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Review
. 2021 Dec;110(12):3743-3756.
doi: 10.1016/j.xphs.2021.08.006. Epub 2021 Aug 10.

Levothyroxine Sodium Pentahydrate Tablets - Formulation Considerations

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Review

Levothyroxine Sodium Pentahydrate Tablets - Formulation Considerations

Navpreet Kaur et al. J Pharm Sci. 2021 Dec.

Abstract

Even though levothyroxine sodium pentahydrate tablets have been in the market since 1955, there continue to be recalls due to sub potency. We have comprehensively reviewed the factors affecting its stability in solid oral dosage forms. A compilation of marketed formulation compositions enabled the identification of the potential 'problem excipients'. Two excipient properties, hygroscopicity and microenvironmental acidity, appeared to be responsible for inducing drug instability. In drug products, depending on the formulation composition and storage conditions, the pentahydrate can dehydrate to highly reactive levothyroxine sodium monohydrate, or undergo salt disproportionation to the free acid form of the drug. The USP assay method (HPLC based) is insensitive to these different physical forms of the drug. The influence of physical form of levothyroxine on its chemical stability is incompletely understood. The USP has five product-specific dissolution tests reflecting the complexity in its evaluation.

Keywords: Drug product stability; Excipients; Levothyroxine sodium; Tablets.

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Conflict of interest statement

Declaration of Interests The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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