Oral Liquid Formulation of Levothyroxine Is Stable in Breakfast Beverages and May Improve Thyroid Patient Compliance

Patients on treatment with levothyroxine (T4) are informed to take this drug in the morning, at least 30 min before having breakfast. A significant decrease of T4 absorption was reported, in fact, when T4 solid formulations are taken with food or coffee. According to preliminary clinical study repor...

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Main Authors: Alberto Bernareggi, Elia Grata, Maria Teresa Pinorini, Ario Conti
Format: Article
Language:English
Published: MDPI AG 2013-12-01
Series:Pharmaceutics
Subjects:
Online Access:http://www.mdpi.com/1999-4923/5/4/621
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author Alberto Bernareggi
Elia Grata
Maria Teresa Pinorini
Ario Conti
author_facet Alberto Bernareggi
Elia Grata
Maria Teresa Pinorini
Ario Conti
author_sort Alberto Bernareggi
collection DOAJ
description Patients on treatment with levothyroxine (T4) are informed to take this drug in the morning, at least 30 min before having breakfast. A significant decrease of T4 absorption was reported, in fact, when T4 solid formulations are taken with food or coffee. According to preliminary clinical study reports, administration of T4 oral solution appears to be less sensitive to the effect of breakfast beverages on oral bioavailability. In the present study, stability of T4 oral solution added to breakfast beverages was investigated. A 1 mL ampoule of single-dose Tirosint® oral solution (IBSA Farmaceutici Italia, Lodi, Italy) was poured into defined volumes of milk, tea, coffee, and coffee with milk warmed at 50 °C, as well as in orange juice at room temperature. Samples were sequentially collected up to 20 min and analyzed by validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) methods. The results of the study demonstrated that T4 is stable in all beverages after 20 min incubation. Demonstration of T4 stability is a prerequisite for a thorough evaluation of the effect of breakfast beverages on the bioavailability of T4 given as oral solution and for a better understanding of the reasons underlying a decreased T4 bioavailability administered as solid formulations.
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spelling doaj.art-39eb02fa5e6a463fa34441b71dc443182022-12-22T04:23:10ZengMDPI AGPharmaceutics1999-49232013-12-015462163310.3390/pharmaceutics5040621pharmaceutics5040621Oral Liquid Formulation of Levothyroxine Is Stable in Breakfast Beverages and May Improve Thyroid Patient ComplianceAlberto Bernareggi0Elia Grata1Maria Teresa Pinorini2Ario Conti3Institut Biochimique SA (IBSA), Centro Insema, Via Cantonale, Manno CH-6928, SwitzerlandAlpine Foundation for Life Sciences (AFLS), Alpine Institute for Chemistry and Toxicology, Olivone CH-6718, SwitzerlandAlpine Foundation for Life Sciences (AFLS), Alpine Institute for Chemistry and Toxicology, Olivone CH-6718, SwitzerlandAlpine Foundation for Life Sciences (AFLS), Alpine Institute for Chemistry and Toxicology, Olivone CH-6718, SwitzerlandPatients on treatment with levothyroxine (T4) are informed to take this drug in the morning, at least 30 min before having breakfast. A significant decrease of T4 absorption was reported, in fact, when T4 solid formulations are taken with food or coffee. According to preliminary clinical study reports, administration of T4 oral solution appears to be less sensitive to the effect of breakfast beverages on oral bioavailability. In the present study, stability of T4 oral solution added to breakfast beverages was investigated. A 1 mL ampoule of single-dose Tirosint® oral solution (IBSA Farmaceutici Italia, Lodi, Italy) was poured into defined volumes of milk, tea, coffee, and coffee with milk warmed at 50 °C, as well as in orange juice at room temperature. Samples were sequentially collected up to 20 min and analyzed by validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) methods. The results of the study demonstrated that T4 is stable in all beverages after 20 min incubation. Demonstration of T4 stability is a prerequisite for a thorough evaluation of the effect of breakfast beverages on the bioavailability of T4 given as oral solution and for a better understanding of the reasons underlying a decreased T4 bioavailability administered as solid formulations.http://www.mdpi.com/1999-4923/5/4/621levothyroxineT4liquid formulationLC-MS/MSstabilitycoffeemilkteaorange juicebioavailability
spellingShingle Alberto Bernareggi
Elia Grata
Maria Teresa Pinorini
Ario Conti
Oral Liquid Formulation of Levothyroxine Is Stable in Breakfast Beverages and May Improve Thyroid Patient Compliance
Pharmaceutics
levothyroxine
T4
liquid formulation
LC-MS/MS
stability
coffee
milk
tea
orange juice
bioavailability
title Oral Liquid Formulation of Levothyroxine Is Stable in Breakfast Beverages and May Improve Thyroid Patient Compliance
title_full Oral Liquid Formulation of Levothyroxine Is Stable in Breakfast Beverages and May Improve Thyroid Patient Compliance
title_fullStr Oral Liquid Formulation of Levothyroxine Is Stable in Breakfast Beverages and May Improve Thyroid Patient Compliance
title_full_unstemmed Oral Liquid Formulation of Levothyroxine Is Stable in Breakfast Beverages and May Improve Thyroid Patient Compliance
title_short Oral Liquid Formulation of Levothyroxine Is Stable in Breakfast Beverages and May Improve Thyroid Patient Compliance
title_sort oral liquid formulation of levothyroxine is stable in breakfast beverages and may improve thyroid patient compliance
topic levothyroxine
T4
liquid formulation
LC-MS/MS
stability
coffee
milk
tea
orange juice
bioavailability
url http://www.mdpi.com/1999-4923/5/4/621
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