Oral liquid levothyroxine solves the problem of tablet levothyroxine malabsorption due to concomitant intake of multiple drugs
Abstract
BACKGROUND: Unlike the tablet (TAB) formulation, liquid L-T4 (LIQ) is directly absorbed in the intestine. The aim of this study was to assess whether LIQ was superior to TAB, such that it would overcome the interference induced by co-ingestion of multiple interfering drugs (ID). METHODS: In this prospective cohort study, we recruited 11 patients with apparent reduced TAB absorption due to ≥ 2 ID, and switched them to LIQ while maintaining the daily dose and the co-ingestion of the ID. Serum TSH was assayed at least twice every eight weeks. RESULTS: Serum TSH was significantly lower on LIQ compared with TAB (P < 0.0001), in patients who took L-T4 for either replacement (P = 0.002) or TSH-suppression (P < 0.0001). This difference was evident already at the first measurement post-switch (P = 0.008 or P = 0.03). Regardless of the purpose of L-T4 therapy, patients who took two ID had lower serum TSH on LIQ compared with patients who took three ID (P = 0.0006). Interestingly, 2/3 patients who failed to reach target TSH levels while on LIQ took three ID. CONCLUSIONS: LIQ overcomes the concurrent interference exerted by the ingestion of multiple ID. In such cases, switching from TAB to LIQ permits patients to reach target TSH within 8 weeks.
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Novel LT4 preparations are designed to reduce the high TSH levels induced by malabsorption due to calcium and iron supplements, PPIs, coffee, and breakfast.
“Furthermore, novel LT4 preparations are designed to reduce the high TSH levels induced by malabsorption due to calcium and iron supplements, PPIs, coffee, and breakfast (97–101).”
From Levothyroxine: conventional and novel drug delivery formulations. (2023) · cites this paper as [100]
Liquid LT4 can eliminate malabsorption in patients treated with multiple interfering drugs.
“Furthermore, liquid LT4 can eliminate malabsorption in patients treated with multiple interfering drugs (100, 198).”
From Levothyroxine: conventional and novel drug delivery formulations. (2023) · cites this paper as [100]
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- Authors
- Vita, R., Di Bari, F., & Benvenga, S.
- Affiliations
- University of Messina (IT)
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
- Corresponding author
- Vita, Roberto
- Venue
- Expert Opinion on Drug Delivery
- Publisher
- Informa UK Limited
- Published
- 2017-02-13
- Volume
- 14
- Issue
- 4
- Pages
- 467-472
- ISSN
- 1742-5247 (ISSN-L)
- 1744-7593
- OpenAlex
- W2585025665
- Semantic Scholar
- d5dd6609ae613f7bdfcb9442aa3a0f95192c3ebf
- Cited by
- 43
- References
- 34
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2023: 7 · 2022: 4 · 2021: 6 · 2020: 3 · 2019: 6 · 2018: 11 · 2017: 1
- FWCI
- 4.54
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Expert Opinion on Drug Delivery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmaceutical Science › Drug Solubulity and Delivery Systems
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Keywords
- levothyroxine, oral liquid formulation, drug-drug interactions, malabsorption, serum TSH, thyroid hormone replacement, TSH suppression
- MeSH terms
- Adult, Aged, Chemistry, Pharmaceutical, Female, Humans, Male, Middle Aged, Prospective Studies, Tablets, Thyroxine, Cohort Studies
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