T3 / T4 IR or SR

Capsule

4.5 mcg / 19 mcg | 9 mcg / 38 mcg
13.5 mcg / 57 mcg | 18 mcg / 76 mcg
22.5 mcg / 95 mcg | 27 mcg / 114 mcg
50 mcg / 12.5 mcg

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Disclaimer: Images are for reference only; actual products may vary.

Product Overview

T3/T4 Oral Formulation Description1,2

The T3/T4 combination is an oral compounded formulation that may be prepared as either an immediate-release or sustained-release dosage form. T3 acts in a manner comparable to the naturally occurring thyroid hormone triiodothyronine. It is available as an oral capsule and is intended for use as replacement or adjunctive therapy in the management of hypothyroidism.

The human body produces two primary thyroid hormones: triiodothyronine (T3), also known as liothyronine, and thyroxine (T4), also referred to as levothyroxine. Triiodothyronine is the more biologically active hormone. Within the body, T4 is converted into T3. Additionally, T3 has a more rapid onset of action than T4 and may be utilized in individuals who have limited conversion of T4 to T3.

The combination of T3 and T4 is indicated for use in the following:

Hypothyroidism: As replacement therapy in primary (thyroidal), secondary (pituitary), or tertiary (hypothalamic) congenital or acquired hypothyroidism.

Mechanism of Action1-3

3 and T4 release from the thyroid gland is regulated by thyroid stimulating hormone (TSH) which is secreted by the anterior pituitary gland. The release of TSH from the anterior pituitary gland is controlled by the blood levels of T3 and T4. As blood levels of T3 and T4 decrease TSH secretion from the anterior pituitary gland increases. This feedback mechanism helps to manage the levels of T3 and T4 in the body. In the body, T4 is converted into T3

Triiodothyronine (T3) exerts its physiologic actions through control of DNA transcription and protein synthesis. It does this by entering the cell nucleus and binding to thyroid receptor proteins attached to DNA. This hormone nuclear receptor complex activates gene transcription and synthesis of messenger RNA and cytoplasmic proteins. The physiological actions of thyroid hormones are produced predominantly by T3.

Common (mimic symptoms of hyperthyroidism)1,2

  • Cardiac-arrhythmias, myocardial infarction, palpitations
  • Nervousness or anxiety
  • Irritability
  • Insomnia
  • Weight loss
  • Heat intolerance
  • Diarrhea or abdominal cramps
  • Temporary hair loss, especially in pediatric patients early in therapy

Contraindications1

  • Hypersensitivity to liothyronine or any tablet component

Precautions1  

  • Use caution in patients with cardiovascular disease (e.g., angina, coronary artery disease, arrhythmias) due to the risk of exacerbation from increased metabolic demands
  • Monitor glucose levels in diabetic patients; thyroid hormone can alter insulin requirements
  • Use lower initial doses in elderly patients or those with longstanding hypothyroidism
  • Osteoporosis risk increases with over-replacement of thyroid hormone
  • Store at controlled room temperature (20°C to 25°C / 68°F to 77°F)
  • Protect from moisture and light
  • Keep in a tightly closed container
  1. Cytomel (Liothyronine Sodium) Prescribing Information. FDA. www.accessdata.fda.gov/drugsatfda_docs/label/2018/010379s054lbl.pdf. Revised December 2018. Accessed May 26, 2025
  2. Clinical Pharmacology liothyronine clinical monograph 2025 https://www.clinicalkey.com/pharmacology/
  3. Clinical Pharmacology levothyroxine clinical monograph 2025 https://www.clinicalkey.com/pharmacology/

WPPL operates as a 503A compounding pharmacy and prepares individualized prescription medications pursuant to provider direction. Compounded preparations are not reviewed, tested, or approved by the FDA.

This listing also includes commercially manufactured products for convenience; these items are not compounded by our pharmacy and are sold as provided by their manufacturers. Actual products in stock at time of dispensing may vary due to supply chain variability. Any statements regarding non-compounded products are manufacturer-supplied, have not been evaluated by the FDA, and are not intended to diagnose, treat, cure, or prevent any disease. WPPL does not verify or endorse any therapeutic claims made by manufacturers. Please refer to original labeling for complete product information.

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