McCall McPherson describes a pharmacy error where a patient was nearly given 50 microgram Cytomel tablets instead of 5 microgram ones, which would have increased their daily dose tenfold. He urges patients to verify prescriptions at pickup and warns about the dangers of excess thyroid hormone.
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I'm here to tell you about something that happened in clinic yesterday and to remind you to check and double check your prescriptions, y'. All. I had a patient who was on cytomel, only cytomel or lyothyrenine, that's pure active thyroid hormone. She was on a total of 15 micrograms a day, spread out throughout the day. She received a refill right before our follow up appointment yesterday. And she's like, oh, I very subdued in its delivery, just barely said, well, it was, I thought it was a little strange that you wrote for 50 micrograms of cytomel. And I was like, excuse me? She's like, yeah. I'm like, I didn't write for 50 micrograms of cytomel. I went back through my system. We refilled your 5 micrograms. Are you sure it was 50? She's like, yeah, I think so. Like, send me a picture of your bottle. She goes home, sends me a picture of her prescription bottle. It is in fact 50 micrograms of cytomol. So this Walgreens just took her prescription from 15 total micrograms of Cytomol every day to 150. And you know what I did yesterday? I increased her dose of 5 micrograms cytomel in my instructions and almost. And doubled it. So I had doubled her total dose over the course of a month if she hadn't brought that up and she started using her 50 microgram tablets thinking they were five, didn't pay attention. This is where bad things happen with T3. This is one of the unique cases where it actually can. So y' all check and double check. No one should have 50 micrograms of cytomel. No one should be taking that much at one time. Not to give you medical advice, but I'll tell you, no one in my practice is taking 50 micrograms of cyanol. Nor do I think even people post thyroidectomy need to be taking that much. So double check your prescriptions with you, receive them, okay? Keep yourself safe. Most of all, be in charge and be empowered for your own health care because it could save your hide one day.
