Name: Emcitate (tiratricol) in MCT8 deficiency: Dosage
Published: 2026-09-14T15:39:06-04:00

Individualized dosage

“EMCITATE dosage is individualized based on weight, total T3 levels, and signs and symptoms of thyrotoxicosis” (opens the prescribing information at this quote)
“Assess total T3 levels by a liquid chromatography tandem mass spectrometry (LC-MS/MS) method” (opens the prescribing information at this quote)

Starting dosage, titration increment, and dosage reduction by body weight

Body weight	Recommended starting dosage	Titration increment	Dosage reduction for new or worsening thyrotoxicosis	Discontinuation taper
10 kg or less	“175 mcg/day”	“175 mcg/day.”	“175 mcg”	“reduce EMCITATE by 175 mcg/day once every two weeks.”
Greater than 10 kg	“350 mcg/day”	“350 mcg/day.”	“350 mcg”	“reduce EMCITATE by 350 mcg/day once every two weeks.”

Maximum recommended dosage by body weight

Body weight	Maximum recommended dosage
Less than 10 kg	“100 mcg/kg/day”
10 kg to less than 40 kg	“80 mcg/kg/day”
40 kg to less than 60 kg	“60 mcg/kg/day”
60 kg and above	“50 mcg/kg/day”

Dose titration to total T3

“Measure individual total T3 levels using an LC-MS/MS method.” (opens the prescribing information at this quote)
“Based on total T3 levels, increase the dosage approximately every two weeks in the following increments for patients weighing:” (opens the prescribing information at this quote)
“Increase the dosage until a total T3 level below the midpoint of the normal range for age has been achieved (the maintenance dose) or until the maximum recommended dosage based on weight is achieved” (opens the prescribing information at this quote)
“If total T3 is within the normal range, the dosage may be further adjusted up to the maximum recommended dosage based on the patient’s heart rate and blood pressure.” (opens the prescribing information at this quote)
“Once on a stable dose of EMCITATE, reassess total T3 levels once every 6 months and modify the dosage as clinically required.” (opens the prescribing information at this quote)

Dosage reduction for new or worsening thyrotoxicosis

“If signs or symptoms of thyrotoxicosis either occur for the first time or worsen, and do not resolve within two weeks, reduce the EMCITATE dosage by 175 mcg for patients with a body weight equal to or less than 10 kg or by 350 mcg for patients with a body weight greater than 10 kg” (opens the prescribing information at this quote)
“Continue to reduce the dosage by these amounts every two weeks, if needed, until the signs or symptoms of thyrotoxicosis have resolved.” (opens the prescribing information at this quote)

Missed dose or vomiting

“If a dose is missed and there are more than 4 hours to the next scheduled dose, the missed dose should be taken as soon as possible. If a dose is missed and the next dose is scheduled within 4 hours, the dose should be skipped and the next dose taken according to the regular schedule. Doses should not be doubled.” (opens the prescribing information at this quote)
“If vomiting occurs within 30 minutes after administration, administer a new dose.” (opens the prescribing information at this quote)

Discontinuation

“Do not abruptly stop EMCITATE treatment in order to avoid occurrence or worsening of symptoms of thyrotoxicosis” (opens the prescribing information at this quote)
“If discontinuing EMCITATE, reduce the dosage approximately every two weeks as follows:” (opens the prescribing information at this quote)

Starting dose by body weight: published management recommendations

Body weight	Starting dose
Less than 10 kg	“175 µg once daily”
10 kg or greater	“350 µg once daily”

Maximum daily dose by body weight: published management recommendations

Body weight	Maximum daily dose
Less than 10 kg	“100 µg/kg/day”
10–40 kg	“80 µg/kg/day”
40–60 kg	“60 µg/kg/day”
More than 60 kg	“50 µg/kg/day”

Origin of the dosing regimen

“No distinct dose-finding was performed in the development program of tiratricol for use in MCT8-deficiency and the dose had been adopted from the reference medicinal product Téatrois.” (opens the source at this quote in a new tab)

Dose escalation in Triac Trial I

“Triac was administered in a predefined escalating dose schedule-after the initial dose of once-daily 350 μg Triac, the daily dose was increased progressively in 350 μg increments, with the goal of attaining serum total T3 concentrations within the target range of 1·4-2·5 nmol/L.” (opens the source at this quote in a new tab)

Maintenance dose in a real-life cohort

“The daily starting dose was based on body weight (175 µg Triac < 10 kg; 350 µg Triac ≥ 10 kg). The daily dose was increased with increments of 175 µg or 350 µg with a goal of attaining serum total T3 concentrations within the target range of 1.4 to 2.5 nmol/L.” (opens the source at this quote in a new tab)
“The mean time to reach the maintenance dose was 5.0 (SD 4.7) months, with a mean of 2.7 (SD 1.1) dose increments. The median maintenance dose was 38 µg/kg/day (interquartile range, 31-61 µg/kg/day; range, 15-105 µg/kg/day).” (opens the source at this quote in a new tab)