthioruracil used for patients with sensitivity to carbimazole or in pregnacy.
Warn patients that if a sore throat develops, in the first 6-8 weeks of therapy they should stop treatment and seek medical advice.
GREEN      Carbimazole tablets 5mg, 20mg
GREEN      Propylthiouracil tablets 50mg 
Partial thyroidectomy 
Iodine may be given for 10 - 14 days before surgery.
RED           Aqueous iodine oral solution 100mL (Lugol’s solution)
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