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Milton Keynes Formulary
Milton Keynes University Hospital NHS Foundation Trust
Bedfordshire, Luton and Milton Keynes Clinical Commissioning Group
Milton Keynes Community Health Services
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 Formulary Chapter 6: Endocrine system - Full Chapter
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06.02.01  Expand sub section  Thyroid hormones
Levothyroxine
(Thyroxine)
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Formulary
Green

Tablets 25 micrograms, 50 micrograms, 100 micrograms
Oral solution 25 micrograms/5ml, 50 micrograms/5ml, 100 micrograms/5ml

 
Link  UKMI suggested drug monitoring schedule
   
Liothyronine (oral)
(Triiodothyronine)
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Formulary
Red Red

Tablets 20 microgram

For existing patients only

Liothyronine (oral) is not recommended for prescribing in Milton Keynes and
is therefore classified Double Red for all new patients.
Liothyronine (oral) is not supported by local NHS endocrinologists and it is not
included in the recommendations for the treatment of hypothyroidism from the
Royal College of Physicians.
The British Thyroid Association recommends levothyroxine as the standard
treatment for hypothyroidism. Treatment with combination L-T3 plus L-T4
should only be considered in exceptional cases and should be started and
supervised by accredited endocrinologists.
The Milton Keynes Prescribing Advisory Group (MKPAG) does not recommend
liothyronine (T3) as a treatment option for resistant depression in adults.
The only UK licensed liothyronine tablet is available as a 20mcg strength. Other
strengths are available from special's manufacturers but are not licensed in the
UK and should not be routinely prescribed. Liothyronine currently costs
approximately £3000 per patient per year based on a 10 microgram twice daily
dose. The equivalent daily dose of levothyroxine is 100 micrograms and costs
the NHS approximately £20 per patient per year.
There are potential risks from liothyronine therapy (on the bone - osteoporosis

 
Link  NHS England: Items which should not be routinely prescribed in primary care
Link  RMOC Liothyronine guidance
Link  Switching T3 to T4 - Frequently Asked Questions for GP’s (British Thyroid Association)
Link  Switching T3 to T4 - Frequently Asked Questions for patients (British Thyroid Association)
Link  Switching T3 to T4 - Information for Endocrinologists (British Thyroid Association)
   
Armour thyroid®
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Restricted Drug Restricted
Red Red
 
Link  UKMI Q&A: What clinical evidence is there for “Armour thyroid” or desiccated thyroid extract?
   
Liothyronine (IV)
(Triiodothyronine)
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Restricted Drug Restricted
Red Red

Injection 20 micrograms

 
   
 ....
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
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Link to adult BNF
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Link to children's BNF
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Link to SPCs
SMC
Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

Green

Routine prescribing within licensed indication  

Amber 1

Specialist recommendation followed by GP initiation and continuation  

Amber 2

Specialist or GP initiation in line with local guideline after 1st line failure followed by GP continuation   

Amber 3

Specialist initiation and stabilisation followed by GP continuation  

Amber SCG

Specialist initiation and stabilisation followed by GP continuation in line with an agreed shared care guideline  

Red

Hospital or specialist prescribing only  

Red Red

These medicines have been evaluated and rejected by MKPAG and are NOT approved for use within MK. They are not recommended for use because of lack of clinical effectiveness, cost effectiveness or safety.  

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