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Cytomel and Imatinib Mesylate

Determining the interaction of Cytomel and Imatinib Mesylate and the possibility of their joint administration.

Check result:
Cytomel <> Imatinib Mesylate
Relevance: 04.11.2023 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Using liothyronine together with imatinib can decrease the effects of liothyronine. Contact your doctor if your condition worsens or if you become tired, sluggish or weak. You may need a dose adjustment or special test to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

ADJUST DOSE: Imatinib has been reported to induce clinical hypothyroidism in patients receiving levothyroxine. The exact mechanism is unknown but may involve stimulation of the non-deiodination clearance of T4 and T3 by imatinib. In 11 patients treated with imatinib for an average of six months, eight patients who had previously undergone total thyroidectomy and used levothyroxine developed symptoms of hypothyroidism, while the three patients with thyroid in situ remained clinically and biochemically euthyroid. On average, thyrotropin (TSH) levels in the eight patients increased to 384% of the upper limit, whereas free T4 and T3 values decreased but remained within the reference range. Levothyroxine dosage was incrementally increased up to an average of 206%, but hypothyroidism could only be reversed in three patients in whom the condition was recognized relatively early. TSH levels returned to normal in the other five patients following discontinuation of imatinib. Separating the times of administration of levothyroxine and imatinib did not appear to help. The interaction may also occur with other forms of thyroid replacement therapy, although clinical data are lacking.

MANAGEMENT: Monitoring of thyroid function including laboratory serum TSH concentrations should be performed before, during, and after any dosage change or discontinuation of imatinib therapy, and the levothyroxine dosage adjusted accordingly. The authors of the study cited above suggest a minimum 2-fold increase in levothyroxine therapy before initiation of imatinib treatment and close monitoring of thyroid function during treatment.

References
  • de Groot JW, Zonnenberg BA, Plukker JT, van Der Graaf WT, Links TP "Imatinib induces hypothyroidism in patients receiving levothyroxine." Clin Pharmacol Ther 78 (2005): 433-8
Cytomel

Generic Name: liothyronine

Brand name: Cytomel, Triostat

Synonyms: n.a.

Imatinib Mesylate

Generic Name: imatinib

Brand name: Gleevec

Synonyms: Imatinib

In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

Interaction with food and lifestyle
Disease interaction