Napredna pretraga

Pregled bibliografske jedinice broj: 890870

Factors affecting gastrointestinal absorption of levothyroxine : A review

Skelin, Marko; Lucijanić, Tomo; Amidžić Klarić, Daniela; Rešić, Arnes; Bakula, Miro; Liberati- Čizmek, Ana-Marija; Gharib, Hossein; Rahelić, Dario
Factors affecting gastrointestinal absorption of levothyroxine : A review // Clinical therapeutics, 39 (2017), 2; 378-403 doi:10.1016/j.clinthera.2017.01.005 (međunarodna recenzija, pregledni rad, znanstveni)

Factors affecting gastrointestinal absorption of levothyroxine : A review

Skelin, Marko ; Lucijanić, Tomo ; Amidžić Klarić, Daniela ; Rešić, Arnes ; Bakula, Miro ; Liberati- Čizmek, Ana-Marija ; Gharib, Hossein ; Rahelić, Dario

Clinical therapeutics (0149-2918) 39 (2017), 2; 378-403

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, pregledni rad, znanstveni

Ključne riječi
Absorption, GI diseases, interactions, levothyroxine

Levothyroxine (LT4) is a drug with a narrow therapeutic index, applied in small amounts (micrograms), which makes interactions in the absorption phase clinically significant. The main aim of this article was to review and present the latest information on factors that affect the gastrointestinal absorption of this drug. Relevant data were collected by using the MEDLINE, PubMed, EMBASE, Web of Science, Science Direct, and Scopus databases with the key words levothyroxine and absorption. Searches were not limited to specific publication types, study designs, dates, or languages. The reports were highly variable in the amount of information provided regarding study design and methods. Because of the heterogeneity of studies, no statistical analysis was performed. Findings: Many gastrointestinal disorders, such as celiac disease, atrophic gastritis, lactose intolerance, and Helicobacter pylori infection, may impede the absorption of levothyroxine. During treatment of these disorders, it is necessary to monitor serum thyroid-stimulating hormone and free T4 values to reduce the risk of developing iatrogenic hyperthyroidism. Soybeans and coffee have the greatest impact on the reduction of absorption, whereas vitamin C has the ability to increase it. Conversely, the effect of dietary fiber on the absorption of LT4 is not yet fully understood ; further research is needed on this topic. A decrease in the absorption of LT4 is established and clinically significant when administered concomitantly with cholestyramine, colesevelam, lanthanum, calcium carbonate, calcium citrate, calcium acetate, iron sulfate, ciprofloxacin, aluminum hydroxide, sevelamer, or proton pump inhibitors. This effect should be taken into consideration when prescribing these drugs concomitantly with LT4. The effects of Giardia lamblia infection and the influence of orlistat, polystyrene sulfonate, raloxifene, and simethicone on absorption of LT4 have been poorly documented. For bariatric surgery, sucralfate and H2-antagonist interactions are not well founded or contradictory evidence is available regarding their existence ; additional research should be conducted. The majority of the interactions are clinically significant. They are based on the LT4 adsorption on interfering substances in the digestive tract, as well as a consequently reduced amount of the drug available for absorption. These interactions can be avoided by separating the administration of LT4 and the interfering substance.

Izvorni jezik

Znanstvena područja
Temeljne medicinske znanosti, Kliničke medicinske znanosti, Farmacija

Rad/časopois indeksiran je i u slijedećim bazaam: ; PharmacoEconomics and Outcomes News ; Research Alert ; SIIC Data BasesSmoking and Health.


Farmaceutsko-biokemijski fakultet, Zagreb,
Klinička bolnica "Sveti Duh",
Opća bolnica Šibenik,
Klinička bolnica "Dubrava",
Klinika za dječje bolesti

Časopis indeksira:

  • Current Contents Connect (CCC)
  • Web of Science Core Collection (WoSCC)
    • Science Citation Index Expanded (SCI-EXP)
    • SCI-EXP, SSCI i/ili A&HCI
  • Scopus

Uključenost u ostale bibliografske baze podataka:

  • BIOSIS Previews (Biological Abstracts)
  • CA Search (Chemical Abstracts)
  • EMBASE (Excerpta Medica)
  • PsychINFO
  • Cancerlit
  • Current Opinion Series
  • De Haen Drug Data
  • Cambridge Scientific Abstracts
  • Current Awareness in Biological Sciences
  • Derwent Drug File
  • IDIS
  • International Pharmaceutical Abstracts
  • Martindale Online
  • Medical Documentation Service
  • MUST
  • Nursing and Allied Health