Stability of levothyroxine tablets in blister packaging versus bottles and vials under simulated in-use conditions

Abstract Introduction Levothyroxine, the standard-of-care treatment for hypothyroidism, is susceptible to degradation when exposed to light and moisture and is an FDA-designated narrow therapeutic index drug. In this report, we examined how different packaging (e.g., cold form blister packs, manufac...

Full description

Bibliographic Details
Main Author: Jonathan Chun
Format: Article
Language:English
Published: SpringerOpen 2022-10-01
Series:AAPS Open
Subjects:
Online Access:https://doi.org/10.1186/s41120-022-00062-5
_version_ 1811182270015340544
author Jonathan Chun
author_facet Jonathan Chun
author_sort Jonathan Chun
collection DOAJ
description Abstract Introduction Levothyroxine, the standard-of-care treatment for hypothyroidism, is susceptible to degradation when exposed to light and moisture and is an FDA-designated narrow therapeutic index drug. In this report, we examined how different packaging (e.g., cold form blister packs, manufacturer’s bottles, or pharmacy amber vials) affects the physicochemical integrity and potency of levothyroxine in conditions simulating real-world patient use. Methods In part 1 of this study, we evaluated changes in the physicochemical properties (e.g., moisture gain, hardness, and disintegration time) of levothyroxine tablets stored in high-density polyethylene (HDPE) bottles, amber vials, and blister packs when exposed intermittently to different relative humidities (RH), 25 °C/75% RH and 25 °C/90% RH for 90 days, or 54 °C/75% RH continuously for 2 days. In part 2 of the study, we compared the potency of levothyroxine tablets in bottles and aluminum/aluminum cold form blister packs exposed to 28 °C/65% RH intermittently over 105 days and continuously over 30 days. Results Moisture content, hardness, and disintegration time were relatively unchanged for blister-packaged levothyroxine tablets under all conditions studied. Conversely, the physicochemical properties of tablets stored in amber vials and bottles were altered over time. Levothyroxine potency remained relatively consistent for blister-packaged tablets (100.8% at baseline, 99.6% at day 105) and decreased for bottled levothyroxine (101.4% at baseline to 93.9% at day 105). Conclusion Levothyroxine packaging can influence tablet integrity. Blister packages preserved physicochemical properties and potency better than bulk bottles. Additional studies are needed to determine the impact of packaging and changes in tablet integrity on patient outcomes.
first_indexed 2024-04-11T09:29:58Z
format Article
id doaj.art-392d718cc7494a88a71c9ce3dfbd1d25
institution Directory Open Access Journal
issn 2364-9534
language English
last_indexed 2024-04-11T09:29:58Z
publishDate 2022-10-01
publisher SpringerOpen
record_format Article
series AAPS Open
spelling doaj.art-392d718cc7494a88a71c9ce3dfbd1d252022-12-22T04:31:55ZengSpringerOpenAAPS Open2364-95342022-10-01811910.1186/s41120-022-00062-5Stability of levothyroxine tablets in blister packaging versus bottles and vials under simulated in-use conditionsJonathan Chun0Alliance Technologies, LLCAbstract Introduction Levothyroxine, the standard-of-care treatment for hypothyroidism, is susceptible to degradation when exposed to light and moisture and is an FDA-designated narrow therapeutic index drug. In this report, we examined how different packaging (e.g., cold form blister packs, manufacturer’s bottles, or pharmacy amber vials) affects the physicochemical integrity and potency of levothyroxine in conditions simulating real-world patient use. Methods In part 1 of this study, we evaluated changes in the physicochemical properties (e.g., moisture gain, hardness, and disintegration time) of levothyroxine tablets stored in high-density polyethylene (HDPE) bottles, amber vials, and blister packs when exposed intermittently to different relative humidities (RH), 25 °C/75% RH and 25 °C/90% RH for 90 days, or 54 °C/75% RH continuously for 2 days. In part 2 of the study, we compared the potency of levothyroxine tablets in bottles and aluminum/aluminum cold form blister packs exposed to 28 °C/65% RH intermittently over 105 days and continuously over 30 days. Results Moisture content, hardness, and disintegration time were relatively unchanged for blister-packaged levothyroxine tablets under all conditions studied. Conversely, the physicochemical properties of tablets stored in amber vials and bottles were altered over time. Levothyroxine potency remained relatively consistent for blister-packaged tablets (100.8% at baseline, 99.6% at day 105) and decreased for bottled levothyroxine (101.4% at baseline to 93.9% at day 105). Conclusion Levothyroxine packaging can influence tablet integrity. Blister packages preserved physicochemical properties and potency better than bulk bottles. Additional studies are needed to determine the impact of packaging and changes in tablet integrity on patient outcomes.https://doi.org/10.1186/s41120-022-00062-5LevothyroxineBlister packagingStabilityHumidityPotency
spellingShingle Jonathan Chun
Stability of levothyroxine tablets in blister packaging versus bottles and vials under simulated in-use conditions
AAPS Open
Levothyroxine
Blister packaging
Stability
Humidity
Potency
title Stability of levothyroxine tablets in blister packaging versus bottles and vials under simulated in-use conditions
title_full Stability of levothyroxine tablets in blister packaging versus bottles and vials under simulated in-use conditions
title_fullStr Stability of levothyroxine tablets in blister packaging versus bottles and vials under simulated in-use conditions
title_full_unstemmed Stability of levothyroxine tablets in blister packaging versus bottles and vials under simulated in-use conditions
title_short Stability of levothyroxine tablets in blister packaging versus bottles and vials under simulated in-use conditions
title_sort stability of levothyroxine tablets in blister packaging versus bottles and vials under simulated in use conditions
topic Levothyroxine
Blister packaging
Stability
Humidity
Potency
url https://doi.org/10.1186/s41120-022-00062-5
work_keys_str_mv AT jonathanchun stabilityoflevothyroxinetabletsinblisterpackagingversusbottlesandvialsundersimulatedinuseconditions